SOC 152A Chapter Notes - Chapter 14: Premature Ejaculation, Delayed Ejaculation, Erection
Chapter 14
●A sexual difficulty must occur at least 75% of the time and over a period of at least 6
months to qualify as a disorder
●Leading problems for women are lock of interest in sex, inability to orgasm, problems
with physiological arousal (especially vaginal lubrication) and pain during sex.
●For men, climaxing too early is the leading problem, followed by anxiety about
performance and a lack of interest in sex
○Men most likely to seek help for problems with sexual performance while
women enter treatment for concerns about sexual feelings
●Sex therapists commonly use a standard core of therapeutic techniques to treat sexual
problems. One is a set of exercises known as sensate focus
○Sensate focus is a form of sex therapy that involves graduated touching
exercises
●Sexual disorders can be primary secondary or situational
○A primary disorder is lifelong
○A secondary disorder is one that appears after some period of normal function
○A situational disorder is one that appears in some situations but not others
●Premature ejaculation is ejaculation before the man wishes, often immediately on
commencement of coitus. Also called rapid ejaculation
○Average sex time is 2 to 8 minutes, average being 5
●BOX 14.1 sensate focus
○Focusing on the physical sensations of gently touching or being touched
○First caress a non erogenous zone, should be gentle
○Focus mind
○After an agreed time u and partner exchange roles
○Ask questions and figure out what feels good
○Discuss after
○Repeat exercises several times
○Sequence of non erogenous zones, and progressing to naked caressing of the
back, the front, and than the genitals, over a period of a few weeks
○Used to overcome anxiety
●Premature ejaculation can be primary secondary of situational
○Causes are not well understood
○Traditional view is it is learned, conditioned
○Another hypothesis is that lifelong premature ejaculation is caused by a
dysfunction in certain receptors for the neurotransmitter serotonin
○Psychological theories seem most plausible in cases where premature
ejaculation is situation
■Remedies
●Masturbating before sex
●Distracting with thoughts
●One aspect of sex therapy is simply talking through the history of a man’s condition
and the factors that may exacerbate it.
○May be useful to concentrate on cognitive distortions
●Exercises can be specifically designed for premature ejaculation.
○Stop-start method
■First masturbation
■Than with partner,
■Than coitus
●Man gets accustomed to sensations of coitus without being too
excited
○Squeeze technique
■May be counterproductive and difficult to incorporate into real life
lovemaking
●Instead, keesling emphasizes the teaching of relaxation,
especially relaxation of the pelvic floor muscles, along with
conscious awareness of arousal
●Drug treatment
○The drugs used to treat PE are mostly selective serotonin reuptake inhibitors
○Topical anesthetics can also be used
■But may also numb womens vulva
●Delayed ejaculation
○Opposite of PE
○Sometimes specific to certain kind of sexual behaviors such as coitus or
partnered sex
○In other cases the man may not be able to reach orgasm under any
circumstances.
○Fairly uncommon
○Causes not certain
■One idea is it affects men who are accustomed to frequent lengthy
masturbation using tight grips and vigorous stokes
■Too much viewing of porn
■Can also follow traumatic life event
■Biological causes such as neurological damage
○No drug treatment
■Sometimes lube helps
○A few men have no difficulty reaching orgasm but dont ejaculate this is most
likely a neurological problem
●Erectile disorder (ED)
○A recurrent inability to achieve adequate penile erection or to maintain it
through the course of the desired sexial bahvior
○May be partial or complete and it may be primary secondary or situational
○Becomes more common as men age
○Affects about half of men over 60 and majority of men who are 70 or older
■Physical or psychological causes
●behavioral /lifestyle factors - smoking, alc abuse, obesity, lack of
exercise, extended bike riding
●Medical conditions - diabetes, hypertension, prostate surgery,
atherosclerosis
●Drugs - tranquilizers, antidepressants, and some recreational
drugs
●Injuries - spinal cord injuries, nerves and blood vessels that
supply to the penis, to penis itself
●Psychological - performance anxiety, distraction, inadequate
stimulation, relationship difficulties, stress and depression
●Developmental issues - childhood trauma, sexual orientation
issues
○Simple measures can fix ED
Document Summary
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