We find this sexual problem in a minority. With any masculine orgasm disorder, it is a good idea to start off by considering the physical aspects (physiological or medical) to discard them, if that is the case. Moreover, it will be necessary to go into the psychological aspects.
With respect to the physiology of the masculine orgasm phase, we have to say that it consists of three sub-phases: sperm emission; formation of pressure chamber, and seminal expulsion.
During the emission, the contraction of the internal genital muscles transports the whole of sperm to the posterior urethra. Following that, due to the sympathetic stimulus, the internal and the external urethral sphincters, contract. When the inframontanal urethra relaxes, it forms the so called “pressure chamber”, that contains the semen stored there. Lastly, the clone-tonic contraction of the periuretral and perennial muscle increases the semen pressure in the posterior urethra. This forces the opening and provokes the relaxation of the external urethral sphincter, at the time that it projects the semen to the exterior between 3 and 5 shots.
During the emission, most men experiment the subjective impression equivalent to the ejaculatory imminence or “point of no-return”.
Like the rest of sexual disorders, the orgasm disorders take place in heterosexual or homosexual people and relationships.
In the masculine orgasm disorder, be it premature or retarded ejaculation, generally is referred to in relation to the sexual intercourse of vaginal penetration, for heterosexuals. In homosexual relations between men, it refers in relation to the anal coitus.
The key factors to its diagnosis are the same for heterosexual and homosexual males, no matter if it takes place in the vaginal or anal penetration, and is generalized to all penetration form, or it happens in all sexual practices.
In general, ejaculation is identified with orgasm, even if non pleasant ejaculations take place, without any medical explanation. It is believed that the main reason is that brain does not perceive the ejaculation signal, and if it does not get it, it does not translate it either as pleasure.
Ejaculatory control is one of the main concerns in males with respect to their sexual performance. To get to know when it is the best moment to ejaculate can become sometimes in an intense worry and can generate anxiety.
Trial and error affect some males negatively. It can undermine their self-esteem and their confidence in relation to their sexual performance. This may show up as a lack of ejaculatory control, in which the male has difficulties to get an orgasm and ejaculate.
There are different types of exercises and techniques, as a part of sexological therapy, to resolve the orgasm disorders in males (and females).
The length of therapy will depend on various issues, such as the degree of severity of the problem.