Retarded ejaculation: a review

Retarded ejaculation is the persistent difficulty or inability to ejaculate despite the presence of adequate sexual desire, erection, and stimulation. The causes of this dysfunction may be organic, i.e., medical illness or drug ingestion (particularly medications with antiadrenergic effects), the result of surgical interventions, or secondary to inhibiting psychological factors. With regard to psychological determinants, fear, guilt, resentment, and passively have all been implicated, although objective studies are rare. The sexual object choice of men with retarded ejaculation has ben reported by several clinicians and investigators to be other than adult members of the opposite sex, while the marital relationship of these males has been considered etiological in other instances. Outcome assessment to date consists mostly of individual case reports or reports on small groups of patients treated without controls. To some extent, routine reliance on long-term traditional therapy has yielded to shorter, symptomatic learning-based treatments. While improved outcomes have been reported, many patients do not respond well. It is not yet possible to objectively predict succes or failure. Since it is our impression that this sexual dysfunction is more common than previously assumed (or is increasing in frequency), our present lack of data should soon be remedied.