Bernard Apfelbaum has done a lot of research on sexual dysfunction in men.

He believes that some men who have trouble reaching their climax during partnered sex actually have an “autosexual orientation”.

In other words, they prefer masturbatory stimulation by their own hand rather than any kind of sex with a partner.

He says such men are not being selfish. Rather, he suggests, they may be over-concerned with pleasing their partners, because they focus too much on their partner’s pleasure at the expense of their own.

That means they are unaware of their own sexual pleasure or arousal and don’t “notice” or respond to the stimulation they are experiencing.

Apfelbaum called this “partner anorgasmia”, because the symptoms of delayed ejaculation only show up in the presence of a partner.

The difficulty that a man with delays in his ejaculation has in obtaining sexual satisfaction (or even sexual arousal) with his partner is hidden behind a hard and prolonged erection, but this physical sign of apparently high arousal is actually associated with low levels of sexual arousal.

Apfelbaum believes that such an erection is not really an expression of sexual desire and excitement, but an automatic mechanism which the man uses to fulfill his partner’s expectations.

He suggests men with delayed ejaculation (also called retarded ejaculation) may be driven by a desire to satisfy their partner rather than to obtain their own satisfaction or take care of their own sexual needs and desires.

They are in effect too conscientious, too controlled, and too aware of their responsibilities during sex – which they see as satisfying and pleasing their partner.

This, suggests Apfelbaum, makes the man unable to satisfy himself, and gives the man an aura of being unable to enjoy sex, which in turn makes his partner feel that she cannot do anything pleasing for him.

This idea has a lot to support it; a recent study seemed to show that men with delayed ejaculation have lower levels of sexual arousal than men with other sexual dysfunctions and men who come easily during sex.

An Interesting Way Of Looking At Delayed Ejaculation (DE)

The simplest and most common definition of delayed ejaculation is the inability to ejaculate during intercourse, or difficulty in doing so.

Delays in ejaculation may mean a man is slow to reach (or cannot reach) his point of no return.

In days gone by, the preferred treatment was to apply highly intense stimulation to a man’s penis before intercourse, at a level which was so intense it would (hopefully) make the man ejaculate.

This so-called treatment was based on the belief that once a man had overcome his inhibitions around ejaculation, and in particular once he’d managed to ejaculate inside the vagina, he’d be able to enjoy intercourse successfully in the future.

 A Problem Like DE Needs Radical Answers

When a man is slow to ejaculate, his erection – which is usually hard and long lasting – may not represent arousal at all. It may just represent an automatic response to sexual stimulation.

Often, men with DE do not particularly enjoy intercourse, and they may even regard it with some distaste, or perhaps as a “job” which has to be done because the man’s sexual partner expects it.

And it may even be the case that a man who has difficulty ejaculating is more aroused sexually by his own touch than by the touch of a partner.  

Another person’s touch – could it be a turn-off?

More importantly, some men may even be inhibited by the touch of another person. Even more oddly, a man with delayed ejaculation may find his penis to be more or less insensitive to stimulation when he’s involved in a sexual relationship with a woman.

According to Bernard Apfelbaum’s, delayed ejaculation can be seen as a sexual desire disorder, specific to the relationship with a particular sexual partner.

This is most clear during sexual intercourse, when the man’s sexual arousal is really low – and stays that way.

Degrees of Severity

At one end of the range are men who reach orgasm and ejaculate easily during self-pleasuring [masturbation], and for whom reaching orgasm is only challenging during intercourse.

The opposite end of the range is represented by the very few men who have never had an orgasm of any kind under any circumstances.

Treatment Of Ejaculation Difficulty?

Apfelbaum says treatment strategies have usually been directed only at the man’s inability to reach orgasm during intercourse, which cuts out men who cannot reach orgasm under any circumstances.

He says that part of the difficulty of both defining and treating DE is accounted for by the fact that there are in fact two separate syndromes which we call delayed ejaculation.

He observes that one type of delayed ejaculation involves a man who can reach orgasm easily and enjoys doing so during masturbation.

The other group, he suggests, is composed of men who cannot even reach orgasm during masturbation.

That leads us to a new definition – which seems to define the condition by a single factor: that only a man’s own touch is erotically arousing, and his orientation is basically “autosexual” i.e. masturbatory.

(By the way autosexuality is not an indication of homosexuality.)

Of course there are more defining factors: one is that a man will experience sexual intercourse as unpleasant or even disagreeable.

And here’s the thing: when a therapist starts from the presumption that all men will or “should” enjoy sexual intercourse, the whole course of treatment is defined too – often incorrectly. Start from a different place, and everything that follows is different too.

Can multiple female orgasms result from delayed ejaculation during long-lasting intercourse?

In general, one oddity of delayed ejaculation is that the partners of men with this dysfunction are indeed often multi-orgasmic.

They often respond with multiple orgasms to the sexual stimulation they are receiving during intercourse, despite the fact that these women may feel rejected and frustrated during intercourse.

This is often due to the fact that a man with this condition can sustain a hard erection which can give his partner a lot of physical stimulation.

And that’s true even when psychological or emotional stimulation is missing. In Bernard Apfelbaum’s words, he is the “workhorse” of sexual relationships. And he resents it.

Finally, Apfelbaum observes that many men with anorgasmia have a kind of compulsion to please their partner sexually, and that this compulsion creates both resentment and (sometimes) pleasure for the man as he unconsciously withholds his orgasm from his sexual partner.

But of course, you have to be careful here (especially if you’re a therapist), because saying that a man experiences sex as “a continuous demand for performance” is something you can never prove.

“Apfelbaum is not only a creative theorist in the field of sex therapy; he is an innovator in the practice of sex therapy.” From Principles and Practice of Sex Therapy (2nd Ed), S. R. Lieblum & L.A. Pervin (Eds), Guilford Press: NY, 1989.