Rowland David L, Padilla Sarah, Kӧvi Zsuzsanna, Hevesi Krisztina
Department of Psychology, Valparaiso University, Valparaiso IN 46383, United States.
Institute of Psychology, Károli Gáspár University of the Reformed Church, Budapest 1037, Hungary.
Sex Med. 2023 Jul 3;11(3):qfad030. doi: 10.1093/sexmed/qfad030. eCollection 2023 Jun.
Difficulty reaching orgasm/ejaculation during partnered sex, a primary characteristic of delayed or absent ejaculation, affects about 5% to 10% of men, but the reasons underlying this problem are poorly understood.
The study sought to gain insight into possible etiologies of delayed ejaculation by assessing men's self-perceptions as to why they experience difficulty reaching orgasm.
We drew 351 men reporting moderately severe to severe difficulty reaching orgasm during partnered sex from a sample of over 3000 respondents obtained through an online survey. As part of the 55-item survey, participants responded to 2 questions asking about their self-perceived reasons for having difficulty reaching orgasm and selected from a list of 14 options derived from the research literature, a series of men's focus groups, and expert opinion. The first question allowed respondents to select all the reasons that they felt contributed to the problem, the second to select only the most important reason. In addition, both men with and without comorbid erectile dysfunction were investigated and compared.
Hierarchical ordering of men's self-pereceived reasons for having difficulty reaching orgasm, including typal reasons established through principal component analysis.
The major reasons for difficulty were related to anxiety/distress and lack of adequate stimulation, with relationship and other factors endorsed with lower frequency. Further exploration using principal components analysis identified 5 typal reasons, in descending order of frequency: anxiety/distress (41%), inadequate stimulation (23%), low arousal (18%), medical issues (9%), and partner issues (8%). Few differences emerged between men with and without comorbid ED other than ones related to erectile problems, such as higher level of endorsement of medical issues. Typal reasons showed correlations, albeit mostly weak, with a number of covariates, including sexual relationship satisfaction, frequency of partnered sex, and frequency of masturbation.
Until supplemental medical treatments for delayed ejaculation are developed and approved, a number of men's purported reasons for difficult or absent ejaculation/orgasm-anxiety/distress, inadequate stimulation, low arousal, relationship issues-fall into areas that can be addressed in couples counseling by a trained sex therapist.
This study is unique in scope and robust in sample size. Drawbacks include those associated with online surveys, including possible bias in sample selection, limitation to Western-based samples, and the lack of differentiation between men with lifelong and acquired difficulty.
Men who have difficulty reaching ejaculation/orgasm identify putative reasons for their problem, ranging from anxiety/stress, inadequate stimulation, and low arousal to partner issues and medical reasons.
在有性伴侣的性行为中难以达到性高潮/射精是射精延迟或缺失的主要特征，影响着约5%至10%的男性，但这一问题背后的原因却鲜为人知。
该研究旨在通过评估男性对自身难以达到性高潮原因的自我认知，深入了解射精延迟的可能病因。
我们从通过在线调查获得的3000多名受访者样本中，抽取了351名报告在有性伴侣的性行为中存在中度至重度难以达到性高潮问题的男性。作为55项调查的一部分，参与者回答了2个关于他们自我认知的难以达到性高潮原因的问题，并从一系列源于研究文献、男性焦点小组讨论和专家意见的14个选项中进行选择。第一个问题允许受访者选择所有他们认为导致该问题的原因，第二个问题则只能选择最重要的原因。此外，还对患有和未患有共病性勃起功能障碍的男性进行了调查和比较。
男性对难以达到性高潮原因的自我认知的分层排序，包括通过主成分分析确定的典型原因。
难以达到性高潮的主要原因与焦虑/痛苦和缺乏足够刺激有关，人际关系及其他因素的认同频率较低。使用主成分分析进一步探索发现了5个典型原因，按频率从高到低依次为：焦虑/痛苦（41%）、刺激不足（23%）、性唤起低（18%）、医疗问题（9%）和伴侣问题（8%）。除了与勃起问题相关的差异外，患有和未患有共病性勃起功能障碍的男性之间几乎没有其他差异，比如医疗问题的认同程度较高。典型原因与一些协变量存在相关性，尽管大多较弱，这些协变量包括性关系满意度、有性伴侣性行为的频率和自慰频率。
在开发和批准用于治疗射精延迟的补充药物之前，许多男性声称的难以射精或达到性高潮的原因——焦虑/痛苦、刺激不足、性唤起低、人际关系问题——都属于经过培训的性治疗师在夫妻咨询中可以解决的领域。
本研究在范围上具有独特性，样本量充足。缺点包括与在线调查相关的问题，包括样本选择可能存在的偏差、仅限于西方样本以及未区分终生存在困难和后天出现困难的男性。
难以达到射精/性高潮的男性确定了他们问题的假定原因，范围从焦虑/压力、刺激不足、性唤起低到伴侣问题和医疗原因。
