We're out of sync in the bedroom

"Delayed ejaculation is the least well understood of all male sexual dysfunctions, because it can be caused by so many different things"

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My boyfriend takes a long time to climax, which means I usually get there before him. Once I've had an orgasm I don't really feel like having sex any more, I just want the postcoital hug. He says that he doesn't mind but I feel really guilty.

Most men orgasm within four to ten minutes once they begin active thrusting during intercourse, but between 1 and 4% of men never get there, or take so long to achieve orgasm that their partner has already put the kettle on by the time they do. Delayed ejaculation (DE) doesn't necessarily require a diagnosis. After all, the concept of sexual duration is entirely subjective. If, for example, a man's partner enjoys lengthy episodes of penetrative sex, his DE can be an absolute boon. On the other hand, for a woman who is prone to thrush or cystitis, endless thrusting can be a pain in every sense of the word.

Although there is no gold standard for sexual duration, to establish how long is 'too long', the Third International Consultation on Sexual Medicine defined DE as an active "thrusting" threshold of more than 20 minutes. Diagnosis also requires evidence of "significant distress" and, although your partner says that he is fine, research by Giovanni Corona and a team at the University of Florence found that men who suffer from DE experience considerable anguish, anxiety and lack of sexual confidence. They are also more likely to fake orgasm because they feel that their partner will feel let down if they don't appear to climax.

The way a man feels about the time it takes for him to ejaculate is intricately linked to how his partner feels about it, so the way you respond to this situation is hugely important. If your partner senses that you lose interest in sex immediately after your own orgasm, he is more likely to end sex rather than risk putting pressure on you.

However, the longer his sexual difficulties are ignored or accommodated the more compromised your sex life will be. 

DE is the least well understood of all male sexual dysfunctions because it can be caused by so many different things. It can be a lifelong condition or it can come on suddenly. It can be situational, relational or caused by medication. Between 16% and 37% of men who take SSRI antidepressants experience it as a side-effect. It can also be triggered by stress, anxiety or just by being a bit long in the tooth. What is certain is that once a man becomes anxious about it, it creates a negative feedback loop where worrying about the problem only serves to perpetuate it.

Fortunately, there is a safe and simple solution. Although sex therapy or CBT are often advised,  vibratory stimulation has been used as an adjunct therapy to treat delayed or inhibited orgasm in men and women for decades. It was confirmed to be a cheap and convenient first-line treatment for men with DE in a 2016 study by the clinical psychologist Christian J Nelson at the Memorial Sloan-Kettering Cancer Centre in New York.

Nelson ran a small trial with 36 men who had sought help because they had been unable to achieve a climax during sex for at least three months. The men were all in committed relationships and were not using antidepressants, suffering from illness or trying to get their partners pregnant. All they had to do was to apply a normal vibrator to the frenular area of their penis for three one-minute periods, separated by one-minute rest periods. The results of the study were extraordinary. After six months 72% of the men had experienced orgasm using vibratory stimulation and 62% had experienced an orgasm during intercourse. Sounds to me like this method is well worth a try. Good luck!

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