Abnormal Psychology

502 CHAPTER 11

ever reach orgasm); and (3) its prevalence (less than 10% of the general male popu-

lation) is lower than that of female orgasmic disorder (Spector & Carey, 1990).

Men with orgasmic disorder—particularly those who only have difficulty

achieving orgasm with vaginal intercourse—do not necessarily seek treatment be-

cause couples may not view it as a signifi cant problem; both partners may come to

orgasm, although the man may do so through sexual activities other than vaginal

intercourse, as the man in Case 11.12 does. Usually what brings men with this sex-

ual dysfunction to seek treatment is the desire to have a baby, at which point male

orgasm during vaginal intercourse becomes necessary.

Premature Ejaculation

A second type of orgasm-related problem for men is premature ejaculation, which is

characterized by orgasm and ejaculation that occur earlier than the man expects—

usually before, immediately during, or shortly after penetration (American Psychi-

atric Association, 2000; see Table 11.5 for the diagnostic criteria). Criterion A in

Table 11.5 uses the phrase “minimal sexual stimulation” to indicate that the man

ejaculates after less intense or briefer stimulation than would normally result in

orgasm. Premature ejaculation is the most common male sexual dysfunction (Hell-

strom et al., 2006; Laumann, Paik, & Rosen, 1999; Spector & Carey, 1990). Ac-

cording to Masters and Johnson (1970), premature ejaculation occurs when the

man is unable to control his ejaculation suffi ciently to satisfy his partner at least

50% of the time. Another defi nition is that premature ejaculation occurs when the

man cannot voluntarily delay the ejaculation refl ex (Kaplan, 1981).

Premature ejaculation is considered by some to be a couple’s problem, as with

Mr. and Mrs. Albert in Case 11.13. That is, it is a problem only insofar as the couple

prefers the man to ejaculate in a particular phase of his partner’s sexual response

cycle: Some couples try to have both partners achieve orgasm at around the same

time, but this is diffi cult with premature ejaculation. Other couples do not fi nd early

ejaculation a problem: The partner is sexually stimulated to orgasm in other ways

after the man ejaculates (Malatesta & Adams, 2001).

Premature Ejaculation

CASE 11.12 • FROM THE OUTSIDE: Male Orgasmic Disorder

[A man, 43 and never married, had sexual relationships with many women and was proud that

he could sustain erections for a long time.] He nevertheless found masturbation more satisfy-

ing and had never come close to [having an orgasm during vaginal intercourse.] He had only

reached orgasm four times with a partner, all with the same partner, by masturbating and

then switching to fellatio only at the point of ejaculatory inevitability.... He was afraid that

if he reached orgasm [during vaginal intercourse], he would be “under a woman’s dominion.”

(Apfelbaum, 2000, pp. 236–237)

CASE 11.13 • FROM THE OUTSIDE: Premature Ejaculation

Mr. and Ms. Albert are an attractive, gregarious couple, married for 15 years, who [are in]

the midst of a crisis over their sexual problems. Mr. Albert, a successful restaurateur, is 38.

Ms. Albert, who since marriage has devoted herself to child rearing and managing the home,

is 35. She reports that throughout their marriage she has been extremely frustrated because

sex has “always been hopeless for us.” She is now seriously considering leaving her husband.

The diffi culty is the husband’s rapid ejaculation. Whenever any lovemaking is attempted,

Mr. Albert becomes anxious, moves quickly toward intercourse, and reaches orgasm either

immediately upon entering his wife’s vagina or within one or two strokes. He then feels hu-

miliated and recognizes his wife’s dissatisfaction, and they both lapse into silent suffering.

He has severe feelings of inadequacy and guilt, and she experiences a mixture of frustration

and resentment toward his “ineptness and lack of concern.” Recently, they have developed a

pattern of avoiding sex, which leaves them both frustrated, but which keeps overt hostility to

a minimum.... [Mr. Albert’s] inability to control his ejaculation is a source of intense shame,

and he fi nds himself unable to talk to his wife about his sexual “failures.” Ms. Albert is highly

Premature ejaculation
A sexual dysfunction characterized by orgasm
and ejaculation that occur earlier than the
man expects, usually before, immediately
during, or shortly after penetration.