When sex becomes work or is physically or emotionally painful, fun and enjoyment ceases! There are many reasons why this situation might be occurring. I will review some of these: Sometimes physical (medical) conditions interfere with erections and ejaculation. If you are taking medications or drugs, have a disease, an injury or pain, your erection and/or ejaculation ability may be negatively impacted. You didn't tell me your age. Sometimes, men will gradually loose erection ability as they age. Ejaculations also change as a result of the aging process. Worrying about it compounds these problems, no matter what the causes, because anxiety creates interference with sexual response. Sometimes psychological (emotional) issues create erection and/or ejaculation problems. If a man has certain emotional issues or has circumstances from his emotional/sexual history, he could have difficulty getting erections or ejaculating with a partner (or even by himself).

As mentioned before, anxiety is one emotion that is a major culprit in erections/ejaculation problems. When a man is anxious (i.e., worried) about sexual performance, he often tends to monitor how his penis is working. In other words, he may worry if it is hard enough, if it will go inside her vagina, if it will stay up, etc. This monitoring is called "spectatoring" because a person is actually watching himself, as if from an audience perspective. The spotlight is on him! Unfortunately, monitoring usually reeks havoc with a man's sexual response because monitoring causes him to be "in his head," thinking, rather than "in his body," feeling and experiencing the sexual stimulation his body needs to respond properly. This can surely delay ejaculation. Conversely, if a man also monitors his penis because he is worried that he will not last long enough to please his partner, you can bet that he probably won't. He will probably ejaculate before he wants to because of this performance anxiety.

Performance anxiety and anxiety in general are major causes of rapid ejaculation. All of these factors can cause feelings sexual and emotional frustration, and also lead to feelings of sexual inadequacy. A lack of sexual enjoyment can obviously be the result. Sometimes relationship problems cause sexual problems. If relationship problems create feelings of anger and resentment toward one's partner or if a man is not feeling sexually attracted, his ability to respond sexually could also be inhibited. Furthermore, some people don't feel comfortable with any intimate relationships. Hence, they are unable to get close enough to have a good and enjoyable sexual experience with any partner.

Can you relate to any of these issues? My suggestions: First have a physical checkup to make sure that you are healthy. Go to your family doctor (or to a urologist) and try to talk openly about your sexual concerns. Your problems might be physically based, at least in part. However, I think that you could especially benefit from seeking out the help of a board certified sex and relationship counselor or therapist. Click on www.assect.org or www. sexhelp.org for a listing of qualified professionals in your area. If you have had a problem with rapid ejaculation in the past and don't enjoy sex with a partner because you ejaculate too fast and, therefore, are always soft (I am saying this based on your last sentence), you could definitely also benefit from the book MALE SEXUAL ENDURANCE: A Man's Book about Ejaculatory Control by Robert W. Birch, Ph.D. Go to www. oralcaress.com to buy the book from the author or to www.amazon.com. There is hope for you to have a better sex life and better life if you get the help you desire.

Best wishes, Cynthia Ruberg, LPCC, FAACS

Reviewed by: Kathleen VanKirk DHS