Treatment for Delayed Ejaculation: Progressive Orgasmic and

Gradual Orgasmic Erotization Phase

The sexological approach to delayed ejaculation requires desensitizing performance anxiety and increasing proprioceptive stimulation through a systematic and structured sequence.

In the orgasmic arousal phase, the primary goal is for the patient to transfer the ejaculatory reflex—which is typically restricted to individual self-stimulation—to the presence of and active interaction with his partner.

Initially, solitary masturbation is prescribed using lubricants or assistive devices to enhance the quality of tactile sensations and intensify erotic fantasies.

Subsequently, the partner is gradually integrated into the same physical space, with the interaction sequenced in stages: first through passive presence without direct visual observation, then by witnessing the autoerotic act, and finally by incorporating non-genital physical caresses on the man.

This step-by-step approach eliminates cognitive inhibition, reduces spectator-like self-observation, and conditions the orgasmic response to the shared context of the current relationship.

Transition and Intravaginal Integration

Once the ability to ejaculate in the active presence of the partner has been established, progressive intravaginal eroticization begins, aimed at transferring the climax to intercourse.

In this stage, the partner gradually takes on the direct manual stimulation of the penis, using caresses guided by the man himself until he approaches the threshold of imminent or inevitable ejaculation.

To facilitate penetration without losing the required arousal, specific sexual positions are recommended that increase contact, tactile pressure, and physical friction, such as the rear-entry position or the woman straddling the man.

The patient should initiate penetration only when arousal is at its peak, combining the entry of the penis with coordinated pelvic movements and voluntary contractions of the anal sphincter.

This focused physical stimulation facilitates the neuromuscular activation necessary to trigger the rapid and fully effective ejaculation of semen into the vaginal canal.

Specific Techniques and Coital Consolidation

To reinforce the functional pattern and coital fluidity, advanced strategies are applied as orgasm approaches.

A highly effective technique involves continuing manual self-stimulation while standing or near the bed until reaching the critical point of no return, at which point immediate or surprise penetration is performed to ensure that the ejaculation occurs entirely within the vaginal tract.

Systematic repetition of this procedure eliminates cognitive hypervigilance, deactivates the inhibitory association linked to intercourse, and reconditions the executive reflex.