If the man has never ejaculated through any form of stimulation (such as wet dreams, masturbation, or intercourse), a urologist should be consulted to determine if there is a congenital or physical cause. If, however, he is able to ejaculate in a reasonable period of time by some form of stimulation, he should seek sex therapy from a therapist specializing in ejaculatory problems. Treatment usually includes both partners. The therapist will usually educate the couple about the fundamentals of sexual response and how to communicate and guide the partner to provide ideal stimulation, rather than trying to make a sexual response occur. Therapy commonly involves a series of homework assignments wherein the couple, in the privacy of their home, engage in sexual activities that reduce performance pressure and focus on pleasure. Typically, sexual intercourse will be prohibited for a limited period of time, while the couple gradually enhances their ability to enjoy ejaculation through other types of stimulation. In cases where there is a problematic relationship or an inhibition of sexual desire between the couple, therapy to enhance the relationship and emotional intimacy may be required as a preliminary step. Sometimes hypnosis may be a useful adjunct to therapy, particularly if a partner is not willing to participate in therapy. Self-treatment of this problem will probably be unsuccessful in most cases. If a medication is believed to be the cause of the problem, other medication
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