Dear Dr Mitchell,
My boyfriend has been unable to ejaculate inside my vagina. We have been dating a year and a half. He was a 40-year-old virgin when we met.

Could this be caused by his lack of experience or does he just find it easier to masturbate? He also said he sometimes doesn't come when he masturbates. Is there something he can do to have an orgasm with me?

The problem that your boyfriend is experiencing with his inability to have an orgasm is somewhat uncommon among men but tend to be a common complaint among women.
Sexual arousal is usually achieved following psychological and physical stimulation which may include sexual stimuli, music, alcohol or drugs. Usually, as long as a man achieves an erection, orgasm is generally automatic. Problems in the relationship may be a significant factor in his failure to achieve an orgasm. It is of interest that he was still a virgin at 40 years.

It would be of interest to determine why he was never sexually active before. Was it because of religious reasons or does he have problems with his sexuality? Did he have a girlfriend prior to being involved with you? If he did not indulge in sexual activity because of religious reasons, then he might be having problems because of guilt and the fact that he thinks that sexual activity before marriage is wrong.

Orgasm in a male as in female is a learned response and this reflex can be interfered with by many things such as sexual abuse, guilt, fear of pregnancy and infidelity. The fact that he does achieve an orgasm by masturbating suggests that he does not have a physical problem and that his problem may be more psychological.

You need to have a detailed discussion with him and determine how he feels about the relationship and also if possible, determine if has any deviant sexual practices. He might have fears and anxieties that he needs to overcome and these will have to be dealt with by a psychologist. It is important that you are able to communicate verbally, physically and sexually since this is an important prerequisite to a good sexual relationship. It is important to receive counselling with your partner. Consult your family doctor or gynaecologist who will advise you further and make the appropriate referral if necessary.

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@
jamaicaobserver.com; mail c/o Jamaica Observer, 40-421/2 Beechwood Ave, Kingston 5; or fax to 968-2025.

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