I’m a thirtysomething man who suffers from delayed ejaculation. Mine seems to be of the lifelong variety. I enjoy sex and often stay erect for an extremely long time, yet I have rarely ejaculated with another person. I have no issue doing so through masturbation. It is worth mentioning that I am very against having children. I am the third of six children and have seen my parents struggle, raising my siblings and me. I am deathly afraid of repeating the cycle and bringing a child into an uncertain world, ultimately to die. I ended a relationship two years ago, and am filled with dread at the idea of admitting this all over again. Are there any tips/treatments to help me to enjoy sex enough to ejaculate?

You seem to have diagnosed yourself with delayed ejaculation due to psychological causes. If this is correct, the answer would be to seek help from a psychologist/sex therapist. It would be wise to seek help anyway because sexual problems usually have a complex set of causes, and there is commonly a mind-body connection.

But I suspect that there is at least in part a physiological reason why you do not enjoy partner sex enough to reach an ejaculatory threshold. For example, men who have become accustomed to high friction (perhaps through a pattern set up during teenage masturbation) might find that partner sex fails to provide that same sensation. Many men with the same complaint as you are lauded for “lasting” but in fact they are simply going through the motions sexually without becoming sufficiently aroused to climax. As you have discovered, this only builds resentment and despair.

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For them – and for you – the goal of sex needs to change from “trying to ejaculate” to simply enjoying the sensations. Never continue with sex unless you are enjoying it. You do not need to apologise or explain your sexual self … but some partners may take delayed or absent ejaculation personally and, in such a case, reassurance may be kind and advisable. Most important, try to recognise that your particular sexual challenges and needs are not unusual and that you fully deserve to have pleasurable partner sex.

• Pamela Stephenson Connolly is a US-based psychotherapist who specialises in treating sexual disorders.

• If you would like advice from Pamela on sexual matters, send us a brief description of your concerns to [email protected] (please don’t send attachments). Each week, Pamela chooses one problem to answer, which will be published online. She regrets that she cannot enter into personal correspondence. Submissions are subject to our terms and conditions.