Orgasm Disorders · Clinical Exercise

The Number Is Normal

Most men presenting for premature ejaculation treatment have an ejaculatory latency inside the population normal range. This is the domain where accurate information does the most clinical work and gets reached for the least.

What this exercise practises

Deciding what the first move actually is in an orgasm presentation, recognising when a client's distress rests on a factual error about what is typical, and separating a medication contributor you can name from a medication decision that is not yours.

One of the seven presentations is sorted into the wrong bin by construction. Four plausible first moves were available and none of them was right, which is the situation in which a clinician reaches for the most familiar one.

Estimated time to complete this exercise: 25 minutes

1First moves
2The sertraline
3Never, by any means
4Close

Before you begin

How this one works

Orgasm presentations are where accurate information does the most clinical work and gets reached for the least. Several of them are resolved by telling the client a number.
Part 1 sorts seven presentations by what the first move should be. One of them is in the wrong bin by construction and the reveal explains why, so read the note on that one carefully.
Parts 2 and 3 are the two presentations where the temptation runs in opposite directions: one where you will want to advise on a medication, and one where you will want to reassure.
Nothing is graded and nothing is recorded. Reloading starts it again.

Most men presenting for premature ejaculation treatment have an ejaculatory latency inside the population normal range. That single finding reorganises how this whole domain is approached, and delivering normative data is the first-line intervention in many of these presentations rather than the thing you do before intervening.

References

  1. American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
  2. Clayton, A. H., & Montejo, A. L. (2006). Major depressive disorder, antidepressants, and sexual dysfunction. Journal of Clinical Psychiatry, 67(Suppl. 6), 33–37.
  3. Herbenick, D., Fu, T. C., Arter, J., Sanders, S. A., & Dodge, B. (2018). Women’s experiences with genital touching, sexual pleasure, and orgasm: Results from a U.S. probability sample of women ages 18 to 94. Journal of Sex & Marital Therapy, 44(2), 201–212. https://doi.org/10.1080/0092623X.2017.1346530
  4. LoPiccolo, J., & Lobitz, W. C. (1972). The role of masturbation in the treatment of orgasmic dysfunction. Archives of Sexual Behavior, 2(2), 163–171. https://doi.org/10.1007/BF01541870
  5. Perelman, M. A. (2016). Delayed ejaculation. Journal of Sexual Medicine, 13(9), 1380–1386. https://doi.org/10.1016/j.jsxm.2016.05.012
  6. Waldinger, M. D., Quinn, P., Dilleen, M., Mundayat, R., Schweitzer, D. H., & Boolell, M. (2005). A multinational population survey of intravaginal ejaculation latency time. Journal of Sexual Medicine, 2(4), 492–497. https://doi.org/10.1111/j.1743-6109.2005.00070.x