At this point it seems logical to mention coitus interrup-tus, coitus obstructus, and coitus reservatus. These are further along the spectrum from trying to overcome premature ejaculation in that, by using these techniques, the object is to control ejaculation for purposes of contraception or, in the case of Tantric Yoga, to achieve a higher state of bliss. Needless to say, they are difficult to practise and we would not advise anyone to rely on these techniques as their sole method of birth control.
Coitus interruptus is the technique in which the man pulls out from the vagina when he feels the inevitability of ejac-ulation. Now one problem with this, besides the obvious timing problems, is that often a little seminal fluid and sperm leak out before full ejaculation and all it takes to fertilise an egg is one sperm. Also, this usually leaves the woman hanging on a cliff, and both partners feeling less than satisfied by the experience.
Mary was a sweet sixteen-year-old who came to Michele’s office for antenatal care—she and her boyfriend Bruce had been using coitus interruptus as their means of contraception. Mary believed Bruce, who was all of seventeen, that ‘sure, I can control it; no problem’.
Coitus obstructus is fully engaging in intercourse while at the same time pinching the shaft of the penis in such a way as to close off the urethra, forcing the ejaculate into the bladder. Frankly, we cannot believe anyone is really able to do this regularly, and we imagine it would be rather painful!
Coitus reservatus is full intercourse, presumably until the woman comes to orgasm, while holding back from climax—apparently by concentrating the mind on other things. This is practised in Tantric Yoga, but it takes that type and level of discipline and training. Clearly, this is not for casual sex.
We should also mention another problem that is more common in older men or in men who have had surgery of the prostate or urethra. This is called retrograde ejaculation and is characterised by a lack of external ejaculation with part or all of the ejaculate going into the bladder. As one jokester put it: ‘The charges get reversed.’ Orgasm is experienced, but with a slightly different feeling owing to the lack of a feeling of fullness in the urethra—Sam, who had prostate surgery in his sixties, described it as ‘now a one-stage procedure whereas it used to be a two-part performance’. One study reports that about 62 per cent of men experience this problem after prostate surgery done through the urethra, and it is generally more common in men with diabetes.
