The Sexology Outpatient Clinic of São João Hospital Center is specialized in the attendance of users with problems or dysfunctions related to sexuality, such as male sexual dysfunctions.

46 year old man, single, with late onset of sexual activity which relates with his fears (partner becoming pregnant and sexually transmitted diseases) and his markedly obsessive personality.

He describes previous occasional or short-term relationships and premature ejaculation on his first sexual experiences. During a phase without relationships, he began to discover his sexuality through masturbation, which tended to occur very frequently. He reported to especially appreciate the instant that precedes ejaculation, which led him to constantly try to delay the moment of ejaculation. Finding himself in a stable relationship, he reports that he cannot ejaculate during intercourse, achieving it only through masturbation, despite he could obtain sexual pleasure and have a sustained erection. At this point, the couple decided to have sex therapy.

Premature ejaculation is a psychosexual disturbance defined as a persistent or recurrent ejaculation with minimal sexual stimulation before, on or shortly after penetration and before the person wishes it to occur. The main option for treating premature ejaculation are behavioral therapies such as the stop-start technique. In this case, the patient used this technique autonomously, by the means of masturbation, to delay his ejaculation, leading him to the point of being unable to ejaculate during intercourse.