Dear Bearded Confidant,

I have a problem ejaculating - most of the time I can't.  (Even when I am masturbating or during intercourse).  However, when I do ejaculate, it is when my partner is inside me.  Do you know of any reasons or causes that would delay ejaculation? 

Dear Jay,

It sounds as though you need extra stimulation of the anus and prostate to get off.  Because you are able to have an orgasm during receptive anal intercourse, there isn't a problem with your body's ability to climax.  It sounds as though regular friction on the nerves of the penis doesn't send a strong enough signal to your brain that you are sexually excited.  That is not necessarily a bad thing (similarly, many men have certain fetishes that they require in order to get off and are essentially impotent without those special forms of stimulation).  But if your delayed ejaculations are making your life difficult then I would suggest you visit a doctor of Traditional Chinese medicine as he will have a holistic approach to improving your sexual function.  Otherwise, I would suggest that you masturbate with a dildo and engage in intercourse as often as possible in order to reach the level of sexual release you desire.