Maybe a type of sexual dysfunction?

Patient : My fiance can not feel if he will ejaculate. He feels no escalation and is not able to tell if what we are doing will work. It is the same if he masturbates or has intercourse. Sometimes he can't ejaculate, although I suspect it is because he is giving up too soon because it is impossible for him to tell if he is close or increasing pleasure. When he finally does ejaculate it takes a while and he has little pleasure from it. It is always very quick and he doesn't seem to have a "cool down period". Often he begins to go flaccid and we are about to give up... them boom it happens. It is always a surprise when he orgasms. Neither of us can guess when or if it will happen. Is there something we can do to help this problem?
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