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Coitus reservatus, also known as karezza, is commonly thought of as a form of sexual intercourse in which the man does not attempt to ejaculate within his partner, but instead attempts to remain at the plateau phase of intercourse for as long as possible. In fact, the goal of this practice is to enable the man to actually separate orgasm from ejaculation, being able to experience one without the other. The term "karezza" was coined by the physician Alice Bunker Stockham, and is akin to sexual practices in Buddhist Tantra. Importantly, Stockham's contribution was to apply this same philosophy to women as much as to men. The principles of karezza also apply to masturbation, whereby a man attempts to delay his ejaculation as long as possible to prolong pleasure in a process known as "edging."

The primary purpose of karezza is the maintenance, and indeed, intensification of desire within the context of long-term relationships. According to Stockham, it takes from two weeks to a month for the body to recover from ejaculation. If ejaculation is experienced more frequently, the effect is to 'drain the basin' before it has been replenished. This, in turn, induces feelings of irritation and rejection of the lover, as the body seeks to prevent further ejaculation. However, and arguably especially in modern Western culture where 'more is better', people often pursue orgasms, and therefore, ejaculation as a way of trying to overcome those feelings, thus compounding the problem. The result is that over time (reportedly within two to four years), the 'honeymoon of desire' is over, leading to substantial change in the nature of the relationship. Stockham's advocacy was that this same 'honeymoon period' could be maintained in perpetuity through limiting the frequency of ejaculation.

Once lovemaking is no longer undertaken as a means to orgasm, Stockham suggested, the nature and purpose of lovemaking changes dramatically, being focused on communication and physical communion. Orgasm should, she suggested, occur when 'the basin' overflows, perhaps once a month and no more than once a fortnight.

Coitus reservatus is not a reliable form of preventing a sexually transmitted infection, as the penis leaks pre-ejaculate, which may contain all of the same infectious viral particles and bacteria as the actual semen. Beyond that, it is also unreliable for contraception, even if ejaculation is successfully avoided, because pre-ejaculate may contain sperm. The method is also unreliable because of the difficulty of controlling ejaculation.

Another difficulty of this method is that if the man begins to orgasm (before ejaculation proper begins), the muscles can tense tightly in the lower body, such as legs and buttocks, causing the removal of the penis to be difficult. This could cause some ejaculate to enter his partner.

• Coitus interruptus

• LLoyd, John William, The karezza method, or, Magnetation the art of connubial love, Health Research, 1964, ASIN B0007HUYDY
• Stockham, Alice B, Karezza Ethics of Marriage, Kessinger Publishing, 2004 ISBN 1417939699

The Welsh writer Norman Lewis, in his celebrated account of life in Naples in 1944, claimed that San Rocco was the patron saint of coitus reservatus: "I recommended him to drink -- as the locals did -- marsala with the yolks of eggs stirred into it, and to wear a medal of San Rocco, patron of coitus reservatus, which could be had in any religious-supplies shop."