Men with PE have a lack of ejaculatory control, which can cause psychological distress among men who suffer from it. Likewise, partners of men with premature ejaculation express dissatisfaction with the timing of ejaculation, and may also experience reduced self-esteem and sexual pleasure.
It's one of the commonest of all sexual problems. Recently, we did a survey of several thousand British males, and approximately 10 per cent of them said that they 'often' or 'sometimes' had this trouble. We found that it's commoner in younger men - which is not surprising, as there's a distinct tendency for it to improve with age. Men generally get better control as they grow older. However, a 2004 survey in Europe showed that middle-aged men still have this problem. Fortunately, good treatments are available.
Premature ejaculation is one of the most common sexual problems. The condition is most often described as being an inability to delay ejaculation to a point when it is mutually desirable for both partners. The definition of when ejaculation is premature is subjective. While some men have trouble controlling their orgasm upon entry, others consider 5-10 minutes of copulation too little time. How long a man is able to last is not the important factor in diagnosing premature ejaculation. The crucial issue is if a man is satisfied with the length of coitus.
(read more on ejaculation control)
More on ejaculation control
The main cause of premature ejaculation is biological. Upon sexual stimulation and arousal, the normal physical responses for a man and a woman are similar. A man will achieve a climax and then ejaculate about two to three minutes after penetrating the vagina. Women will reach orgasm about 12 to 14 minutes after intercourse occurs. Many women do not achieve orgasm especially if only penetration of the vagina by the penis occurs during sexual activity. Many women achieve orgasm through other methods of sexual stimulation although for some, orgasm is not achieved under any circumstances nor with any type of stimulation. Roughly 10% of women fall into this category. Other causes of premature ejaculation include psychological factors such as marital and relationship issues; performance anxiety (with partners new to each other and especially in the inexperienced partner); fear (associated with concerns regarding getting caught or discovered, sexually transmitted diseases or potential pregnancy ); and guilt (believing the activity is sinful e.g., premarital or extramarital sex).
"The penis can be trained without the hassle of starting and stopping or pressing your fingers anywhere," says sex therapist and former sex surrogate Anita Banker-Riskin, coauthor (with her husband, Michael Riskin) of Simultaneous Orgasm & Other Joys of Sexual Intimacy (Hunter House, 1997). "But first you must make the effort to develop your pubococcygeus (PC) muscle, which you’re now sitting on. The PC muscle involuntarily contracts as you ejaculate, causing semen to fly. But if you purposely contract it during the peak of sex, the PC muscle, says Banker-Riskin, acts like the brakes on a car and can bring an ejaculation to a halt. "Like any other muscle, you need to exercise the PC," says Banker-Riskin.
Most cases of premature ejaculation do not have a clear cause. With sexual experience and age, men often learn to delay orgasm. Premature ejaculation may occur with a new partner, only in certain sexual situations, or if it has been a long time since the last ejaculation. Psychological factors such as anxiety, guilt, or depression can cause premature ejaculation. Since alcohol can delay orgasm, stopping the regular use of alcohol before sex may also play a role in this problem. In some cases, premature ejaculation may be related to an underlying medical cause such as hormonal problems, injury, or a side effect of certain medications.
Finally, there's no question that anxiety plays a part in many cases of premature ejaculation. If you're nervous, you're likely to come too quickly. That's why many males have discovered for themselves that a small amount of alcohol eases their nerves and makes them less likely to climax prematurely. But we wouldn't recommend alcohol as a treatment!
ejaculation control
A common side effect of one class of antidepressants is "sexual dysfunction." These Selective Serotonin Reuptake Inhibitors (SSRI) medications such as Prozac, Zoloft, Paxil, Celexa, and others, actually can inhibit the ability to ejaculate. Because of this, they have been used by some clinicians in the treatment of premature ejaculation. Your doctor or therapist can give you more information on this treatment.
Your health professional may recommend that you and your partner practice specific techniques to help delay ejaculation. These techniques may involve identifying and controlling the sensations that lead up to ejaculation and communicating to slow or stop stimulation. Other options include using a condom to reduce sensation to the penis or trying a different position (such as lying on your back) during intercourse. Counseling or behavioral therapy may help reduce anxiety related to premature ejaculation.
Behavioral therapy is one possible approach for treating premature ejaculation. Most commonly, the "squeeze technique" is used. If a man senses that he is about to experience premature orgasm, he interrupts sexual relations. Then the man or his partner squeezes the shaft of his penis between a thumb and two fingers. The man or his partner applies light pressure just below the head of the penis for about 20 seconds, lets go, and then sexual relations can be resumed. The technique can be repeated as often as necessary. When this technique is successful, it enables the man to learn to delay ejaculation with the squeeze, and eventually, to gain control over ejaculation without the squeeze. Behavioral therapy helps 60% to 90% of men with premature ejaculation. However, it requires the cooperation of both partners. Also, premature ejaculation often returns, and additional behavioral therapy may be needed.
The emergence of sexual tension and relationship difficulties are greatly reduced if sexual activity occurs under these circumstances: only after the partners know each other well and are comfortable with one another. Both partners consent to sexual intimacy without feeling pressured. Sexual activity should occur in a private and relaxed setting. In addition, contraception issues should be discussed, decided and acted upon by the couple. (read more on ejaculation control)
ejaculation control - Tips
Then, your lover strokes your penis by hand as you lie still. When you approach your point of no return, give the "stop" signal. Your lover immediately stops stroking you and simply holds your penis gently, as you continue to breathe deeply and pays close attention to the sensations you're feeling. When you no longer feels close to ejaculation, gives the "start" signal, and your lover begins stroking you again. How many stops and starts should you do? A half-dozen over a 15-minute period works well for most couples. Do what feels comfortable for you.
Don't use drugs or alcohol. They're distracting and they interfere with the self-awareness crucial to learning ejaculatory control.
Some penile skin creams advertise that they help a man last longer. These products contain topical anesthetics that dull sensation in the penis. If you like to play with penile sensation, there's no harm in using them. But they're not a good idea for learning to last longer. They dull sensation. But the key to lasting longer is for the man to become more familiar with what he feels so he can back off from his point of no return while still remaining highly aroused.
