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Premature Ejaculation
What
is premature ejaculation?
Premature
ejaculation is one of the most common sexual problems among men. 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 very subjective.
While some
men have trouble controlling their orgasm upon entry, others consider 5-10
minutes of copulation (sex) 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.
What
causes premature ejaculation?
Most men have
experienced this sexual problem at some time in their life. Premature ejaculation
was once thought to be caused by drugs or certain infections such as urethritis,
but popular wisdom suggests it is more psychological in nature. The exact
cause of the condition, however, still remains a mystery.
Premature ejaculation
often occurs during the first experiences with sex, and in this case is
most commonly attributed to anxiety. The majority of men gradually learn
to control their orgasm, and have no lasting effect. Some men will develop
a longer-term anxiety toward sex, which can cause a prolonged experience
with premature ejaculation.
Sexual behavior
is also a factor. The longer the period since last ejaculating, the quicker
young men typically reach orgasm. Younger men tend to ejaculate more quickly
than older men, as experience seems to be associated with ejaculatory control.
What
can I do to delay ejaculation?
Desensitizing
creams
Desensitizing
creams are products that can lessen the sensations felt by men during intercourse
so that they can last longer. Pleasure Balm is a good, mild and safe desensitizing
cream that only requires a small amount be applied.
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The best way
to fighting premature ejaculation is learning how to identify and control
the sensations leading up to orgasm. The Masters and Johnson method does
just that. The Masters and Johnson method requires a great deal of patience
and practice, but is very effective. Follow the steps below.
You may want to
start with masturbation. Begin by bringing yourself to a point relatively
close to climax, and stop, allowing yourself to relax before starting again.
Each time you do this, bring yourself closer and closer to orgasm until
you cannot control it any longer. You may want to practice with the
aid of a lubricant. We recommend trying Astroglide. Repeating this
procedure a number of times on different occasions will help you learn
where your point of climax is.
Once you have
an idea about your "point of no return" you should be able to direct stimulation
from your partner leading up to orgasm. The best way to practice this method
is with a caring lover, although you can try to prepare by yourself. With
your partner, engage in non-coital stimulation (like masturbation or oral
sex) and gradually allow yourself to reach that point just before ejaculation.
Some men can
successfully increase their control with the Masters and Johnson method,
but have a very difficult time maintaining control once a partner enters
the scene. Of course it's normal that you're going to be more aroused when
your lover is present. If this is the situation you find yourself in, here's
what can help:
Add a 'simulation'
step between the masturbation and intercourse phases discussed above. This
will help you learn to control a higher sense of arousal than is possible
with simple masturbation, and you get to do it in private without worrying
about what your partner is thinking. There are a lot of products out there
that simulate real intercourse.
We recommend that
you get a toy such as the CyberSnatch with a nice, high quality lubricant
such as Astroglide. This will help simulate the sensations of real intercourse.
To heighten your arousal, get a virtual sex DVD such as My Plaything With
Jewel DeNyle. These are interactive sexual videos that will help
you simulate a real sexual encounter.
If you don't
have a DVD player, any erotic video should do the trick. Follow the
same steps as the masturbation stage of the Masters and Johnson method
using one of these videos and the CyberSnatch. Once you can control your
ejaculation in this simulation, then move on to intercourse with a partner.
Squeeze
technique
The squeeze
technique is really just a variation of the Masters and Johnson method,
except that the assisting partner squeezes the tip or base of the penis
just before the point of climax to essentially cancel the orgasm. The "squeeze"
forces blood out of the penis and reduces the erection. You may want to
use the squeeze technique if the Masters and Johnson method alone is not
working.
Other
techniques
Masturbation
is a technique used by many young men to increase their level of control.
It is thought that masturbation before sexual activity will lessen the
amount of desire a man feels thereby increasing control. This technique
is not very effective, however, as level of arousal is only part of what
contributes to the condition.
Condoms are an
effective means of reducing the amount of stimulation experienced during
sex. Some men find that a condom helps them prevent premature ejaculation
by lowering their arousal.
If one condom
does not decrease the stimulation enough, then put on one more. Condoms
provide excellent protection against STDs and pregnancy, so they’re certainly
worth a try. A good
Sexual positions
can affect a man's ability to control his ejaculation. The typical "missionary"
position (on top of your partner) is not the best position while attempting
to control ejaculation.
Try laying
on your back, allowing the partner to control copulation. In this position
you are more relaxed, and can guide your partner easily.
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What
Is It?
Premature ejaculation
occurs when a man reaches orgasm and ejaculates too quickly and without
control. In other words, ejaculation occurs before a man desires it.
It may occur before or after beginning
foreplay or intercourse. Some men experience significant personal distress
because of this condition. As many as one in five men experience difficulty
with uncontrolled or early ejaculation at some point in life.
When premature ejaculation happens
so frequently that it interferes with the sexual pleasure of a man or his
partner, it becomes a medical problem. Several factors may contribute to
premature ejaculation. Usually, the underlying cause is psychological.
Stress, depression and other factors
that affect mental and emotional health can aggravate this condition. Rarely,
a physical cause, such as inflammation of the prostate gland or a spinal-cord
problem, is a factor.
Symptoms
The key symptoms of
premature ejaculation include:
-
Ejaculation
that routinely occurs with little sexual stimulation and with little control.
-
Decreased sexual
pleasure because of poor control over ejaculation.
-
Feelings of
guilt, embarrassment or frustration.
Diagnosis
Premature ejaculation
is diagnosed based on typical symptoms. To understand your problem, your
doctor will need to discuss your sexual history with you. Be frank and
open. The more your doctor knows, the better he or she can help you.
If your sexual history
fails to reveal significant mental or emotional factors that might contribute
to premature ejaculation, your doctor may want to perform a physical examination.
Your doctor may examine your prostate or perform neurological tests (tests
of your nervous system) to determine if there is an underlying physical
problem.
Expected
Duration
Sometimes, premature
ejaculation goes away on its own over weeks or months. Working to relieve
stress or other psychological issues may help the situation to improve.
Other men have persistent
difficulties with premature ejaculation, and require professional help.
Some men respond to treatment promptly, while others struggle with this
problem over a prolonged period. Effective treatment is available.
Prevention
There is no known
way to prevent premature ejaculation. However, you should consider the
following advice:
-
Maintain a healthy attitude toward sex.
If you experience feelings of anxiety, guilt or frustration about your
sex life, consider seeking psychotherapy or sexual therapy.
-
Keep in mind that anyone can experience
sexual problems. If you experience premature ejaculation, try not to blame
yourself or feel inadequate. Try speaking openly with your partner to avoid
miscommunication.
Treatment
Behavioral therapy
offers 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.
Behavioral therapy
helps 60 percent to 90 percent 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.
Alternatively, your
doctor may prescribe medication that helps to delay ejaculation. Delayed
orgasm is a common side effect of certain drugs, particularly those used
to treat depression. This is true even for men who are not depressed. When
this type of medication is given to men who experience premature ejaculation,
it can help to postpone orgasm for up to several minutes.
Drugs used for this type of treatment
include selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine
(Prozac), paroxetine (Paxil) or sertraline (Zoloft); and tricyclic antidepressants,
such as clomipramine (Anafranil).
Some men with premature
ejaculation also benefit from reducing the stimulation they experience
during sex. A number of creams are available that can partially anesthetize
(numb) the penis and reduce the stimulation that leads to orgasm.
Another option is to use one or more
condoms. However, either of these techniques may interfere with the pleasure
experienced during sex.
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When
To Call A Professional
Speak with your doctor
if you consistently ejaculate before you want to. Remember, one instance
of premature ejaculation does not mean that you have a condition that requires
treatment.
Your doctor may refer you to a sex
therapist if premature ejaculation is causing major problems in your sex
life or personal relationships or if you would like to consider behavioral
therapy.
Prognosis
Many men experience
a brief period of premature ejaculation, then improve on their own. Even
for men who require medical treatment the prognosis is usually good.
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