Wednesday, July 25, 2012

How to Deal with Premature Ejaculation?

What is it?

Premature ejaculation (PE) means coming too quickly, and it's one of the most common sexual problems among older men. Actually, this issue cannot be attributed to the aging, since, based on the statistical data, it is even more common in younger men, and it tends to improve with aging. However, multiple surveys confirmed that many middle-aged men still complain on this problem.


It’s almost impossible to get an accurate definition of premature ejaculation (PE): what some couples consider a satisfactory length of intercourse would be very inadequate for others. If a man and his partner don't mind how long it takes him to ejaculate, then it really doesn't matter. For example, Ian Kerner, PhD, a sex therapist and author of She Comes First, advises men to bring their partners to the brink of orgasm before having intercourse. Then, if he's prone to premature ejaculation, it doesn't matter since both of them come away satisfied.

After studying data gathered by the National Health and Social Life Survey, sociologist Edward Laumann, PhD, estimated that a third of American men complain that they ejaculate too quickly. They want to last longer during intercourse to prolong the pleasure, both for themselves and their partners.

At the 2006 Congress of the European Society for Sexual Medicine, an American research paper reported:
  1. The average lasting time of men with PE was 1.8 minutes.
  2. 'Normal' men lasted an average of 7.3 minutes.

But there were males who claimed to have premature ejaculation, yet who could last up to 25 minutes. This clearly shows people have wildly differing ideas about what is normal!

At the same Congress, Professor Waldinger reported that 2.5 per cent of men couldn't last 90 seconds inside the vagina. Those males undoubtedly have PE.

As a working definition, if either you or your partner feels that orgasm is happening too soon, there probably is some degree of PE.

Does it matter?

In most cases premature ejaculation does matter, because it makes people unhappy and frustrated. And in severe cases PE can threaten or even ruin a marriage – simply because it spoils the sex lives of both partners. Sometimes, the condition is so bad the man can't have sex because he ejaculates before he can get into the vagina. This can be devastating for a man's self-confidence. And it can be hugely frustrating and annoying for his partner.

Premature ejaculation in mature men, who have a sufficient sexual experience, can also be generated by their disinterest to satisfy their partner, and many other causes. Communication between the two is essential; they must coordinate their senses and learn to control their bodies. Men, who suffer from premature ejaculation, generally do not wish to discuss about it or can have a partner who doesn’t want to get into details. In both cases it is very likely for the two to break up instead of trying to solve their problems. Disinterest in satisfying their partner is a major couple issue and must be taken out of the discussion from the beginning, because if this disinterest really exists, there’s no point in trying to solve the situation as the man has no problems whatsoever, but is simply egocentric and insufficiently related to his partner from an emotional point of view.

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What causes it?

For many years, sex experts have tended to say that premature ejaculation is caused by early conditioning. In other words, the man's early, rushed sexual experiences had to be quick so as to avoid detection. The idea is that this conditions him to climax as quickly as possible.

It's worth noting that from an evolutionary point of view, it's probable that males who climaxed quickly were more likely to have children. In other words, if you were a caveman who came very fast, you'd stand more chance of impregnating your woman and enlarging your tribe.

Some men seem to be highly triggered right from the start of their sex lives, and there are correlating records on the instances where their fathers were much the same. Therefore, the tendency to reach orgasm quickly may possibly be inherited rather than learned.

Finally, there's no question that performance anxiety plays a part in many cases of PE. If you're nervous, you're likely to come too quickly. This is 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.

Note that communicating your anxiety is helpful to improve your PE. We hear the expression, “a big relief to get that off my chest,” yet it’s rarely used for premature ejaculation. Talking with a partner, friend or therapist opens the door for anxiety relief and can help address and alleviate some of our fears. Men are notorious for keeping things inside and it’s no different for a delicate subject like this.

Treatment for mild cases

If you have mild PE – for instance, you can last five minutes but would like to last 10 – there's probably no point in going to a doctor because you probably might be able to improve matters by simple distraction techniques. This means turning your mind to something else when you sense that climax is near. For example, you can think about something totally unconcerned with sex or pinch yourself.

While this may work for some, it has the unfortunate side effect of distancing men from their partners and the sexual experience.

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Local anesthetic

Some men try to treat themselves with a local anesthetic gel that's applied to the shaft of the penis shortly before intercourse. This product is advertised to the public as a good way to 'damp down' sexual sensation in the penis. There is a substantial drawback for this approach since using this gel because the local anesthetic can 'dull' the sex sensation for your partner. It can also cause a distressing skin reaction in either partner, with intense itching, redness and soreness.

German scientists have come up with a slightly different approach that won't cause vaginal irritation. It's called the 'long love condom’ and it contains a local anesthetic (benzocaine or lidocaine) inside it. Long love condoms are now being sold in many countries, under a variety of brand names.

Treatment for more severe cases

If PE is causing you significant problems, it is best to consult an expert for treatment.

The Masters-Johnson method

This method cures the vast majority of men, provided that both partners are keen to co-operate. It's based on a special 'penis grip' developed by the American therapists Masters and Johnson. They employed it in a’re-education' course lasting weeks or months. The finger-grip abolishes the desire to climax, so if, under careful instruction, the couple uses it over a period of weeks, they can usually re-train the man so he can last much longer.

The technique involves the following steps:
  1. Your partner places her hand so that her thumb is on one side of the man's erect penis (the nearer side to her when she is facing him).
  2. Her index and middle fingers are on the other side.
  3. The index finger is just above the ridge of the glans (the 'head'), while the middle finger is just below the ridge.
  4. When the man feels that he's near to a climax, he tells his partner.
  5. She then squeezes his shaft firmly between her thumb and the other two fingers.

This approach may be effective both for male couples as well as for heterosexual ones. However, unless this is done as part of a long-term program, it probably won't work. It is recommended to approach trained sexual therapist for a brief training session, since most couples who try to learn it from the Internet or a book get it wrong.

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Antidepressant drugs

In recent years, it has also proved possible to treat PE with antidepressant drugs taken a few hours before intercourse. The group that are mainly used for this purpose are the SSRIs (selective serotonin re-uptake inhibitors).

The use of these drugs may seem a little odd, but delaying male climax is a well-known side-effect of certain antidepressants. For most men, that side-effect is unwanted. But for guys with premature ejaculation, it's highly desirable. Antidepressants that are commonly used for this purpose include clomipramine (Anafranil), fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil).

Note however that these are powerful drugs that can last a long time in the body, and have a considerable list of potential side-effects. Before opting for one of them, talk it over carefully with your doctor.

Although they also have not been FDA approved for use to treat premature ejaculation, the antihistaminecyproheptadine and the anti-flu drug amantadine have been used with moderate success to treat delayed ejaculation as well.

Constriction devices

In 2000, a clinical trial of a new technique for treating premature ejaculation was published in the medical press. It was developed at St George's Hospital, London, and involved wearing a slightly constricting ring below the head of the penis for 30 minutes each day. The theory was it would make the organ less sensitive.

Unfortunately, so far the inventors of the device have not been able to publish any results of large scale trials.

Pelvic muscles

Ever notice the tension you feel in your body? Men are less likely to find ways to release pelvic tension. Often, men are engaged in actions and behaviors throughout their lives and during sex that reinforce muscular tension. During sex, if you’re holding your breath, flexing your abs and muscles, or supporting your weight in certain sexual positions (missionary), you’re creating muscle tension that increases the potential for premature ejaculation.

The classic example is men who tighten their muscles as they push out their erection to feel and appear larger to their partner. Since orgasm is muscular contractions that release muscular tension, it’d be wise for us to work on our muscle tension levels. Activities like yoga, stretching, anxiety reduction skills, and working out are all ways to decrease the tension in your pelvic and abdominal regions outside of the bedroom.

It is also recommended to encourage your partner to give you a full body massage. Be mindful of the performance anxiety you experience and the tension release you feel as they touch your stomach, your thighs, your buttocks, and other areas of your body. It’s not about genital stimulation; it’s about managing the discomfort we may feel with our bodies, being touched and feeling exposed. Men that are comfortable with their body image and with being touched often have lower ratings of sexual anxiety.

Another important technique to lasting longer is doing Kegel exercises. There’s no better method to strengthen your pelvic region and to create strong pubococcygeus muscles.

Sex position

Traditionally, the most popular position in the U.S. is male superior (missionary), which is also the position associated most with premature ejaculation. This is because muscular tension is increased as the male is supporting his body weight with his arms and core strength. For a male looking to cure premature ejaculation, utilize positions that limit muscular tension such as female superior (female on top), side-to-side (spooning) and rear entry (doggy style) when both partners are on their knees. Incorporate deep breathing with these sex positions to keep the blood and oxygen circulating.

CBT treatment (stop-start technique)

The CBT (the mainstream cognitive behavioral therapy) may help not just for common mental disorder, such as depression, but also for PE as a method addressing the kind of male thinking that has proved unhelpful. For example, a man may believe that ‘real men’ must thrust endlessly to give a woman pleasure. Such thinking is not only damaging to the man, but wrong. Most women want penetration but also derive great pleasure from love play – often preferring fondling and oral sex to intercourse.

The CBT method also aims to alter the man’s behavior: he is encouraged to masturbate using the stop-start technique to gain more control over his responses and his urge to ejaculate quickly.

Your doctor may recommend that you and your partner experiment with customized 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.

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Herbal treatment

There are many herbs for men's sexual health available in the market today. Some of these, such as yohimbe and maca extracts, are basically stimulants and may have unwanted side effects, especially for older men.

A very promising herb is purified Tribulus terrestris extract, available under the brand name Libilov. Taken regularly, Tribulus has been proven by many scientific medical studies to help men overcome premature ejaculation without side effects. Moreover, the herb helps boost sex drive, increases stamina and control, and even improves sensation.

Helpful Tips

Here are some of the simple lifestyle tips which will help you to delay your PE, while probably not giving you the magic solution on reaching the desirable results. Still, they are easy to follow, and may improve your performance substantially:
  • Masturbate. For many, it is a most natural and cheapest, and easy to arrange solution. From the ancient times, masturbation was considered as effective method of preventing premature ejaculation.
  • Remember to breathe. Believe it or not, breathing deeply and relaxing your body during intercourse can help! Deep breathing is a form of meditation that can sometimes help control the arousal and tension that lead to early ejaculation. Avoid shallow, short breathing, which speeds up the heartbeat and can trigger PE.
  • Drink a glass of red wine. It is another very old known premature ejaculation tip but also true. Here we can talk about two things: first of all the effect that any type of alcohol has: de-concentration. Second, the effect that red wine itself has: a good erection, caused by the growth of blood pressure. Note, when we say a glass, we mean a glass, and not an entire bottle.
  • Smoke medical marijuana. If you leave in the state, where the medical marijuana is not outlawed, and you have a card, you can experiment with smoking a joint before the sexual intercourse. That will amplify your sensitivity, and will delay PE at the same time.
  • Give her a minimum 15 minutes of foreplay, continued by oral sex that ends with an orgasm. During a long prelude your excitation level drops. If your partner accepts oral sex you have the possibility to give her an orgasm even before penetration. Take maximum advantage of this. Your success will bring you confidence in your own forces and so you can have memorable sex.
  • Use a condom. Any kind of condom will work by lowering the sensitivity and extending your play time. Using thick condoms works even better to help you last longer during sexual intercourse! Though these condoms are solely used for the preventing condom breakage during sex, they are also good for sexual endurance as well.
  • Try having sex in the morning. A simple phenomenon, but a true fact! Men perform better after fully rested night’s rest. The reason for this is because a man’s energy level, focus, ease of mind, and health is at its peak at the moment when he awakes from a fully rested sleep.
  • Exercise regularly. Visit the gym everyday or do some other form of exercise such as walking or running. Since premature ejaculation is caused to a large extent due to stress, exercising helps as it not only reduces stress levels but also gets you more in touch with your body. In addition, it can reduce any depression or anxiety that you may be experiencing due to the condition.

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Sources and Additional Information:

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