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.
Definitions
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:
- The
average lasting time of men with PE was 1.8 minutes.
- '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.
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.
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:
- 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).
- Her
index and middle fingers are on the other side.
- The
index finger is just above the ridge of the glans (the 'head'), while the
middle finger is just below the ridge.
- When
the man feels that he's near to a climax, he tells his partner.
- 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.
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.
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.
Sources
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