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ejaculation: what is PE?
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 has been defined as persistent or recurrent ejaculation with minimal sexual stimulation before, during, or after intromission and before the patient wishes it. There have been a number of psychological approaches to treatment, though we could not find any papers that defined the effectiveness of these approaches.
The number 1 cause of premature ejaculation is an uncontrollable and overwhelming urge to ejaculate, produced from over-stimulation by your lover. This urge seems impossible to fight, or so people think! Your body reacts like this to ensure impregnation and the survival of our species. So basically it's a natural reaction. A natural reaction that you can alter. You know it can be altered because some men don't suffer from premature ejaculation and if it's a natural reaction it can't be a physical problem. So there is nothing medically wrong with you.
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. (read more on ejaculation)
More on ejaculation
"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.
Several factors may contribute to premature ejaculation. Psychological problems such as stress, depression and other factors that affect mental and emotional health can aggravate this condition. However, there is growing evidence that biological factors can make some men more prone to experience premature ejaculation.
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!
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).
ejaculation
Premature ejaculation should never be a problem for a considerate lover. A man is usually satisfied after he reaches a climax. If he reaches it before she does and doesn't help her to reach one also, he's inconsiderate whether he climaxes in 2 seconds or 5 hours. Most women take more than 20 minutes to climax with conventional penile-vaginal contact and only 4 minutes when they stimulate themselves because women know more about women than men do.
Squeeze Methods: this method involves either the man or his partner squeezing (fairly firmly) the end or the tip of the penis for 10 to 20 seconds when ejaculation is imminent, withholding stimulation for about 30 seconds, then continuing stimulation. This can be repeated until ejaculation is desired. The stop and start method can be used with the squeeze method as well.
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 impact premature ejaculation can have on men and their partners can be devastating for a relationship and, currently, there are no truly optimal therapies for premature ejaculation," says Jon L. Pryor, M.D., chairman and program director of the Department of Urologic Surgery at the University of Minnesota and lead investigator of the dapoxetine phase III clinical trials. "The results with dapoxetine are compelling. They demonstrate that, for the first time, a medicine can be taken by men on an on-demand basis and provide significant improvement in their premature ejaculation condition. The unique profile of dapoxetine translated into targeted treatment of premature ejaculation compared to existing therapies. There are meaningful improvements in this study across all primary and secondary endpoints, including a three-to-four fold increase in IELT." (read more on ejaculation)
ejaculation - Tips
Make some noise. Love moans help men (and women) relax, and they often help men last longer.
The program we recommend for learning ejaculatory control is very likely to provide your lover with greater sexual enjoyment, but not just because you last longer. Women generally prefer leisurely, playful, whole-body, massage-oriented sensuality that includes the genitals but is not limited to them. Women's main complaints about men's sexual style are that it's too rushed, too mechanical, too eager for intercourse, and that it focuses only on the breasts and genitals. Women generally feel that the whole body is a sensual playground, and can't understand why so many men explore only a few corners of it. Like women, penises generally prefer leisurely, playful, whole-body, massage-oriented lovemaking. The rushed, penis-centered, intercourse-fixated sex style puts a lot of pressure on the penis, and leads to premature ejaculation. But when men make love the way women prefer, whole-body arousal takes the pressure off your penis and you last longer. Basically, if men would make love the way women prefer, women would have fewer complaints, and men would have fewer sex problems.
Once you have good control during masturbation, and appreciate whole-body sensuality, and feel comfortable breathing deeply during lovemaking, then you're ready for the couples program -- if you're in a couple. The couple approach is called the "Stop-Start Technique." First, arrange "stop" and "start" signals with your lover, for example, a light pinch or tap, or a tug on an ear.
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