We are asked many questions here on Clitical, but one of the many we asked often is “How do I deal with premature ejaculation?” Ok, this is a female masturbation site, but if we can help our male members, we do try to answer all their questions. So let me see if I can help those of you who might be having some problems in this area. Read on...

What is premature ejaculation? Premature ejaculation is one of the most common sexual problems, and 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. Premature ejaculation is a problem which plagues up to 36 million men!

As with many sexual dysfunctions, different degrees of premature ejaculation exist. Some men are so severely afflicted that they cannot last long enough to penetrate a woman for intercourse. Some men can easily climax in their pants with the slightest mention of possible sex. Again, what is important is that even if a man cannot last five minutes past the point he wants to, he will fall under the diagnosis of a premature ejaculator. It is important to note that you do not have a premature ejaculation problem unless you FREQUENTLY ejaculate before or shortly after beginning intercourse. Therefore, a one-time episode is not reason to panic or seek medical treatment.

There are a great number of misconceptions and myths about premature ejaculation. The following are NOT typically causes of premature ejaculation:

Men are too excited to focus on bodily sensation.
Some men's first experience with intercourse was in a tense situation where hurrying was beneficial, like in a car, and then learned a bad habit.
Being so concerned about performance they didn't pay attention to their own sensations.
Guilt about enjoying sex or pleasure of any kind.
Worrying about maintaining erections.
Unresolved relationship issues.
General life stress.

When most males ejaculate they tend to quickly lose a usable erection for the simple reason that their discharge has temporarily released a state of elevated sexual tension. The average male in his twenties takes less than three minutes from the time of insertion till he comes. This cheats him of a lot of fun and satisfaction and doubly cheats the unfortunate female he prematurely has an orgasm into.

The first thing a male must keep in mind is that good sex is unhurried sex. The longer he spends in foreplay prior to his first orgasm, the stronger and more enjoyable that first orgasm will be. The compacting of blood in the sex organs builds slowly, inflating the tissues and sensitizing the millions of nerve endings in and around the genitals. Think of an orgasm like a balloon: the longer you blow air into it, the bigger it gets and the louder the bang when it pops.

Orgasm consists of two stages. One begins when the prostate gland, which encircles the urethra like a tiny donut above the base of the penis, contracts and releases its fluids, along with the contents of the seminal vesicle, into the urethra. To most males this feels like you are going to start a good sneeze, but it's too late to stop. Stage two is similar to the sneeze itself. The pelvic muscle contracts strongly around the bulb, forcing the fluid out under considerable pressure. Orgasm is what a man feels when all this is happening. He has probably learned for himself that it is possible to ejaculate without having an orgasm, but he may not yet realize that he can also have an orgasm without ejaculating. That's exactly what you want to learn to do.

How is premature ejaculation caused?
It seems logical that our prehistoric male ancestors were all rapid ejaculators. The Homo erectus who could couple quickly with his mate and rapidly reach ejaculation was then free to deal with enemy tribesman and predatory saber-toothed tigers. The slowpoke got clubbed or eaten. Therefore, only rapid ejaculators survived long enough to sire descendants. Thus, if speed of ejaculation were hereditary, we all should have fast ejaculatory reflexes.

Obviously, the above theory cannot be proven; however, it does contain an element of truth. It is probably "natural" for healthy males to ejaculate quickly. Lasting longer serves no genetic function that we know of.

Lasting is a learned behavior, like learning to dance. It can prolong and intensify pleasure for a man. Also, many women like to experience orgasm - or have been socially conditioned to enjoy orgasm - when the erect penis is inside them. To reach orgasm this way often requires periods of more or less continuous stimulation by the penis.

Most men have experienced this 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. In the early 1990's, research indicated that the pelvic muscles, specifically the muscles that surround the erectile bodies in the penis, are in a hyperactive state in men with premature ejaculation.
Further, it is known that during the ejaculation process there is increased activity of these same muscle groups. Consequently, it is likely that men who have premature ejaculation have hyperactive muscles that are already on their way toward the threshold to producing ejaculations.

Premature ejaculation often occurs during the first experiences with sex, and in this case is most commonly attributed to anxiety. What horse isn’t nervous the first time out of the gate? The majority of men gradually learn to control their orgasm, and have no lasting effect. However, 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.

Some sex therapists feel that whether a man has been circumcised or not makes a difference. The feeling being that those who have not been circumcised might “cum” a bit quicker, while others totally disagree. Men can learn how to prolong their climax whether or not he is circumcised.

So if this is a problem for you, now what? Well, the first advice I can offer is to seek help. This is not like asking for directions. =) You could keep circling the block looking for the final destination, but why not tackle the problem as soon as possible?? As with many problems, there are variances in solving them. So what might work for Bob, might not work for Dick or Harry.

Methods for Helping
The Masters and Johnson Method: 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. 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. At that point, signal your partner to stop (often this is done with a light squeeze or sound) and allow yourself to partially lose your erection. Repeat these steps several times to get the hang of it. You should practice these steps for several days before you attempt intercourse. Once you are ready to try intercourse, lie on your back, and direct your partner to slowly allow you to penetrate. As soon as you feel that you are about to climax, signal to your partner or give a gentle push upward. Relax for a bit, and then begin again. You should soon be able to control your ejaculation and enjoy having sex.

Both partners must sit down and outline a careful plan that requires dedication, patience and commitment. It necessarily begins by prohibiting intercourse for an extended period of time -- at least a week, often a month. This is very important to the man because "performance anxiety" is the greatest enemy of performance. If he knows he cannot have intercourse he is able to relax and focus on the exercises. The first stage is called "sensate focus" and involves his concentration on the process of sexual arousal and climax. He should learn to recognize each step in the process, most particularly the moment just before the "point of no return." Ideally, this stage of treatment requires the man's partner to be devoted to his sensations. In order to regain equality, he should in turn spend separate time stimulating and pleasing his mate, without intercourse.

Although the method is extremely effective, it could take weeks before you get it just right. Remember, be patient, and try not to put too much pressure on the situation. If you do not get it the first time, shrug it off and remember that you are working towards something that takes time. If you still have trouble, do not hesitate to contact a sex therapist for guidance.

2. The 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. This technique progresses from manual stimulation to motionless intercourse to intercourse with both moving. Masters and Johnson reported that 98 percent of couples who learned and used these techniques had success treating premature ejaculation.

3. Stop Start Method: Stop-start involves the partner stimulating the man's penis, except that when the man instructs, the partner stops stimulating the man's penis before ejaculation becomes inevitable. Then as he feels he regains control, he instructs the partner to begin stimulating his penis again. This procedure is repeated three times before allowing the man to ejaculate on the fourth time. The couple repeats this exercise three times a week, until the man has good control, then they progress to stop-start with lubrication, and then intercourse with the woman on top and the man not moving. He again instructs her to stop moving when he senses he is losing control. The couple progresses over subsequent times to the having the man move, then side-by-side intercourse. Instead of stopping and starting, the couple may progress to merely slowing down to enable the man to regain control of his urge to ejaculate. The therapists counseling patients using this stop-start technique report a 90 percent success rate in delaying ejaculation.

4. Other Techniques include the following:
Desensitizing creams are products which purport to lessen the sensations felt by men during intercourse so that they can last longer. The limitation that many men feel these creams have is that they make intercourse less pleasurable by decreasing stimulation. Many of these creams are found on condoms. Unfortunately, sometimes these creams may also numb the partner, thus decreasing the partner's sensation.
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 are certainly worth a try.
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 lying on your back, allowing the partner to control copulation. In this position, you are more relaxed, and can guide your partner easily. Some men report side-lying positions work best for them.

Ensuring you have strong, well developed pelvic muscles will allow you better control and make you more aware of what is happening in your nether regions . Pelvic floor muscles are the ones used to stop and start urination. Hold the muscles for three seconds, relax for three seconds, and repeat ten times. You can do this at anytime and in any place. Eventually, you should be able to work your way up to 100 ten-second contractions per day. More on the “male kegels” can be found HERE.
Self-injection therapy is often used as the core treatment in premature ejaculation, and may be used together with sexual counseling. This therapy ensures a prolonged erection, regardless of whether the man ejaculates or not, thus providing a sense of control. Sexual tension diminishes, as the pressure to perform is no longer "in the way." Men develop improved self-esteem and confidence, allowing full attention to penile sensation, which is essential in controlling ejaculation. As the man develops control of his body, dependence on medication is reduced and eventually eliminated. For some men it may take a few weeks, and for others it may take a few months.

Biofeedback treatment enables a man to become aware of the muscles that control ejaculation and relax them. Monitoring and the use of a rectal plug-like device are used. While men were able to delay ejaculation with this technique, male patients were reluctant to stimulate themselves with something in the rectum. No surprise.

Counseling: Although premature ejaculation is a common and frustrating problem, counseling has proved to be a great success in treating the problem. Frequently, marital and relationship issues may be an underlying cause of premature ejaculation. These issues should also be addressed to improve the success of the therapy.

Drug Therapy: Recently there have been reports in the urology literature of successful treatment of premature ejaculation through the use of low dose antidepressants including Anafronil, Prozac, and Zoloft.

One of the known side effects of these medications when used for depression is significantly delayed ejaculation. In the studies, extremely low doses of the antidepressant medication have prolonged ejaculation by at least 5-10 minutes with very few side effects.

Currently these medications are the most popular treatment alternative selected by our patients. The medication is given approximately four hours before intercourse and will result in a significant delay of ejaculation.

Few patients have described any side effects with this treatment. On certain occasions, the medication is given on a daily basis. It should be pointed out that these medications have not approved by the FDA for treatment of premature ejaculation.

Premature ejaculation is a common problem, so you are not alone out there. Learning to exercise control is not easy, or the world would be filled with skinny nonsmokers. =) If this problem has been going on for some time, it is going to take some effort on your part to reverse the problem. However, many men are truly successful in reversing the problem! Premature ejaculation can be easily countered with patience, effort, and knowledge. Informing yourself is the first step, and once you know about the problem, you are halfway there. Overcoming the mental and physical aspects of this problems are also much easier if both partners are involved, aware of the situation and open to discuss it. Good luck!

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