Premature ejaculation: What Can We Do?

Premature ejaculation (PE) is the most common sexual dysfunction in men younger than 40 years. Most professionals who treat premature ejaculation define this condition as the occurrence of ejaculation prior to the wishes of both sexual partners.

This broad definition thus avoids specifying a precise duration for sexual relations and reaching a climax, which is variable and depends on many factors specific to the individuals engaging in intimate relations.

An occasional instance of premature ejaculation might not be cause for concern, but, if the problem occurs with more than 50% of attempted sexual relations, a dysfunctional pattern usually exists for which treatment may be appropriate.

Faced with involuntary ejaculation, most men try to distract themselves during intercourse, believing that by thinking about other things, they can trick themselves into lasting longer. Usually, that only makes things worse.

It is important for the man to not tune out his body. BUT TO TUNE INTO IT.

He needs to become more familiar with his different levels of sexual arousal. He also needs to recognize how he feels as he approaches ejaculation. Once he can recognize how he feels close to ejaculation, it's not difficult to make small sexual adjustments that allow him to remain highly aroused without ejaculating.

Sexual arousal is a four-phase process.

In the Excitement Phase, breathing deepens and erection begins.

In the Plateau Stage, erection becomes full and he will feel highly aroused.

When arousal builds to a certain point, the next phase occurs, Orgasm with Ejaculation Phase.

Then during the Resolution Phase, breathing returns to normal and erection subsides.

The key to ejaculatory control is to extend the Plateau Phase, to maintain arousal without triggering Orgasm and Ejaculation.

To learn ejaculatory control:
    * Don't use drugs or alcohol. They're distracting and they interfere with the self-awareness crucial to learning ejaculatory control.

    * Appreciate whole-body sensuality. Men often think sex happens only in the penis and only during intercourse. That view is a one-way ticket to uncontrolled ejaculation (not to mention erection problems, and women with those proverbial headaches).

The best sex involves head-to-toe arousal. Men learning how to approach -- but not arrive at – ejaculation, need to appreciate whole-body sensuality, the pleasure potential in every square inch of the body.

Whole-body sensuality releases tension. Tense bodies that have no other outlet often find release through involuntary ejaculation. But as you learn to appreciate sensual pleasure from head to toe, whole-body arousal takes the pressure off the penis, and he may last longer.

    * Whole-body sensuality means relaxation, but the "relaxation" involved in great sex is not the kind that includes an easy chair, a six pack, and Monday Night Football. It's the kind you feel after a hot bath or a good massage. In fact, bathing or showering together before lovemaking can help men relax and appreciate whole-body sensuality -- and last longer.

    * Breathe deeply. One very easy way to stay relaxed while making love is to breathe deeply. The body has a natural tendency to breathe deeply during sex. When men work to control their breathing, they often sacrifice ejaculatory control. Try breathing deeply. Let your breath go. Many men are amazed how much this one little change improves their ejaculatory control.

    * Start with masturbation with a dry hand. By varying how he caresses his penis, he can learn to stay highly aroused for quite a while without ejaculating. When he feels himself approaching ejaculation, simply back off a bit, stroke more gently or not at all, and stay aroused without ejaculating.

Then as he feels himself getting a little distance from ejaculation, return to more vigorous self-stimulation. Repeat this several times over several sessions. Approach the point of ejaculation, then back off. For most men, it doesn't take long to develop good ejaculatory control while alone.

    * Then encourage him to move on to masturbation with a lubricated hand. For most people, lubricants increase the sensual intensity of erotic fondling. Follow the same program: masturbate until he approaches ejaculation, and then back off. Repeat this several times over several sessions.

    * Once he has good control during masturbation, appreciates whole-body sensuality, and feels comfortable breathing deeply during lovemaking, then he is ready to try this with a partner. This is called the "Stop-Start Technique." First, encourage "stop" and "start" signals with his lover, for example, a light pinch or tap, or a tug on an ear.

    * Then, his partner strokes his penis by hand as he lies still. When he approaches ejaculation, have him give the "stop" signal. His lover immediately stops stroking and simply holds his penis gently, as he continues to breathe deeply and pays close attention to the sensations he is feeling. When he no longer feels close to ejaculation, have him give the "start" signal, and his partner should begin stroking him again. How many stops and starts should you do? Do what feels comfortable for you – there is no exact method that is perfect for everyone.

      Once he’s gained good ejaculatory control with his partner’s hand, try the same stop-start procedure with oral caresses.  Once he has gained good control orally, try intercourse. 

Here are some other suggestions for lasting longer:
    * The man-on-top (missionary) position can be fun, but it's harder for most men to control their ejaculatory timing, because they have to hold themselves up. Try making love with the woman on top. This position is more relaxing for men, and it often helps ejaculatory control.

    * It's important to understand that learning ejaculatory control takes time and practice. You may feel a little awkward along the way. Try to maintain a sense of humor about any accidental spills.

    * Finally, 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 the penis and he can last longer.

If you are still having concerns with premature ejaculation, please see your health care provider.  They may be able to provide you with another level of control, which may include taking medication.