Premature ejaculation (PE) is far more common than you might think. Luckily, it can be treated effectively.
Premature ejaculation is one of the most common types of sexual dysfunction in men. In fact, according to an extensive review published in the Journal of Sexual Medicine, approximately 30% of men will deal with some form of premature ejaculation in their life!
This is a problem, because Premature ejaculation can have overwhelming effects on a man’s self-esteem, relationships and his or his partner’s general quality of life.
Luckily, PE is also one of the most treatable sexual conditions. In this article, we describe PE, its causes and the different types of the disorder. We will also guide you through the pros and cons of each available treatment option, so that you can decide what would be best for you.
What Is Premature Ejaculation?
While PE has been defined in different ways by different experts, the formal definition of PE is as follows:
- Ejaculation which occurs within one minute of penetration, and
- An inability to delay ejaculation on all or most vaginal penetrations
But we, like many other sex therapists, prefer to define premature ejaculation more broadly, as:
ejaculation that occurs before a man or his partner wishes it to.
Most men are unaware that there are actually four different types of premature ejaculation:
- Lifelong – PE that occurred from the first sexual encounter.
- Acquired – PE that suddenly begins in a man who has had normal sexual performance up until then.
- Variable – PE that occurs irregularly and inconsistently, perhaps with one partner or only with specific partners.
- Subjective – A condition in which a man thinks he experiences PE, but a medical doctor or sex therapist determines that there is no issue.
The good news is that all four types of PE can be treated! But, to understand how to manage PE, we first need to understand what causes it.
The Causes of Premature Ejaculation
There are many possible underlying causes of PE. For many men, however, the exact cause can’t always be pinpointed. Nonetheless, we’re still able to treat PE successfully because all men who suffer from PE experience the same difficulty in identifying their ‘point of no return’. What does this mean?
Imagine trying to learn to walk on a tight rope without being able to feel when you’re about to fall. Because you can’t recognize the point at which you start to lose balance, you don’t have an opportunity to develop the strength and skills that you need to stay upright on the rope!
PE is similar, because men with this condition cannot identify the feelings that happen right before orgasm – this is the point of no return. In other words, men with PE are unable to recognize that they are about to come until it’s too late. This makes it difficult for them to pace themselves and prevent ejaculation from happening too soon, which also means that their stamina never has a chance to improve.
So, how can you improve your ability to identify the ‘point of no return’ in good time?
How to Overcome Premature Ejaculation
Behavioral sex therapy exercises can help. These are special masturbation or full penetration exercises that are designed to help men stop premature ejaculation. These exercises will teach you to better identify your ‘point of no return’; and also to use this ability to improve your stamina and delay orgasm.
During the exercises you will practice identifying your ‘point of no return’ as well as prolonging the time until ejaculation.
An exercise session looks something like this:
- You or your partner will stimulate your penis until your arousal level almost reaches climax.
- You cease the stimulation, so your arousal level will subside.
- Once you’re relaxed, you will continue with the stimulation.
- You will need to repeat this process several times. With practice, the time until ejaculation will increase, and your control will improve.
During the exercise session, one of two sex therapy techniques are used to cease the stimulation. The first is the ‘squeeze technique’. Here you stop the stimulation and firmly squeeze the glans (head) of your penis to help stop ejaculation. the second is the ‘stop-start method’. As the name suggests, this requires you to stop the stimulation before orgasm so that your arousal levels can be reduced before you start up again.
The full treatment protocol includes a number of steps and contains different stimulation techniques and/or positions. Each step provides a higher stimulation level than the one before. The pace in which you progress between the exercises varies from person to person, but it usually takes between 4 and 12 weeks.
At the end of the treatment you should be able to last longer and to control your ejaculation simply by changing the strength and speed of the stimulation, just like a man without PE does.
Who Is This Right For?
These exercises provide an excellent solution for those who are looking for a long-term solution and are willing to put in the time and effort. Here is a list of pros and cons.
- Long-term solution – The main advantage of behavioral sex therapy exercises is that they provide a long-term solution. By training yourself, you acquire the ability to control your own ejaculation. Many men find this incredibly empowering.
- Can improve your relationship – If therapy is done with a partner (although this is not mandatory), this has the potential to bring you closer together as a couple, thereby increasing intimacy and strengthening the relationship.
- Proven to be effective – These exercises have been in use by sex therapists as a primary treatment option for PE for over 5 decades. Numerous studies have shown their efficacy. This recent 2006 shows an 8.5-fold increase in the duration of intercourse for PE patients.
- Spontaneous sex life – You will not be dependent on any medications or other materials. This allows you to enjoy a stress-free and spontaneous sex life.
- Results take time and effort – It usually takes between 4 and 12 weeks to see results; and during this time you will be required to commit to the process. Not all men are motivated enough to put in this effort. But the power of a satisfactory sex life should never be underestimated; and if PE is something that you seriously want to overcome, we believe you will find it worthwhile to give this a go.
- Not easy without guidance – It is very important to know when to move between the exercises for the treatment to properly work. A personalized treatment plan, created and supervised by a sex therapy professional, is the best way to get results.
Where to Seek Treatment
There are a few ways that you can get treatment. You can seek out professional help and schedule a session with a certified sex therapist. He or she would be able to guide you regarding how to perform these exercises and will create for you a personal exercise plan. You will return to the sex therapist for follow-up meetings so he or she can adjust your exercise plan according to your progress.
Dealing with Premature Ejaculation
While sex therapy exercises may be the only way to truly improve your ejaculatory control, there are a few other solutions that help men deal with the symptoms of premature ejaculation.
Prescription Anti-Depressants and Pain Killers
Some sex therapists ‘off-label’ prescription anti-depressants or pain killers in men struggling with premature ejaculation. Off-labeling means taking advantage of the side effects of a drug that was designed to treat one problem, in order to treat a different problem.
For example, some common anti-depressants from the SSRI group such as Prozac and Seroxat may have the outcome of delayed ejaculation. The downside to this, however, is that the person taking the pills may also experience a loss of sexual desire.
Who Is This Right For
While many men are reluctant to take psychiatric pills, this may be a viable option for those who are open to it. Here is a list of pros and cons.
- Easy – The most obvious advantage is the minimal effort required. After your trip to your doctor’s office, all you have to do is take the drug as instructed.
- Effective – For some men the drugs can be highly effective. If this is the case for you – and you don’t experience any side effects – this could be an excellent solution.
- Can cause side effects – These drugs can cause various side effects such as headaches, dizziness, nausea, dry mouth, drowsiness, and reduced libido.
- Loss of spontaneity – The cost of taking certain drugs is a loss of spontaneity in the bedroom. Anafranil (Clomipramine), for example, is only effective six hours after administration. This means you either have to take them daily or six hours before every sexual encounter.
- High costs – The costs can become significant over time.
- Temporary solution – The most important disadvantage, in our opinion, is the fact that the drugs treat the symptoms without actually addressing the underlying problem. In other words, once you stop taking the pills, your PE is likely to return.
Where to Seek Treatment
Since all of these drugs require a prescription, you would have to schedule an appointment with a licensed doctor or a sex therapist. You can find a list of sex therapists near you on the AASECT website.
Desensitizing Sprays, Creams and Condoms
Another solution that has been around for many years and which increases ejaculation latency time is the use of numbing materials. These usually come in the form of a spray or cream which you apply to the penis. Today, there are also condoms which have the numbing material inside them. In our experience, condoms are not practical, because the desensitizing material takes about 5-20 minutes to be absorbed.
Who Is This Right For
We’ve listed the pros and cons to help you find out if desensitizing materials are right for you:
- Effective – The desensitizing materials have been shown to be effective. They have been marketed for over 25 years. Some studies have shown that desensitizing materials can help men last up to 6.3 times longer.
- Quick results – This is a quick and easy solution; and unlike the drugs we mentioned before, a prescription is not required.
- Decreased enjoyment – Since the material numbs the penis, your own sexual satisfaction could be decreased. Still, some men put their partner’s needs before their own and feel that this is a small price to pay.
- Loss of spontaneity – The material should be applied to the penis while flaccid, 20 minutes before penetration.
- Risk of numbing the partner – There is a risk that the material could pass on to your partner’s vagina, numbing her as well. It is important to make sure the material is completely absorbed before penetration or oral sex.
- Not easy to use – Finding the right dosage is a delicate process. Not applying enough will be ineffective, while applying too much will greatly decrease your sexual enjoyment and may actually render you unable to achieve an erection.
- A temporary solution – The most significant disadvantage, in our opinion, is the fact that this is only a temporary solution. Your PE will likely return once you stop using the desensitizers.
Where to Seek Treatment
You can purchase desensitizing sprays, creams or condoms in many pharmacies without a prescription. They are also available in many online stores.
Ineffective Things Men with Premature Ejaculation Do
Many men find PE embarrassing and are reluctant to talk about it with a professional. While there is some good advice available online, there is also a lot of inaccurate and unhelpful information, from ineffective tips to counterproductive ideas. Here is a list of bad advice that you should beware of:
Relying on the Second Round
Masturbating before sex or having more than one orgasm during sex is a common tip for men to last longer. And while it is true that some men are able to last longer the second time round, this does not solve the underlying problem; especially as the older you get, the longer it will take you to get an erection after ejaculation. Some of our clients are older men who used to rely on the second time and decided to treat their problem when they could no longer get a second erection quickly enough.
Also, another thing to take into account is that many women may not want to have sex a second time. All this means that treating the problem is a far better solution than relying on everything going smoothly the second time round.
Trying Different Sex Positions
It is true that it is easier to control ejaculation in some sex positions, but if you truly suffer from PE, relying on a sex position to solve the problem is unrealistic. If you decide to treat PE, you could try those positions after completing treatment (just as some men without PE use different positions to pace themselves).
Drinking Alcohol or Using Illegal Drugs
You don’t need us to tell you that this is not a long-term strategy. Excessive consumption of alcohol or illegal drugs poses a serious health risk, and engaging in these behaviors every time you want to have sex is a bad idea. But other than the health risks, it is also counterproductive. As we mentioned earlier, PE is caused by an inability to identify the feelings and sensations that you experience before orgasm. Instead of being more in touch with your body, alcohol only reduces your focus and perpetuates your problem.
To Sum Things Up
Premature ejaculation is a very common sexual dysfunction, and it is nothing to be ashamed of. Luckily, it is also one of the most treatable sexual conditions. Behavioral sex therapy exercises are one powerful solution that could help you overcome PE; and you can learn to use this method with the help of a sex therapist or with the PE Program. There are also several temporary solutions that could help you treat the symptoms, such as desensitizers or anti-depressant medications.
Don’t let PE discourage you! Take action sooner rather than later, and this could all be behind you.