Premature ejaculation is quite a common medical condition that occurs when a male experiences an orgasm in presence of minimal sexual stimulation or soon after penetration. In the world where a man's successfulness is judged by how long he can make love, early ejaculation can be an embarrassing problem difficult to overcome without professional help. According to a number of studies, PE is a far more common problem in younger males compared to older ones. This has to do with the fact men are likely to control themselves better as they grow older, plus they gain more experience while dating different people.

What is premature ejaculation and how can it be treated?

What’s the No.1 sexual issue that men face today? OK, the guy who said finding a sexual partner wins I’ll give you that one. What’s the second then? Chances are most of you said premature ejaculation, and most of you likely had a reaction to that term you felt some anxiety or thought about clicking back to your streaming porn that’s taking forever to download. It’s time to stop avoiding the issue and look at it. Why? For the simple reason that we only live once and having the best possible sex life should be an item on our bucket lists.
The Diagnostic Statistical Manual of Mental Disorders defines premature ejaculation as a persistent or recurrent ejaculation with minimal sexual stimulation before, on or shortly after penetration and before a person wishes. Wow, that’s not a sexy definition. Personally, I define it as you come quicker than you or your partner wants.How often does this occur in different age groups for men? According to the survey by Laumann et al., 30% of men ages 18-29, 32% ages 30-39, 28% ages 40-49, and 31% ages 50-59 stated climaxing too early was an issue. I know some of you were hoping age would slow things down. If men were asked if they’ve ever had at least one experience of premature ejaculation, almost every guy would get in line for their membership card.  What causes premature ejaculation? There’s not one cause; it’s a combination of factors. Some believe anxiety is the culprit, repetitive learned behaviors, excessive or insufficient arousal, or muscular tension. They’re all associated, and addressing each of them is the key to curing premature ejaculation. Evolutionary psychology suggests men learned to ejaculate quickly to ensure they completed the sex act before a predator attacked, a female escaped, a male interrupted, or to increase the chance of procreation. Maybe we can blame the cavemen? For our purposes, let’s leave the scientists to figure out the causes and let’s focus on tips for curing premature ejaculation.

The causes of premature ejaculation

But how long is sexual penetration supposed to last to be considered successful? When do you have a problem and when is it just your unreasonable expectations standing in the way? As studies show, the period can be very different and vary from man to man. To compare, men with premature ejaculation demonstrated the average lasting time in sexual intercourse of 1.8 minutes, while the average result for men that do not experience this kind of problem was 7.3 minutes.Provides a urology consultation on premature ejaculation.The definition of the problem, however, can be very different: some males consider the 10-15 minutes they can last insufficient, claiming they have PE and seeking medical help. Numerous studies and clinical experience of specialists working on the problem show that most couples consider any result less than 20 minutes less than satisfactory, while any ejaculation occurring in under 10 minutes is considered premature ejaculation.The causes of early ejaculation are being debated to this day, with some scientists considering it an evolutionary aspect. From the evolutionary point of view, males that managed to have an orgasm sooner had a better chance of having children and increasing the number of people in the tribe. Therefore, many scientists now believe the tendency to climax faster is not something that's learnt, rather than something that's inherited. Many cases of PE, however, have an additional contributing factor: anxiety. When the man is anxious, embarrassed, confused etc for any reason, premature orgasm is more likely.

Treatment for more severe cases

More severe cases of premature ejaculation need to be discussed with a sexologist before you take any action, as methods of treatment will vary depending on your needs and budget. The following are the most common solutions for the problem of premature ejaculation: the Masters-Johnson method, taking antidepressants, using drugs administered via nasal inhalation, the cognitive behavior method and using a special constriction device. Each of those treatment options for PE need to be discussed with your doctor to make sure the method chosen is the best and most suitable one for you.

The Masters-Johnson method

The Masters-Johnson method, for instance, is designed for the treatment of premature ejaculation with both partners taking active part. The method is based on using a special penis grip technique developed by two talented therapists Masters and Johnson. The special finger grip the couple is instructed can help the man last longer, although the process of training does not take just one session. The partner is supposed to place a hand on the penis with the thumb on the one side of it, while the index and middle fingers are on the other side. The partner has to squeeze the shaft gently but firmly when the man feels the need to climax.Special constriction deviceUsing a special constriction device is another option that involves wearing a ring providing mild constricting effects below the penis head. The device was designed to be worn for half an hour every day with the intention of making the penis less sensitive. Unfortunately, at this time there is no conclusive evidence on the efficiency of the device for patients with early ejaculation.

Cognitive behavior treatment

Cognitive behavior treatment is another treatment technique for PE that focuses on getting rid of any views that may have proved wrong or unhelpful in the past. The method is intended for changing the behavior of someone affected by the problem, encouraging the man to masturbate alone and stop three times on the verge of an orgasm, before ejaculating. At first, the patient has to masturbate with a dry hand, later, when a certain measure of control over ejaculation is achieved - with a wet hand. This method is efficient and valid for any man, not just those with premature ejaculation.

Drug treatment

Finally, there are special drugs designed for the problem. Certain antidepressants taken several hours before sexual intercourse (mainly from the group of selective serotonin reuptake inhibitors) can delay ejaculation. The main disadvantage of this treatment option for premature ejaculation is that all antidepressants are powerful drugs that should be used only when clearly needed. Dapoxetine (known under a brand name Priligy) is a relatively new SSRI antidepressant used for treating early ejaculation, although the expected effects are achieved in less than 50% of patients.

Treatment Approaches-Mental
  • Now, the good news. Measures can be taken to halt premature ejaculation, or at least to delay it to an acceptable level. These methods can include mental approaches, physical tactics, and drug therapy. Mentally, the idea is quite simple, to reduce the man's excitement level during sex, and thereby lengthen the time before ejaculation. By actively focusing their thoughts during sex on something unrelated, or even unpleasant, men can sometimes sidetrack the rapid ejaculation response. In actuality, this method seldom works very well or for very long. Besides, one's partner is likely to perceive such inaction as a lack of interest or commitment and get angry.
  • If you are in a long-term relationship, you may benefit from having couples therapy. The purpose of couples therapy is two-fold.
  • Firstly, couples are encouraged to explore issues that may be affecting their relationship, and given advice about how to resolve them.
  • Secondly, couples are shown techniques that can help the man to ‘unlearn’ the habit of premature ejaculation. The two most popular techniques are the ‘squeeze technique’ and the ‘stop-go technique’.
  • In the squeeze technique, the woman begins masturbating the man. When the man feels that he is almost at the point of ejaculation, he signals to the woman. The woman stops masturbating him, and squeezes the head of his penis for between 10 to 20 seconds. She then lets go and waits for another 30 seconds before resuming masturbation. This process is carried out several times before ejaculation is allowed to occur.
  • The stop-go technique is similar to the squeeze technique except that the woman does not squeeze the penis. Once the man feels more confident about delaying ejaculation, the couple can begin to have sexual intercourse, stopping and starting as required.
  • These techniques may sound simple, but they do require a lot of practice.
  • Medication
  • As with premature ejaculation, the physical causes of retarded ejaculation can usually be treated. For example, if prescription medication is causing the problem, your GP may be able suggest alternatives.
  • There are also a number of alternative medications that can be used if it is thought SSRIs are responsible for causing delayed ejaculation. These include:
  • amantadine – a medication originally designed to treat viral infections
  • buproprion – a medication originally designed to help people stop smoking
  • yohimbine – a medication originally designed to treat erectile dysfunction
  • These medications help block some of the chemical affects of SSRIs that are thought to contribute towards retarded ejaculation.

Sex therapy uses a combination of psychotherapy and structured changes in your sex life. This can help to increase your feeling of enjoyment during sex, and help make ejaculation easier.Some primary care trusts (PCTs) provide a sex therapy service on the NHS, but others do not. Therefore, levels of availability can vary widely depending on where you live.You can also pay privately for sex therapy. Prices for a single session can vary from around £50 to £80. For information about private sex therapists in your local area you should visit the College of Sexual and Relationship Therapists website.The relationship counselling service Relate also offers sex therapy at a number of its centres; you would be expected to pay for each session.During sex therapy, you will have the opportunity to discuss any emotional or psychological issues related to your sexuality and relationship, in a non-judgemental way.Activities may also be recommended for you to try at home while you are having sex with your partner (you should never be asked to take part in any sexual activities during a session with the therapist).These may include:viewing erotic material prior to having sex, such as videos and magazines, to increase the feeling of sexual stimulationerotic fantasies and ‘sex games’ to make your lovemaking more excitingusing lubricating creams, or jellies, to make the physical act of sex more comfortable and relaxingusing sexual aids, such as vibrators, to increase pleasure.

Retrograde ejaculation
  • Most men do not require treatment for retrograde ejaculation because they are still able to enjoy a healthy sex life and the condition does not have adverse effects on their health.
  • If treatment is required (usually due to wanting to father a child) medicines can be used to strengthen the muscles around the bladder neck. Pseudoephedrine (a medicine commonly used as a decongestant) has proved to be effective in achieving this.
  • However, if the retrograde ejaculation has been caused by significant muscle or nerve damage, treatment may not be possible.
  • Men who want to have children can have sperm taken from their urine for use in artificial insemination or in-vitro fertilisation.
  • premature ejaculation: other treatments
  • Personally, I think desensitizing creams are a short-term fix. Why would you want to reduce your sensation? Isn’t the whole point of sex to feel sensation and find ways to enhance this? Condoms have similar desensitizing aspects but at least protect you from STIs and pregnancy. Ejaculating before intercourse is another way to last longer. The more times we ejaculate in a sexual experience, the longer lasting we become and less semen we produce. Lastly, some MDs are prescribing psychotropic medications known for their sexual side effects of delaying ejaculation. Interesting  you last longer and feel less depressed or anxious.
  • manage premature ejaculation
  • Most of you can eradicate premature ejaculation in a few months if you stick to your program. There are a lot of self-help books, videos, therapists, and sex coaches that can help you through this process. One issue with training yourself to last longer is that once you start lasting longer it’s difficult to go back to quickies. But, I guess most of you can live with long sessions of intense sensation, arousal and partners screaming your name in ecstasy. It’s a decent trade-off.
Solutions for premature ejaculation

No matter what the cause, with a little tweak here and a little squeeze there, you’ll be able to hit a solution that works for you. Here are a few things to try out.Conditional Response Retraining:  We become conditioned to go off in specific ways learning new ways to respond can alter our surefire mechanisms and thus slow us down. For example, if you masturbate with the same hand every time, try switching to the other; or learn to bring yourself to the point just before the moment of inevitability and then stop stimulating yourself until you go soft, then start up again. This will allow greater and greater control over time.Stop and Go Technique: The PC muscle controls all nether functions; if you can learn to use it to control the flow of your urine, you’ll be able to control your other flow as well. So whenever you pee, try stopping yourself mid-flow, count to three, and then start up again. The more you practice with it, the better control you’ll have over your PC muscle and thereby ejaculation.The Squeeze Technique: Any pressure applied to the freanulum the peak-like junction just below the head can stop a man from reaching orgasm, by blocking sensation in one of the most sensitive areas. So just as you feel yourself getting close, you may want to pull out, apply pressure there for a few seconds and then re-enter her, while she lays real still, minimizing stimulation.The Scrotal Pull: If you don’t like pulling out, you can grab the top of your scrotal sack  or train your partner to do it and pull it away from the body, just as it starts to rise into it. This will stop the orgasm and buy you more time. Of course the key lies in you doing it before it’s too late.
Arousal Control: During masturbation, a man can practice decreasing his arousal bit by bit, one point at a time, on a mental scale between 0-10, thereby learning better control, which can be eventually applied during intercourse.

Desensitization: 

Anything from “doublebagging” the penis with two condoms, to applying a desensitizing spray/cream on it, to wearing a cock-ring or a desensitizing condom, can work to slow you down. Of course, none of these can help you with the anxiety that’s an overwhelming concern for a lot of guys. 

 Surgery:

One study reported that a short frenulum was found in 43% of individuals affected by lifelong premature ejaculation. Frenulectomy was effective in relieving the problem and the authors recommended excluding short frenulum in all patients with lifelong premature ejaculation.

Complications

Premature ejaculation may have a significant adverse effect on both self-confidence and the relationship. One study reported that premature ejaculation can lead to sexual dissatisfaction, a feeling that something is missing from the relationship and an impaired sense of intimacy. If the condition remains untreated it can lead to increased irritability, interpersonal difficulties and deepening of an emotional divide.

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