Premature ejaculation is the most common male sexual dysfunction. In the United States, premature ejaculation affects about one in five men ages 18 to 59. Although the problem is often assumed to be psychological, biology also may play a role. In some cases, premature ejaculation is a secondary problem related to erectile dysfunction. Men who are anxious about obtaining or maintaining their erection during sexual intercourse may form a pattern of rushing to ejaculate.
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. (read more on stronger ejaculation)
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There's no medical standard for how long it should take a man to ejaculate. The primary sign of premature ejaculation is ejaculation that occurs before both partners wish in the majority of sexual encounters, causing distress for one or both partners. The problem can occur in all sexual situations, including masturbation, or may only occur during sexual encounters with another person.
"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.
Ejaculation is a reflex that, once a certain level of stimulation is reached, is automatic. Controlling the ejaculatory reflex requires that the man be able to recognize and regulate the amount of stimulation he is experiencing so that he does not reach the level that will trigger the ejaculatory reflex before he wants to.
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!
stronger ejaculation
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.
The knowledge of normal male and female sexual responses prior to engaging in sexual activity may be helpful in preventing premature ejaculation.
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 stronger ejaculation)
stronger ejaculation - Tips
Make some noise. Love moans help men (and women) relax, and they often help men last longer.
Then move on to masturbation with a lubricated hand. Use saliva, vegetable oil, or a commercial sexual lubricant. For most people, lubricants increase the sensual intensity of erotic fondling. Follow the same program: Masturbate until you approach your point of no return, then back off. Repeat this several times over several sessions.
Some penile skin creams advertise that they help a man last longer. These products contain topical anesthetics that dull sensation in the penis. If you like to play with penile sensation, there's no harm in using them. But they're not a good idea for learning to last longer. They dull sensation. But the key to lasting longer is for the man to become more familiar with what he feels so he can back off from his point of no return while still remaining highly aroused.
