Men with PE have a lack of ejaculatory control, which can cause psychological distress among men who suffer from it. Likewise, partners of men with premature ejaculation express dissatisfaction with the timing of ejaculation, and may also experience reduced self-esteem and sexual pleasure.
Premature ejaculation is one of the most common sexual problems. The condition 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 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. (read more on ejaculation control)
More on ejaculation control
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!
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.
Several factors may contribute to premature ejaculation. Psychological problems such as stress, depression and other factors that affect mental and emotional health can aggravate this condition. However, there is growing evidence that biological factors can make some men more prone to experience premature ejaculation.
The main cause of premature ejaculation is biological. Upon sexual stimulation and arousal, the normal physical responses for a man and a woman are similar. A man will achieve a climax and then ejaculate about two to three minutes after penetrating the vagina. Women will reach orgasm about 12 to 14 minutes after intercourse occurs. Many women do not achieve orgasm especially if only penetration of the vagina by the penis occurs during sexual activity. Many women achieve orgasm through other methods of sexual stimulation although for some, orgasm is not achieved under any circumstances nor with any type of stimulation. Roughly 10% of women fall into this category. Other causes of premature ejaculation include psychological factors such as marital and relationship issues; performance anxiety (with partners new to each other and especially in the inexperienced partner); fear (associated with concerns regarding getting caught or discovered, sexually transmitted diseases or potential pregnancy ); and guilt (believing the activity is sinful e.g., premarital or extramarital sex).
ejaculation control
The stop-start method 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.
Your health professional may recommend that you and your partner practice specific techniques to help delay ejaculation. These techniques may involve identifying and controlling the sensations that lead up to ejaculation and communicating to slow or stop stimulation. Other options include using a condom to reduce sensation to the penis or trying a different position (such as lying on your back) during intercourse. Counseling or behavioral therapy may help reduce anxiety related to premature ejaculation.
"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." 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. (read more on ejaculation control)
ejaculation control - Tips
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.
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 -- their point of no return, 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 your penis, and you last longer.
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 your penis and you last longer. Basically, if men would make love the way women prefer, women would have fewer complaints, and men would have fewer sex problems.