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ejaculation problem: what is PE?
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 usually an unmistakable experience to a man or his partner, but through the years it has been difficult for professionals to agree on a precise definition of this common sexual concern. As Helen Kaplan, M.D. and other professionals point out, this phenomenon may occur because the man is unable to recognize that he is about to ejaculate. And even when he does recognize he is approaching ejaculation, he feels he is unable to control or delay the process.
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 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. (read more on ejaculation problem)
More on ejaculation problem
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).
"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.
A premature ejaculation CURE (different approach) provides you with the physical and psychological discipline that can be applied for an eternity. A CURE is usually obtained through more clinical approaches for dealing with premature ejaculation (i,e. therapy, hypnotherapy, mental and physical conditioning).
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.
ejaculation problem
However, the primary treatment of ejaculatory control is helping a man, by various techniques, to repeatedly focus his attention on the increasing erotic sensations in his body as he approaches orgasm. By increasing his awareness of the buildup of these pleasurable sensations he is better able to judge where he is along the path of reaching an orgasm and ejaculating. (Note: orgasm and ejaculation are separate events, caused by separate systems in the male's body, though they usually occur at the same time. The term orgasm is commonly used when speaking of a male's ejaculation. Technically, however, orgasm is just the peak of the intense pleasurable feeling that usually follows a man being highly sexually excited.
"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."
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.
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. (read more on ejaculation problem)
ejaculation problem - 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.
Start with masturbation with a dry hand. By varying how you caress your penis, you can learn to stay highly aroused for quite a while without coming. When you feel yourself approaching your point of no return, simply back off a bit, stroke yourself more gently or not at all, and stay aroused without ejaculating. Then as you feel yourself getting a little distance from your point of no return, return to more vigorous self-stimulation. Repeat this several times over several sessions. Approach your point of no return, then back off. For most men, it doesn't take long to develop good ejaculatory control while alone.
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.
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