Hi mnklmd,
Premature ejaculation is a very common condition. More than 10% of
males admit that they occasionally or regularly climax sooner than
they would like to. The Ancient Greeks even told of a god Hephaestus
who was drawn to the Athena and tried to rape her, but ejaculated so
quickly that he spilled his seed over the thigh of the goddess.
How soon is premature? There's no universally-accepted definition.
Obler defines it as reaching orgasm within two minutes of vaginal
penetration. Masters and Johnson define it as the inability to delay
ejaculation long enough to allow the woman to reach orgasm in at least
50% of a couple's sexual encounters, and there are other definitions
too.
These definitions are not satisfactory because the duration that
counts as "too soon" differs for each couple. Some females may need 45
minutes or longer before they have built up to orgasm, whilst some
females can reach orgasm within a minute, and some actually prefer
that the male climaxes quickly.
So, premature ejaculation is not a medical problem unless the couple
considers it to be one. It is widely believed that male humans tend to
ejaculate quickly because natural selection has favored those who are
more likely to father children due to their ability to impregnate the
woman quickly.
The Abakong Institute for Men's Health claims that:
"Premature ejaculation is one of the most common complaints of men and
couples. Adolescents, young adults and other sexually naive males are
more likely to experience this condition than other age groups and
sexually mature males. Such factors as lack of sexual experience, lack
of knowledge regarding normal male and female sexual responses, and
the association of psychological factors (fear, guilt, and anxiety,
for example) with sexual activity, all increase risk. 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)."
Abakong Institute - Premature Ejaculation
http://www.med.abakong.org/institute/en/HTML/dissertations/premature_ejaculation/awiese/
Anyway, if someone ejaculates sooner than they would like to, what can
they do? The possible solutions fall into two categories: medical
management, and self-help.
Medical managements include depth therapies, behavioural therapies,
hypnosis, drug therapy (with afrodex, clomiphene and sargenor),
mechanotherapy (a firm plastic artificial penis that fits over the
male's penis), supportive therapies and retraining programs.
None of these, apart from the retraining programs, has had any
controlled research conducted that yielded results better than
placebo.
Retraining programs (teaching progressive deep muscle relaxation,
stop-start technique and male-female cotherapy) seem to offer
reasonable initial success but there is no controlled research that
has demonstrated lasting results.
According to the Contemporary Urology Archive
http://www.rnweb.com/be_core/content/journals/u/data/2001/0401/cmeejacu.html
current medical management includes behavioural therapy including
retraining programs, medical treatments including SSRIs, and
occasionally creams applied to the penis:
"Currently, behavioral therapy, including the Semans pause maneuver,
the Masters and Johnson pause-squeeze technique, and the Kaplan
stop-start method, are considered the gold standards for the
mechanical treatment of premature ejaculation. While these techniques
are harmless, painless, and have success rates ranging from 60% to
95%, they mandate partner cooperation. Unfortunately, most patients
who respond with improved ejaculatory latency are unable to maintain
these gains over the long term. Because delayed ejaculation is a known
side effect of many psychotropic and antidepressant agents, oral
pharmacotherapy using tricyclic antidepressants, SSRIs, or both has
been instituted as an alternative to behavioral therapy, especially in
patients for whom psychological treatment has failed, or whose
partners were unwilling to cooperate."
Now let's look at self-help techniques, and here there are many. It's
clear from the web pages describing these techniques that the people
doing them often consider the techniques as a way to enhance their
sexual experience rather than as a way to fix something that needs to
be "cured". I'll list a wide range of techniques here. They are not in
any rigorous order, although I'll start with some that are suggested
frequently.
MASTURBATION BEFORE PENETRATION
This is without doubt the most commonly suggested technique. Some man
masturbate before going on a date. Others masturbate shortly before an
anticipated sexual encounter. The general idea is that the second
orgasm of the day will come more slowly than the first, allowing the
male more time inside the female.
MULTIPLE EJACULATION
The idea here is that it doesn't matter if you come very quickly the
first time. Just keep stimulating your partner with your hands, your
mouth, your words, and after a while you'll be ready to penetrate
again, probably lasting longer this time. For a young man the time
between orgasms might be around twenty minutes - and many women will
relish an extra twenty minutes of time devoted to stimulating their
pleasure.
TRYING DIFFERENT POSITIONS
Experiment with different positions, to find ones that exert less
friction on your penis and therefore do not bring on ejaculation so
quickly.
GET THE WOMAN MORE AROUSED BEFORE PENETRATION
Bring the woman to the verge of orgasm using oral sex and/or
stimulation of her body with your fingers. If she is not depending so
much on the stimulation of vaginal sex for her pleasure, she may not
mind if the vaginal phase is short.
CONTROL YOUR THRUSTING
Speed up or slow down your thrusting according to how quickly you are
moving towards orgasm. It may take time to get to know your body
closely enough to control this just right, and if you feel yourself
approaching the "point of no return" you may need to stop thrusting
completely for a few seconds before starting again slowly. This
technique requires understanding from your partner, but is used
successfully by many.
A variation of this technique is to approach the "point of no return"
as closely as possible before backing off. Although there is a risk
that you will musjudge and ejaculate anyway, you may find that you can
avoid this and will experience an intense orgasmic feeling that is not
associated with ejaculation. If you keep the pace just right, the
ejaculation will come quite a bit later.
GIVE THE WOMAN AN ORGASM AFTER YOU EJACULATE
If you can overcome the urge to roll over and go to sleep after your
orgasm, and can devote your attention to pleasuring your partner, you
may find that she doesn't mind the slightest that her orgasm comes
after yours.
WEAR A CONDOM
Wearing a condom reduces the stimulation your penis will receive from
the woman's vagina (despite what the proponents of condoms sometimes
tell us), and is likely to delay ejaculation.
THINK ABOUT SOMETHING ELSE
This is not a particularly romantic option, but many men report that
it works. Simply think about something else. A friend of mine used to
think about Mama Cass Elliot (I'm showing my age here I guess). Woody
Allen, in the movie "Everything you wanted to know about sex but were
afraid to ask" thinks about baseball. The point is: it takes your mind
off the actual experience and helps you last longer - if your partner
doesn't mind you distracting yourself.
MASTURBATE FREQUENTLY
Masturbate frequently, not just when you are expecting to be having
sex. This may reduce your sex drive enough to prolong the time to
ejaculation.
GROW OLDER (!)
Premature ejaculation tends to be less of a problem as men grow older,
for two reasons. Firstly, the body's physical response is slower as we
grow older. Secondly, we get to know the response of our bodies much
better and can tailor our experience more precisely.
There are several techniques that require training and practise:
THE START-STOP TECHNIQUE
"It was developed in 1955 by Dr. James Seamans a urologist at Duke
University ... this technique starts with manual stimulation working
up to sexual intercourse. It is repeated until premature ejaculation
is under control. The technique is simple and it can be practiced
alone or with a partner. The man is stimulated until he feels himself
approaching orgasm and then stops at that point. He then waits for the
sensations to stop, and then the man starts all over again. This
should then be repeated a number of times each practice session, and
the technique should be practiced regularly."
"Stop Premature Ejaculation..."
http://www.longerencounters.com/naturalway.htm
"Now while it is better to learn how to do this with a partner, it is
also possible to do it without one. You can certainly masturbate
yourself just to the point where you are about to have an orgasm and
then stop yourself. Some men are able to learn how to control their
orgasms during masturbation and then carry this skill over to when
they're with a woman."
"Premature Ejaculation"
http://www.global.dm/premature.html
THE SQUEEZE TECHNIQUE
"This method cures the vast majority of people, PROVIDED that both
partners are keen to co-operate ... It is based on a special 'penis
grip' developed by the American therapists, Masters and Johnson. This
finger-grip abolishes the desire to climax, so if the couple use it -
under careful instruction - over a period of weeks, they can usually
're-train' the man so that he can last much, much longer ... The
Masters and Johnson grip really needs to be demonstrated to you
personally by an expert ... basically, it involves the partner placing
her hand so that her thumb is on one side of the man's erect penis
(the nearer side to her - when she is facing him), while her index and
middle fingers are on the other side. The index finger is just above
the ridge of the glans (the 'head' or 'fireman's helmet') while the
middle finger is just below the ridge. When the man feels that he's
near to a climax, he tells his partner. She then squeezes his shaft
firmly between her thumb and the other two fingers (don't worry: it's
painless!)"
"Premature Ejaculation"
http://www.netdoctor.co.uk/sex_relationships/facts/prematureejaculation.htm
Although you have said you are not interested in pills or surgery,
there are several other aids available. Penile rings are used by some,
although there is a risk of damage to the penis and it would be unwise
to try this technique without medical supervision.
Another approach is to apply a desensitising cream to the penis, to
reduce the perceived sensation. There is a risk that the skin will
become sensitized to this cream, which contains a local anaesthetic
such as lidocaine or benzocaine - and there is a risk of side-effects
if too much is absorbed into the body. It also reduces the sensitivity
for the female partner, although that problem can be avoided by using
a condom that has a small amount of the local anaesthetic applied
inside it.
I received a free sample of one of these condoms (a Durex Performa)
and tried it. I found that the sensation was normal until about a few
minutes after I put on the condom, then the sensation gradually
diminished until the tip of my penis had hardly any sensation at all.
Nevertheless, the erection remained and so did the pleasure. The
company claims that the condom "delays a man's orgasm by minutes", but
the anaesthetic effect was so strong that I didn't reach ejaculation
at all.
Here's a news item announcing the product launch:
BBC News - 'Longer lasting' condom launched
http://news.bbc.co.uk/1/hi/health/2049202.stm
and here's an example of an anaesthetic cream:
Maximus Delay Cream
http://www.shytobuy.co.uk/index.cfm?mm=0&fuse=delaycream&CFID=2043523&CFTOKEN=14441326
Finally, although many men consider premature ejaculation to be a
minor problem and find ways to deal with it, there are others for whom
it causes major problems and is most distressing. For those men there
are options of medical treatment and/or support groups and I encourage
you to explore those options if you want to go beyond what has been
discussed here. If you are interested, there are also ongoing clinical
trials that you can volunteer to participate in:
Clinical Trials - Premature Ejaculation
http://www.centerwatch.com/patient/studies/CAT123.html
Finally, here are some additional links that you may wish to browse.
They range from well-meaning amateur pages to professional medical
pages. Even amongst medical professionals this is a fast-changing
field, so don't assume that everything you read is up-to-date or even
true. Also, please note Google's standard disclaimer that this answer
is not intended as a substitute for professional medical advice.
Additional links:
Sex and Romance - Orgasm Olympics
http://www.canoe.ca/LifewiseSexromance01/sept20_premature_print.html
Male control of ejaculation
http://www.luckymojo.com/tknorthaustin.html
Medline Plus Medical Encyclopedia - Premature Ejaculation
http://www.nlm.nih.gov/medlineplus/ency/article/001524.htm
Sex Education Links - Premature Ejaculation
http://www.bigeye.com/sexeducation/prematureejaculation.html
(large list of links on the right-hand side of this page)
Google search strategy:
"premature ejaculation"
://www.google.com/search?q=%22premature+ejaculation%22
lidocaine cream ejaculation
://www.google.com/search?q=lidocaine+cream+ejaculation
(leads to many controlled trial studies)
anaesthetic condom
://www.google.com/search?q=anaesthetic+condom
"premature ejaculation" "support groups"
://www.google.com/search?q=%22premature+ejaculation%22+%22support+groups%22
Regards,
eiffel-ga |
