Treat Premature Ejaculation Effectively and Quickly! 

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Premature Ejaculation (PE)

The loss of ejaculatory control can represent a significant reduction in a man's quality of life, especially if it stops a couple enjoying sexual activity. Premature ejaculation (or rapid ejaculation) has usually been considered a psychogenic problem caused by sexual performance anxiety. But nowadays, a more integrated approach which takes into account both psychological and neurobiological factors is regarded as useful.

Defining Premature Ejaculation

Clinical definitions of premature ejaculation have been hard to achieve. Objective definitions based on things like the number of penile thrusts before ejaculation, or the time to ejaculation, are now discredited, and subjective criteria such as ejaculation occurring before the desired time, lack of ejaculatory control, and the level of a man's partner's dissatisfaction with the timing of ejaculation have come to the fore.

Prevalence of premature ejaculation

Something like 30% of men between 18 and 59 believe that they reach orgasm too soon. (In his pioneering studies in the 1950's, Alfred Kinsey found that 75% of men ejaculated within 2 minutes of penetration.) Since the definition of premature ejaculation is so subjective, it's hard to get a clear picture of the true frequency of PE, but estimates range from 4% to over 30%.

Diagnostic Criteria for PE

• Persistent ejaculation with little sexual stimulation before, on, or shortly after intromission (penetration) and before a person wishes it. But this is less useful than it seems because youthfulness, novelty of the sexual partner or situation, and recent sexual activity can all affect time between penetration and ejaculation.
• Marked distress or relationship difficulty.
• Absence of drug usage, substance withdrawal, a general medical condition or similar.

Etiology of PE

PE can be caused by psychogenic and organic/neurobiological factors. As far as the psychogenic aspects are concerned, PE usually involves individual patterns of sexual response in a couple, with one or both partners unhappy with the length of sexual intercourse. But to show how complicated this condition might be, consider some of the factors implicated in PE: low testosterone, low magnesium levels in semen, hyperthyroxinemia, short frenulum, reflex hyper-excitability, penile hypersensitivity (whatever that means), prostatic inflammation and bacterial infection, chronic prostatitis, and various neurologic disorders including multiple sclerosis.......

Treating PE

The degree to which a doctor has a role to play in treating PE is questionable. Mostly, they should be ruling out underlying medical conditions, especially when a man complains of the sudden onset of premature ejaculation or of ejaculating very rapidly. A therapist or website like this can probably best provide effective treatment strategies for PE, offering support to both a man and his partner - something that is often too much to ask of a doctor. However, the information and advice provided below may help to alleviate anxiety about PE.

Information for Men Worried About Premature Ejaculation

• PE is very common - roughly one third of men ejaculate before they wish to.
   
• It can be useful to focus on enjoyment and physical pleasure for both partners and not on the question "how long will I last?" since this tends to turn sex into a competition or performance.
   
• Talking about your PE with your partner and hearing about their concerns and desires often lowers any sense of pressure to last longer.
   
• Not talking to your partner about your concerns or any pressure you feel during sex will only make things worse.
   
• Knowing as much as possible about your partner's sexual interests and needs will help you get a more realistic view of sex. For example, a man may think that his partner will only be satisfied if he is able to thrust vigorously for a long period of time. Not many women would agree with this. Many find non-genital stroking, mutual masturbation, and oral sex just as pleasurable.
   
• Men who have not been able to ejaculate for a long time will come more quickly. If a man masturbates and ejaculates several hours before he has sex he may last longer when he does so.
   
• Men can talk to their partners about techniques to slow down ejaculation, such as the ones on this website.

Where both partners are highly motivated to control premature ejaculation, the results of self-help techniques are likely to be good. Men who have occasional sexual partners and couples with deep relationship issues are, fairly obviously, less likely to be successful.

Doctors or therapists can effectively provide brief psychosexual counseling and good information on premature ejaculation. However, the origins of  premature ejaculation can be complicated and in cases where it is caused by,  or is the effect of deep personal or interpersonal issues, psychosexual counseling or information from a website like this one is essential.

Recent improvements in knowing about the organic and non-organic factors associated with premature ejaculation has lead to the development of new treatments that involve drugs. For example, there are suggestions that a treatment approach which combines psychological and/or effective behavioral counseling with the drugs paroxetine and Viagra is very helpful. Increasingly, combining drug and non drug treatment is seen as a useful primary approach to treating premature ejaculation.

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