Overcoming Premature Ejaculation
The one situation in life where you’re trying to be late.
If you’re reading this, most likely you’re a man and not happy with how long you last in bed. I wrote the article from a hetero-male perspective, but most of it also applies to gay men and other owners of a penis.
In many parts of the world, men are defined through power, dominance, and sexual virility. With the advent of feminism, the public image of what it is to be a man started to (very) slowly change, but these changes have found their way into hardly any bedroom yet.
The concept of manliness still includes a hard penis and the ability to satisfy women through penile-vaginal intercourse.
There is a huge pressure on men to perform in bed in order to validate their identity as a man, and ultimately to prove themselves worthy to their partner. This creates stress and anxiety. They, in turn, contribute to sexual dysfunction.
Of course, it is not just society that creates the problem of PE. Men also want to enjoy longer sex, and women have finally found their voice to demand satisfying sexual experiences from their partners. Nowadays, it is (thankfully) not anymore silently accepted that women don’t orgasm and perhaps barely enjoy sex at all. Women demand to be sexually satisfied, and often times in a certain way. If you are a man who loves his partner and you just can not satisfy them the way they want, it can be devastating for your self-esteem, and potentially harm your relationship.
Since sex, and especially sexual dysfunction are still taboo topics, it can be very difficult to talk about them. Hence, men often turn to the internet for help. This is why I wrote this article. I hope that it will help some of you to overcome PE.
It is important to note that PE is a common condition, and it has been studied for decades. This means that you’re not at all alone out there, and that your urologist will most likely have seen many cases of PE and know what treatment options are available.
So what exactly is PE? First I will give you the definition, then I’ll tell you why it’s not so important.
There is no distinct condition of PE, so experts had to draw a somewhat arbitrary line separating PE and not-PE. The most common, but not the only, definition you will find is that lifelong PE means ejaculation always occurs within a minute after starting penile penetration. This time is also called intravaginal ejaculation latency time (IELT). If you lasted significantly longer in the past, but your IELT decreased to less then 3min, this is called acquired PE. The definition of PE additionally includes the inability to delay ejaculation and negative personal consequences.
Dr. Eleswarapu, a urologist at UCLA, notes that not all treatments work equally well for both forms of PE and what works is different from man to man. He also believes that treating PE should not be bound to the definition but rather hinge on whether it can improve your sexual experience.
If you are really unhappy with your IELT, you should consider intervention.
Intervention does not necessarily mean drugs or a medical procedure. In fact, for decades researchers have looked at behavioural and functiona-sexological treatments that try to increase sexual satisfaction by prescribing certain practices and exercises. These treatments are not a silver-bullet — they take some time to implement for each individual, they won’t make you last forever, and are not guaranteed to work, but they have been proven to improve sexual satisfactions for many couples.
In the following, I want to specifically look at these kinds of treatments, since they are not related to drugs. It should be noted though that if you cannot overcome PE by yourself or do not want to attempt behavioral treatments, it would be a good idea to talk to a urologist. There are other forms of treatments out there, like penis-numbing ointments (condoms with numbing agents are available over the counter), antidepressants, or counseling, depending on what the cause of your PE is. Regular cardiovascular exercise might also help with PE.
Behavioral therapies have a good track-record of improving sex lives at least short-term. There are two “classic” approaches: the “start-stop” technique and the “squeeze” method.
Start-stop. This technique dates back to 1956 and follows a very simple pattern: The man’s penis is stimulated (alone or with partner) almost until ejaculation, then the stimulus is removed for a short time to allow for the arousal level to drop. This is repeated 3–4 times before ejaculation. The idea is that the man gets better body awareness and that the spinal chord reflex which leads to ejaculation can be controlled. The negatives are that this training must be done over several months, and not all partners would be willing to participate in it.
Squeeze. The basic idea of this method is from 1970 is that as soon as the man comes close to ejaculation, he or his partner firmly squeeze the tip of the penis to stop the urge, and after arousal has dropped, intercourse can continue. As the start-stop technique, this can break the natural flow of the intercourse, and it requires the partner to be willing to participate.
A functional-sexological therapy has been proposed in 2007. It is based on the premise that ejaculation follows some physiological changes in the body, such as tightening abdominal muscles and quick, shallow breathing. By learning to control these signs of sexual excitement through exercises and sexual practices, men can learn to delay ejaculation. This approach has also been described in the self-help book Confidential File 101.The advantages over the two behavioural treatments are that sexual intercourse is not interrupted and that there is also an educational part of the treatment, that helps thinking about PE the “right” way. This includes information about the stages of sexual excitement, the realization that the journey (intercourse) is as interesting as the destination (orgasm), and the advice not to beat yourself up if you did ejaculate too early.
Any treatment can be supplemented with alternative approaches, such as pelvic floor exercises (especially recommended for acquired PE), regular cardiovascular exercise, or trying different sexual practices that reduce penis stimulation or give you breaks in between.
Kegels, aka, pelvic floor exercises help increasing strength and awareness of pelvic floor muscles. I have been using them myself, and they help me relaxing my pelvic floor and so decreasing my sexual excitement. There are people for whom Kegels work very well, but that does not apply to everyone and probably hinges on the cause of your PE and your dedication to exercise.
Since ejaculation actually consists of three separate events: emission, expulsion (both of them reflexes), and orgasm (a brain response), it is actually possible for men to have multiple orgasms, which is also discussed in a few self-help books, such as the The Multi-Orgasmic Man. The idea is to try experiencing the orgasm while controlling emission and expulsion. Practicing getting multiple orgasms without ejaculation by yourself can also help your body awareness and ejaculation control.
If your main concern is your partner’s pleasure, it is worth considering mixing in some different sexual acts such as fingering and cunnilingus. She Comes First is a book by a self-identified premature ejaculator who is so convinced about cunnilingus that he wrote this book on it. Regardless of whether you have PE or not, adding this practice to your repertoire will most likely make your partner happy if they own a vagina.
I hope that I could give you some pointers to potential remedies in this article. If you’re generally interested in sex and sexuality, check out my compilation of resources on these topics.
