Premature ejaculation
What is it?
Premature ejaculation (PE) means 'coming too quickly'.
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.
Does it matter?
Well, in most cases it does matter - because it makes people unhappy and frustrated. And in severe cases PE can threaten or even ruin a marriage - simply because it spoils the sex lives of both partners. Sometimes, the condition is so bad that the man cannot even manage to have intercourse because he invariably ejaculates before he can get into the vagina. This can be devastating for a man's self-confidence. And it can be hugely frustrating and annoying for his partner, too.
However, most men merely find PE a considerable irritation - a condition that makes them 'come' very soon after they enter their partners (say, after only one to two minutes), so that neither party gets a lot of satisfaction.
What causes it?
For many years, sex experts have tended to say that premature ejaculation is caused by early 'conditioning'. In other words, the man's early, rushed (and perhaps furtive) sexual experiences had to be quick - so as to avoid detection! The idea is that all this hectic rush 'conditions' him to climax as quickly as possible.
However, in our own surveys we have found that many men with PE say that they did not have rushed, hasty early sexual experiences (though others say they did). These maintain that they were 'highly triggered' right from the start of their sex lives.
It's worth noting that from an evolutionary point of view, it's probable that throughout human history, males who climaxed quickly were more likely to have children. (In other words, if you were a caveman who 'came' very fast, you'd stand more chance of impregnating cavewomen - and, therefore, enlarging and strengthening your tribe - than a chap who took all day about it.)
Therefore, we feel that the tendency to reach orgasm quickly may often actually be inherited rather than learned.
Finally, there's no question that anxiety (or 'nerves') plays a part in many cases of PE. 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!
Treatment
So, what can be done for PE?
(i) Very mild cases
If you have very mild PE (for instance, if you can 'last' a good five minutes but would like to last 10), there's probably no point in going to a doctor. Why? Because you should be able to improve matters by simple 'distraction techniques'. This means turning your mind to something else when you sense that a climax is near. For instance, you can:
think very hard about something totally unconcerned with sex.
pinch yourself hard.
bite the pillow.
Some men try to treat themselves with a local anaesthetic gel. This product is advertised to the public as a good way to 'damp down' sexual sensation in the penis. But we do not advise using it firstly, because the local anaesthetic can 'dull' the sex sensation for the partner, and secondly because it can sometimes cause a distressing skin sensitivity reaction.
(ii) Getting help for more severe cases
If PE is causing you more significant problems, it is best to consult an expert for treatment. Some people claim that it's possible to 'self treat'- using the special grip mentioned later on. We don't recommend this: we think you should go to a doctor, psychotherapist or counsellor who is trained in the Masters-Johnson method of curing PE for instance at Relate.
(iii) The Masters-Johnson method
This method cures the vast majority of people, provided that both partners are keen to co-operate (which isn't always the case).
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.
For instance, we have seen many men who had PE so badly that they couldn't even last for 30 seconds. But after careful training with their partners, they were soon able to last as long as half an hour. The programme (and the grip) work for male gay couples as well as for heterosexual ones.
The Masters and Johnson grip really needs to be demonstrated to you personally by an expert. Most couples who try to learn it from the Internet or a book get it wrong! But 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!).
Unless this is done as part of a carefully organised programme, it probably won't work. Our advice: see a professional. In the UK, you can find one through Relate, possibly through Family Planning Clinics, through Couples Counselling Scotland, or through the British Association for Sexual and Relationship Therapy (BASRT).
(iv) Treatment with drugs
In recent years, it has also proved possible to treat PE with antidepressant drugs. That may seem a little odd, but the reason is that certain antidepressants are well known for the side-effect of delaying male climax. For most men, that side effect is unwanted. But for guys with premature ejaculation, it's quite desirable.
Antidepressants that are commonly used for this purpose include clomipramine (Anafranil), fluoxetine (Prozac) and sertraline (Lustral). But please be warned: these are powerful drugs, lasting a long time in the body, and with a considerable list of potential side effects. Before going on to one of them, talk it over carefully with your doctor.
(v) A new anti-PE device
At the start of the 21st century, a clinical trial of a new technique for treating premature ejaculation was published in the medical press. It was developed at St. George’s Hospital, London. It involves wearing a slightly constricting ring below the head of the penis for 30 minutes each day, in order to try and make the organ less sensitive.
Unfortunately, at the present time (2005) the inventors of the device have not been able to publish any results of large scale trials.
Do not attempt any constriction techniques like this off your own bat, please! The new method should only be prescribed by an expert at a sexual problem clinic. It may or may not turn out to be useful.
(vi) A new medication (2005)
At a medical conference we attended in December 2004, it was announced that a new anti-PE medication should be released during 2005.
The product is a tablet called ‘dapoxetine’ (a name which suggests that it is related to Prozac – but much shorter-lasting) . Taken by mouth, it is intended to lengthen the time between a man’s arousal and his climax.
Unfortunately, trial results seen by us in January 2005 do indicate that this is far from a 100 per cent cure for PE! Only about 45 per cent of men said that the drug gave them control that was ‘fair, good or very good.’
Possible side-effects of dapoxetine include dizziness, nausea, insomnia, headache and diarrhoea.
However, if he has bad PE, this drug (which may the first of various such products) would certainly be well worth trying.
2006-11-10 20:38:28
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answer #1
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answered by Krishna 6
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