Premature ejaculation is the most common male sexual dysfunction. In the United States, premature ejaculation affects about one in five men ages 18 to 59. Although the problem is often assumed to be psychological, biology also may play a role. In some cases, premature ejaculation is a secondary problem related to erectile dysfunction. Men who are anxious about obtaining or maintaining their erection during sexual intercourse may form a pattern of rushing to ejaculate.
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 occurs when a man reaches orgasm and ejaculates too quickly and without control. In other words, ejaculation occurs before a man wants it to happen. It may occur before or after beginning foreplay or intercourse. Some men experience a lot of personal distress because of this condition. (read more on ejaculation volume)
More on ejaculation volume
Although premature ejaculation is one of the most common male sexual disorders, it remains widely under-diagnosed and under-treated. Most physicians do not screen for premature ejaculation and patients are extremely reluctant to talk about the condition with their partners or health care professionals. premature ejaculation can have a significant impact on many aspects of a man's life. It can affect his and his partner's sexual satisfaction and their ability to build and maintain relationships - both sexual and non-sexual - and can impact a man's general sense of self-confidence.
Most cases of premature ejaculation do not have a clear cause. With sexual experience and age, men often learn to delay orgasm. Premature ejaculation may occur with a new partner, only in certain sexual situations, or if it has been a long time since the last ejaculation. Psychological factors such as anxiety, guilt, or depression can cause premature ejaculation. Since alcohol can delay orgasm, stopping the regular use of alcohol before sex may also play a role in this problem. In some cases, premature ejaculation may be related to an underlying medical cause such as hormonal problems, injury, or a side effect of certain medications.
There's no medical standard for how long it should take a man to ejaculate. The primary sign of premature ejaculation is ejaculation that occurs before both partners wish in the majority of sexual encounters, causing distress for one or both partners. The problem can occur in all sexual situations, including masturbation, or may only occur during sexual encounters with another person.
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 volume
A common side effect of one class of antidepressants is "sexual dysfunction." These Selective Serotonin Reuptake Inhibitors (SSRI) medications such as Prozac, Zoloft, Paxil, Celexa, and others, actually can inhibit the ability to ejaculate. Because of this, they have been used by some clinicians in the treatment of premature ejaculation. Your doctor or therapist can give you more information on this treatment. Squeeze Methods: this method involves either the man or his partner squeezing (fairly firmly) the end or the tip of the penis for 10 to 20 seconds when ejaculation is imminent, withholding stimulation for about 30 seconds, then continuing stimulation. This can be repeated until ejaculation is desired. The stop and start method can be used with the squeeze method as well.
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.
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. (read more on ejaculation volume)
ejaculation volume - Tips
Then move on to masturbation with a lubricated hand. Use saliva, vegetable oil, or a commercial sexual lubricant. For most people, lubricants increase the sensual intensity of erotic fondling. Follow the same program: Masturbate until you approach your point of no return, then back off. Repeat this several times over several sessions.
Once you have good control during masturbation, and appreciate whole-body sensuality, and feel comfortable breathing deeply during lovemaking, then you're ready for the couples program -- if you're in a couple. The couple approach is called the "Stop-Start Technique." First, arrange "stop" and "start" signals with your lover, for example, a light pinch or tap, or a tug on an ear.
