Premature Ejaculation
What is premature ejaculation?
Premature ejaculation is one of the most common sexual problems. The condition is most often described as being an inability to delay ejaculation to a point when it is mutually desirable for both partners. The definition of when ejaculation is premature is subjective. While some men have trouble controlling their orgasm upon entry, others consider 5-10 minutes of copulation too little time. How long a man is able to last is not an important factor in diagnosing premature ejaculation. The crucial issue is if a man is satisfied with the length of coitus.
How is premature ejaculation caused?
Most men have experienced this problem at some time in their life. Premature ejaculation was once thought to be caused by drugs or certain infections such as urethritis, but popular wisdom suggests it is more psychological in nature. The exact cause of the condition, however, still remains a mystery.
Premature ejaculation often occurs during the first experiences with sex, and in this case, is most commonly attributed to anxiety. The majority of men gradually learn to control their orgasm and have no lasting effect. Some men will develop a longer-term anxiety toward sex, which can cause a prolonged experience with premature ejaculation.
Sexual behaviour is also a factor. The longer the period since the last ejaculation, the quicker young men typically reach orgasm. Younger men tend to ejaculate more quickly than older men, as experience seems to be associated with ejaculatory control.
What can I do to delay ejaculation?
Masters and Johnson's method
The best way to fight premature ejaculation is to learn how to identify and control the sensations leading up to orgasm. The Masters and Johnson method does just that. The Masters and Johnson method requires a great deal of patience and practice but is very effective. Follow the steps below.
You may want to start with masturbation. Begin by bringing yourself to a point relatively close to climax, and stop, allowing yourself to relax before starting again. Each time you do this, bring yourself closer and closer to orgasm until you cannot control it any longer. Repeating this procedure a number of times on different occasions will help you learn where your point of climax is. Once you have an idea about your "point of no return" you should be able to direct stimulation from your partner leading up to orgasm.
The best way to practice this method is with a caring lover, although you can try to prepare by yourself. With your partner, engage in non-coital stimulation (like masturbation or oral sex) and gradually allow yourself to reach that point just before ejaculation. At that point, signal your partner to stop (often this is done with a light squeeze or sound) and allow yourself to partially lose your erection. Repeat these steps several times to get the hang of it.
You should practice these steps for several days before you attempt intercourse. Once you are ready to try intercourse, lay on your back and direct your partner to slowly allow you to penetrate. As soon as you feel that you are about to climax, signal to your partner or give a gentle push upward. Relax for a bit, then begin again. You should soon be able to control your ejaculation and enjoy having sex.
Although the method is extremely effective, it could take weeks before you get it just right. Remember, be patient and try not to put too much pressure on the situation. If you don’t get it the first time, shrug it off and remember that you are working towards something that takes time. If you still have trouble, don’t hesitate to contact a sex therapist for guidance.
Squeeze technique
The squeeze technique is really just a variation of the Masters and Johnson method, except that the assisting partner squeezes the tip or base of the penis just before the point of climax to essentially cancel the orgasm. The "squeeze" forces blood out of the penis and reduce the erection. You may want to use the squeeze technique if the Masters and Johnson method alone is not working.
Other techniques
Desensitizing creams are products that purport to lessen the sensations felt by men during intercourse so that they can last longer. The limitation that many men feel these creams have is that they make intercourse less pleasurable by decreasing stimulation.
Masturbation is a technique used by many young men to increase their level of control. It is thought that masturbation before sexual activity will lessen the amount of desire a man feels thereby increasing control. This technique is not very effective, however, as the level of arousal is only part of what contributes to the condition.
Condoms are an effective means of reducing the amount of stimulation experienced during sex. Some men find that a condom helps them prevent premature ejaculation by lowering their arousal. If one condom does not decrease the stimulation enough, then put on one more. Condoms provide excellent protection against STDs and pregnancy, so they’re certainly worth a try.
Sexual positions can affect a man's ability to control his ejaculation. The typical "missionary" position (on top of your partner) is not the best position while attempting to control ejaculation. Try laying on your back, allowing the partner to control copulation. In this position, you are more relaxed and can guide your partner easily.
Dyspareunia (painful intercourse) In Women
Why do I experience pain during intercourse?
Sex should never be painful. If you are having pain during sex, stop. Sex is supposed to be pleasurable, and pain indicates that something is wrong.
In many cases, your partner's actions can cause pain, such as going too fast or penetrating from an awkward position. Never hesitate to ask your partner to slow down or move to make you more comfortable.
Another common cause of pain during sex is the lack of natural lubrication in the vagina. Antihistamines or other medication may be the cause of this problem. Additionally, natural changes in the vagina during menopause may cause a reduction in natural lubrication. Or, in some cases, more foreplay may be required to produce a sufficient amount of vaginal lubrication. Adding a water-based lubricant to the proceedings may help alleviate this problem.
Failure of the vagina and uterus to respond to sexual arousal can also cause discomfort. The vagina may be too snug for intercourse or the uterus may not be raised so that the penis comes in contact with the cervix during penetration. Use manual penetration to explore the level of arousal before engaging in intercourse.
The muscles near the vaginal opening may also be the cause of some discomfort during intercourse. Various problems can occur depending on the state of these muscles. Vaginismus is a condition in which these muscles are extremely tight and cause intercourse to be painful. One way to determine whether vaginismus is a problem is for the woman to examine herself with her fingers. If she feels that the vaginal walls are tighter than normal, then it may be vaginismus. Vaginismus is not a permanent condition. It is usually caused by nervousness or anxiety. Make sure that you engage in foreplay before intercourse. This will help you produce a healthy amount of lubrication and should help you to relax. Try to reduce the pressure to perform. Fortunately, few women have vaginismus so severely that they have to go for treatment. For most women, it is just important to relax.
Any inflammation of the vagina has the potential to cause problems during sexual intercourse. Infections of the vaginal region due to yeast, herpes, etc. can make intercourse uncomfortable. Creams, fabric or perfumes may also cause irritation which makes intercourse painful. It is best to examine the vaginal area or the products that are being used to determine whether they are causing this problem.
Difficulty with intercourse may also be experienced by women for whom it is the first time having sex. Breakage of the hymen and other sensitive tissue can cause discomfort during penetration. The best advice is to take it slow or begin with forms of penetration other than intercourse.
Some psychological factors may contribute to dyspareunia as well. Those who have been through a sexually traumatic experience or have feelings of guilt associated with sex may find intercourse to be painful. These issues are best resolved by consulting a trained Sex Therapist.
What can cause painful intercourse in men?
Discomfort during intercourse for men can be attributed to a number of causes. One cause could be a result of snugly fitting foreskin. Occasionally during a man's first attempt at intercourse, a tight foreskin will cause retraction to be painful. After a while, the foreskin loosens, and intercourse is more comfortable. Secondly, any lesion on the skin of the penis can make intercourse painful. These lesions may be due to unlubricated masturbation, rapid intercourse or STDs. The blisters caused by herpes can also make intercourse extremely painful. Finally, conditions like Peyronie's disease which cause a bending of the penis may also make intercourse painful. If you can not determine why intercourse is painful then please consult your physician.
Impotence/Erectile Dysfunction Causes
Erectile dysfunction can be caused by any number of physical and psychological factors. In general, ED is divided into organic (having to do with a bodily organ or organ system) and psychogenic (mental) impotence, but most men with organic causes have a mental or psychological component as well.
Erection problems will usually produce a significant psychological and emotional reaction in most men. This is often described as a pattern of anxiety and stress that can further interfere with normal sexual function. This "performance anxiety" needs to be recognized and addressed by your doctor.
Almost any disease can affect erectile function by altering the nervous, vascular, or hormonal systems. Various diseases may produce changes in the smooth muscle tissue of the penis or influence mood and behaviour.
Vascular diseases account for nearly half of all cases of ED in men older than 50 years. Vascular disease includes atherosclerosis (fatty deposits on the walls of arteries, also called hardening of the arteries), a history of heart attacks, peripheral vascular disease (problems with blood circulation), and high blood pressure. Prolonged tobacco use (smoking) is considered an important risk factor for ED because it is associated with poor circulation and reduced blood flow in the penis.
Trauma to the pelvic blood vessels and nerves is another potential factor in the development of ED. Bicycle riding for long periods has been implicated, so some of the newer bicycle seats have been designed to soften pressure on the perineum (the soft area between the anus and the scrotum).
- Medications used to treat other medical disorders may cause ED.
- Systemic diseases associated with ED
- Diabetes
- Scleroderma
- Renal (kidney) failure
- Liver cirrhosis
- Hemochromatosis (too much iron in the blood)
- Cancer and cancer treatment
- Diseases of the nervous system associated with ED
- Epilepsy
- Stroke
- Multiple sclerosis
- Guillain-Barré syndrome
- Alz
- heimer disease Trauma
- Parkinson disease
- Respiratory disease associated with ED: Chronic obstructive pulmonary disease
- Endocrine conditions associated with ED
- Hyperthyroidism
- Hypothyroidism
- Hypogonadism
- Penile conditions associated with ED
- Peyronie disease
- Priapism (painful, abnormally prolonged erections)
- Mental conditions associated with ED
- Depression
- Widower syndrome
- Performance anxiety
- Nutritional states associated with ED
- Malnutrition
- Zinc deficiency
- Blood diseases associated with ED
- Sickle cell anemia
- Leukemias
- Surgical procedures associated with ED
- Procedures on the brain and spinal cord
- Retroperitoneal or pelvic lymph node dissection
- Aortoiliac or aortofemoral bypass
- Abdominal perineal resection
- Proctocolectomy
- Radical prostatectomy
- Transurethral resection of the prostate
- Cryosurgery of the prostate
- Cystectomy
- Common medications associated with ED
- Antidepressants
- Antipsychotics
- Antihypertensives (for high blood pressure)
- Antiulcer drugs such as cimetidine (Tagamet)
- Hormonal medication such as Zoladex, Lupron, finasteride (Proscar), or dutasteride (Avodart)
- Drugs that lower cholesterol
- Alcohol abuse
- Mind-altering agents such as marijuana and cocaine.
Premature Ejaculation Treatment
Psychotherapy
Most treatments for this disorder are behavioural in nature. Unless this problem is caused by taking another medication that lists premature ejaculation as a side effect, the solution to this problem will require practice on your own or with your partner. (If it is caused by another medication you are being prescribed, it is suggested that you contact the physician who prescribed the medication and discuss medication solutions to the problem, which are easily obtained in most instances.)
The most common treatment for this disorder is to become more familiar with the feelings and sensations surrounding the time leading up to ejaculation. By learning to become more familiar with these sensations, you can then slowly learn how to predict when the upcoming ejaculation will occur and gain more control over them. One popular method taught both in self-help books and by therapists is the "stop and start" method. A person begins masturbating (alone or with a partner) and a moment or two before ejaculation, stops. Masturbating resumes when the person has come down from his closeness to ejaculation. Again, masturbation is stopped as the man approaches ejaculation. This is done 5 or 6 times.
After doing this exercise a few times, the man will hopefully become more aware of the sensations leading up to ejaculation and be able to better control them by stopping intercourse for a few minutes. Of course, sexual play doesn't need to end at this time. Combining this method with taking one's mind off of the "performance" aspect of sexual intercourse (and instead thinking about other, non-related activities) can lead to greater control over one's ejaculation.
With medicines, such as serotonergic anti-depressants or SSRIs (Seroxat, Prozac, Cipramil, Zoloft) the ejaculation can be delayed. This medication improves the transmittal of serotonin (a substance in the body) between two nerves. These medicines need to be taken 2 to 3 hours before the expected sexual activity. This can be experienced as a disadvantage because it reduces the spontaneity around making love. One has to take into account that side effects may happen. Good results have also been obtained with sexological treatments. This treatment is aimed at giving the man control over the ejaculation. A part of this is to withdraw the penis while making love to stop stimulation and thus prevent premature ejaculation.
Herbal Treatment
Eros is a herbal alternative to erection enhancer which treats the causes of erectile dysfunction and Premature Ejaculation. The recommended dose is 1 capsule taken 3 times a day, with or without food. We recommend 3 bottles to start. Continued use of Eros even after the symptoms have improved is recommended to keep your sexual desire and performance levels in optimal condition - After COMPLETING 3 months of Eros you can drop your dosage down to one capsule per day for maintenance.
Premature Ejaculation Control
The practice most frequently suggested by sex therapists is called the stop-start method, says Mark Schoen, PhD, a sex educator and producer of the instructional video You Can Last Longer: Solutions for Ejaculatory Control (Sinclair Institute). You basically rock along until you feel an orgasm rushing on. At that point, you freeze, either inside your lover or after you withdraw (she’ll probably feel less bereft if you stay inside). Gain control of your senses. Ask yourself what day it is. Give your penis a moment to cool. Start again. Repeat as needed. Nothing could be simpler. An orgasm, you see, is one part lust, two parts friction. Stop the friction, stop the orgasm. Sam Fields discusses in an article how to improve your sexual performance ability.
To get the most out of the stop-start technique, you should endeavour to bring yourself closer to the detonation point each time you do the technique. That way, you’ll learn to read your body’s signals, monitor your level of excitement, and nail the exact millisecond you need to stop. Over time, experts say, you’ll be able to come so darn close to ejaculation without actually spilling any seed that you’ll almost think you have. Yet you’ll be able to stay erect and keep on going and going with only an occasional moment’s hesitation (perpetually blissful) like some kind of sexual legend.
But will Betty Lou see you as a Casanova or as a cad whose constant stopping and starting makes her feel like your sparring partner? "Most women are very supportive. Why wouldn’t they be? The key is to make sure that the two of you talk about what you’re doing and why," says Rohn Friedman, M.D., director of the human sexuality program at Boston’s Beth Israel Deaconess Medical Center.
Of course, your teammate doesn’t always have to be present for you to practice. Sex experts heartily advise you to take advantage of those tender moments when you’re making love to yourself to practice the stop-start technique. (doesn’t sound quite as pathetic as "masturbating" does it?)
You can’t see it, but there’s an ejaculatory duct down at that low-profile soft spot between the scrotum and the anus (closer to the anus). Press on it as you feel almost ready to spout (firmly for at least three or four seconds), and you will stop the ejaculation. The pressure can be applied with your fingers or hers, or, if you’re flexible enough, just about anything-your heel, for example. (Sit cross-legged atop one heel, then have your sweetheart straddle you, facing in or out.)
"Like any other muscle, you need to exercise the PC," says Banker-Riskin. But first, you need to identify it. Take a leak and stop the flow without using your hands. Now do that same trick (without actually urinating), and squeeze hard. You just flexed your PC muscle. Hold for one second. Now relax. Repeat. Do a set of 10 once every day. After a week, add another set per day. Build up until you’re doing five sets of 10 every day. "By that stage," says Banker-Riskin, "you will likely notice your new power. Proceed with your sex life, halting ejaculation as you would with the stop-start or press technique, but using your newly developed mighty PC muscle instead."
Premature Ejaculation Correction
* Relax. This is the most important thing you can do. Have a bath, use deep-breathing techniques or buy relaxation tape.
* Tackle relationship issues. Be sure that your head and heart are in the mood for sex as well as your body. If you're unhappy about something with your partner then sort it out first.
* Exercise your pelvic floor. Many men say they are able to delay ejaculation by squeezing or pushing their pelvic floor muscles.
* Stop and start. This is the most common technique used in psychosexual therapy. Practise stimulating yourself to the point just before ejaculation, then stop. Start again when the sensations have subsided. Repeat this three times. You should find the length of time before each stop gets gradually longer.
* Change strokes. If you feel you've gained more control with the stop-and-start technique, try changing your stroke to something less stimulating rather than stopping altogether.
* Change positions. During intercourse, try the stop-and-start technique when the sensations become strong. When you're more confident, try changing positions rather than stopping.
You may want to start with masturbation. Begin by bringing yourself to a point relatively close to climax, and stop, allowing yourself to relax before starting again. Each time you do this, bring yourself closer and closer to orgasm until you cannot control it any longer. You may want to practice with the aid of a lubricant. We recommend trying Astroglide. Repeating this procedure a number of times on different occasions will help you learn where your point of climax is. Once you have an idea about your "point of no return" you should be able to direct stimulation from your partner leading up to orgasm.
The best way to practice this method is with a caring lover, although you can try to prepare by yourself. With your partner, engage in non-coital stimulation (like masturbation or oral sex) and gradually allow yourself to reach that point just before ejaculation. At that point, signal your partner to stop (often this is done with a light squeeze or sound) and allow yourself to partially lose your erection. Repeat these steps several times to get the hang of it. You should practice these steps for several days before you attempt intercourse. Once you are ready to try intercourse, lay on your back and direct your partner to slowly allow you to penetrate. As soon as you feel that you are about to climax, signal to your partner or give a gentle push upward. Relax for a bit, then begin again. You should soon be able to control your ejaculation and enjoy having sex.
Although the method is extremely effective, it could take weeks before you get it just right. Remember, be patient and try not to put too much pressure on the situation. If you don’t get it the first time, shrug it off and remember that you are working towards something that takes time. If you still have trouble, don’t hesitate to contact a sex therapist for guidance.
Premature Ejaculation Exercises
The squeeze technique is commonly executed with the premature ejaculator laying down, knees bent, so that his partner who is sitting up and facing him, can sit between his legs. The partner stimulates the genital area until the penis is erect, then applies a squeeze lasting 3 or 4 seconds by holding the penis with the thumb on the ridge between the head and shaft, and the first two fingers situated on either side of the ridge opposite the thumb. This squeeze eliminates the desire for ejaculation. This technique should be repeated several times during genital stimulation so that foreplay can continue without ejaculation. Once mastered, this method can be used in intercourse where a woman (or male partner) inserts her/his partner's penis and sits on top of him motionless. When he feels close to ejaculation, s/he lifts her-/himself off and administers a squeeze, then returns to the sitting position. Over time this results in ejaculatory control.
"Like any other muscle, you need to exercise the PC," says Banker-Riskin. But first, you need to identify it. Take a leak and stop the flow without using your hands. Now do that same trick (without actually urinating), and squeeze hard. You just flexed your PC muscle. Hold for one second. Now relax. Repeat. Do a set of 10 once every day. After a week, add another set per day. Build up until you’re doing five sets of 10 every day. "By that stage," says Banker-Riskin, "you will likely notice your new power. Proceed with your sex life, halting ejaculation as you would with the stop-start or press technique, but using your newly developed mighty PC muscle instead."