Premature ejaculation is the most common sexual dysfunction impacting men, affecting nearly 30% of males, regardless of age, ethnicity, or socio-economic condition. The good news is you can do something about it without the need for costly medical treatments or drugs. Here’s what you need to know.
Premature ejaculation is defined as rapid ejaculation that occurs following sexual stimulation and has the following key features:
In a study of over 1500 men, The Journal of Sexual Medicine reported that the average time between penetration and ejaculation for a premature ejaculator was 1.8 minutes, compared to 7.3 minutes for non-premature ejaculators. Another study of 500 couples across five countries measured time from penetration to ejaculation, with time to ejaculation ranging from 33 seconds to 44 minutes with the median being 5.4 minutes.
Premature ejaculation (PE) can be psychological and/or biological and can occur because of over- sensitive genital skin, hyperactive reflexes, extreme arousal or infrequent sexual activity. Other factors are genetics, guilt, fear, performance anxiety, inflammation and/or infection of the prostate or urethra and can also be related to the use of alcohol or other substances.
PE can be lifelong or acquired and sometimes occurs on a situational basis. Lifelong PE is thought to have a strong biological component. Acquired PE can be biological, based on inflammation/infection of the reproductive tract or psychological, based upon a situational stressor.
PE can sometimes be related to erectile dysfunction (ED), with the rapid ejaculation brought on by the desire to climax before losing the erection. Emphasis on ejaculation as the focal point of sexual intercourse tends to increase the performance anxiety that can initiate the problem.
Once PE has occurred and established itself, fear of and mental preoccupation with the issue can actually induce the unwanted rapid ejaculation, creating a vicious cycle.
The following are the most practical ways to help reduce premature ejaculation without the use of medication or costly medical treatment.
Strengthening your pelvic muscles is one of the most effective ways to prevent the onset of premature ejaculation. The pelvic muscles, which support and help control the penis, have the ability to short circuit premature ejaculation when they are actively engaged immediately before ejaculation is allowed to occur.
For most men these muscles are weak and get weaker with age, increasing the likelihood of premature ejaculation. A recent study found pelvic muscle exercise to be more effective than medication in treating premature ejaculation.
This technique requires you to slow the pace of pelvic thrusting and varying the angle and depth of penetration before the “point of no return.” When done in conjunction with engaging your pelvic muscles this approach becomes very effective.
If slowing the tempo is not sufficient to prevent the PE, one may need to stop thrusting completely while maintaining penetration in order for the ejaculatory “urgency” to go away. Once the sensation to ejaculate subsides, pelvic thrusting may be resumed. Again, engaging the pelvic muscles once you’ve stopped thrusting helps to greatly reduce the sensation.
Originated by Masters and Johnson, as imminent ejaculation approaches, the penis is withdrawn and the head of the penis is squeezed until the feeling of ejaculation passes, after which intercourse is resumed. Although effective, it requires sexual interruption, is cumbersome and demands a very cooperative partner.
Since premature ejaculation can have psychological origins, talking to a sexual therapist can be an excellent approach. Remember guys, there is nothing wrong with talking about our sexual health - in fact, we should do more of it!
Andrew Siegel, M.D., Urologist, Co-founder of The Private Gym, and author of the highly acclaimed book, Male Pelvic Fitness, Optimizing Your Sexual and Urinary Health.
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