Some men have acquired, or situational premature ejaculation (PE), which develops after they've already had previous sexual relationships without ejaculatory problems. Acquired PE can be caused by psychological or relationship concerns or by physical conditions like erectile dysfunction and prostate problems, for example.
Premature Ejaculation
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Dr. Harry Fisch, MD , Urology, answeredSee All 2 Answers
Premature ejaculation is the #1 sexual dysfunction, but it's an emotional killer; it makes men feel terrible! Watch as urologist Harry Fisch, MD, explains how men tend to react to PE, and why it's important to address it properly with a doctor. -
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For many guys, premature ejaculation (PE) is a chronic problem that they've been dealing with their whole lives. If your partner has chronic PE, he's probably experiencing the following three issues:
- He doesn't last long. Most guys can actually only have intercourse for an average of about two to five minutes before ejaculating. For men with PE, though, that's an eternity -- most can only last about a minute or less before they come. How do we know this? Researchers have devised a system called Intravaginal Ejaculatory Latency Time (IELT), which measures how long a man can have intercourse before he ejaculates. Different researchers have found different times, but most report that men with PE typically last somewhere between 15 and 60 seconds. Many guys with PE can't even make it to penetration, so they have a hard time enjoying the full spectrum of sexual possibility. They also have a difficult time explaining why it's so hard for them to receive sexual stimulation, which can often leave you feeling confused and less engaged.
- He can't hold back. The old "think about baseball" trick doesn't work for guys with PE. They can't control or delay ejaculation and often orgasm at or shortly after penetration -- whether they want to or not. All men have a point of what we call ejaculatory inevitability during sex, as well as an ejaculatory threshold. That threshold is lower in guys with PE, and their point of ejaculatory inevitability arrives much more quickly. In fact, one of the worst things you can say to man with PE is to ask him to "wait" to have his orgasm, because the stress of being told to wait until he's ready is likely to speed up ejaculatory inevitability In general, men with PE can't last long enough to satisfy a woman during vaginal intercourse.
- PE affects his life. I don't have to tell you that those first two issues do nothing to inspire sexual confidence. Instead, they can trigger a whole range of negative emotions in men with PE: He might feel angry and frustrated with himself, insecure and anxious about his sex life, embarrassed, worried about his relationship, or a combination of these.
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For years, sex therapists have recommended two exercises aimed at increasing the amount of time a man can last if he has premature ejaculation (PE). These exercises, known as the stop-start technique and the squeeze technique have long been advocated as way to manage PE by controlling sexual arousal.
In the stop-start technique, a man or his partner stimulates his penis until he's close to orgasming, then stops all stimulation and starts again. In the squeeze technique, you place your hand so that your thumb is on one side of his penis and your index and middle fingers are on the other side. When he feels like he's ready climax, you squeeze, which supposedly quashes his desire and prevents orgasm. Both techniques were created by sex therapists and are meant to "retrain" men so they can last longer.
Men can practice the stop-start technique on their own, although most experts recommend using the squeeze technique with a partner. The exercises need to be repeated regularly to be effective, and even then they don't have consistent results. -
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The neurotransmitters (chemical messengers) serotonin and dopamine appear to be involved in premature ejaculation (PE). Serotonin increases ejaculatory threshold and delays ejaculation and orgasm while dopamine decreases them. The proper balance of both neurotransmitters is necessary for optimal sexual function. Men with PE have been shown to have lower levels of serotonin, which may help explain why they ejaculate too quickly.
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If a man has premature ejaculation (PE), desensitizing products like creams, gels, sprays, and other numb the head of a man's penis so that his sensation is dulled and he lasts longer. Condoms, particularly those that are thicker or contain topical numbing creams, are often also used for this purpose.
Some guys may wear two or more condoms at once to blunt their arousal. Sold under names like Maintain, Prolong, and Sta-Hard, such products usually contain some sort of numbing agent like benzocaine, an anesthetic also found in many over-the-counter treatments for canker sores and ear pain. -
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The following are common misconceptions women have about premature ejaculation (PE):
- PE is a sign of passion: At first, you might feel flattered by PE. It's easy to misinterpret it as an indication that he's so hot for you, he can't hold back. Some guys may let you believe this -- it boosts your ego and lets him off the hook in disclosing his PE. But doing so sets up a bogus relationship between his sexual disorder and your sexual self-esteem. In most men with PE -- particularly chronic, lifelong PE -- the dysfunction has little or nothing to do with their sex partner.
- He's just not that into you: On the flip side, you may view his PE -- or the way he deals with it -- as a sign that he's not interested. That's because many guys with PE tend to avoid foreplay or sex altogether as a way of hiding the problem -- out of sight, out of mind. Or they may make up excuses to eschew sex after foreplay so that you don't discover that they've already ejaculated. But guys who act like this aren't fooling anyone, and you're left feeling confused and undesired.
- He's sexually selfish: When a guy finishes fast, it's easy to misconstrue his PE as a "wham, bam, thank you, ma'am" approach. While some men may have this boorish attitude, the typical guy with PE is usually overly sensitive -- often to the point of obsessing over his performance.
- He's inexperienced: If you're uninformed about the condition, you might think that PE is a sign of immaturity or inexperience. And who could blame you? If a man doesn't discuss PE and what it really is, your only exposure to it may be the way it's portrayed in movies or TV shows. That leaves you with an image of an overly horny adolescent who can't control himself. Yet, that's often hardly the case. Guys with PE can be very experienced, mature, and tuned in to their partners' needs -- but they can't translate those intentions into actions.
- He's a bore in bed: With time, men with PE often develop a pre-defined plan for sex -- a script, if you will. It can be helpful for dealing with PE, but you don't know why he's following this "script," you're liable to believe that he just wants to have sex the same way, over and over again.
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Do a quick Internet search or check your spam email folder and you'll find all sorts of claims touting various herbs and other supplements as fast, easy treatments for premature ejaculation (PE). No doubt, there's something appealing about popping a pill to solve your problems, particularly when that pill is "all natural." Supplements for PE typically include passionflower, yohimbe, B vitamins, griffonia seeds, and other ingredients that allegedly improve male sexual dysfunction and promote the body's production of serotonin. Some of these products promise increased stamina within just 24 hours.
Sound too good to be true? It is. Despite manufacturer's claims, there's no good clinical evidence to support the use of such supplements. And remember, just because a product is natural doesn't mean it's safe: Some herbs and vitamins can interact with certain medications and we don't always know enough about their potential side effects. -
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Dr. Harry Fisch, MD , Urology, answered
Premature ejaculation is a very common sexual dysfunction, but it is typically not indicative of a more serious medical problem. Watch urologist Harry Fisch, MD, explain why the opposite - delayed ejaculation symptoms - tend to be more serious.
Find out more about this DVD:
Can Premature Ejaculation Be a Sign of a More Serious Health Problem?
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1 AnswerA
Dr. Harry Fisch, MD , Urology, answered
The inability to ejaculate, or delayed ejaculation, can be caused by certain medications, and also too much self-stimulation or masturbation. In this video, urologist Harry Fisch, MD, discusses some of the most common causes of delayed ejaculation.