All About Premature Ejaculation (PE)
Premature ejaculation (PE) is the most common sexual complaint reported by men, regularly affecting roughly one in three men. When a man ejaculates too quickly during sex with a partner, he may feel like a bad lover. His partner may consider him a selfish lover. A host of other self-defeating emotions are often thrown into the mix—such as shame, resentment, and inadequacy—that only compound the problem.
While PE can be troubling to men and to their partners, a big part of the problem with PE is the way we approach it. In our sexual mythology, we applaud women who can reach orgasm quickly (and, often, do it again) and yet glorify men who can last like the Energizer Bunny in bed. We've somehow made “fast” a good thing for women and something close to the end of the world for men.
What if we thought of PE as part of the same fabulous sexual responsiveness and body-sensitivity that we applaud women for? It would certainly take a lot of the pressure off the guy—and his penis—which, ultimately, is half the battle in managing PE. The truth is, a variety of techniques can help a man gain more control over when he ejaculates. And there are plenty of ways to enjoy satisfying, responsive sex when a guy does reach orgasm early. Attitude, as the old saying goes, is far more important than aptitude, and it's certainly true when handling PE.
Table of Contents
- Common causes of premature ejaculation (PE).
- The difference between premature ejaculation (PE) and occasionally climaxing quickly.
- Tips for men to last longer during intercourse.
- How to talk with a partner about premature ejaculation (PE).
- Why a partner with premature ejaculation (PE) isn't selfish.
- Premature ejaculation (PE) and older men.
- Treatment options for premature ejaculation (PE).
- How to satisfy a partner, despite premature ejaculation (PE).
- What type of expert to see for help.
PE can feel frustrating, painful, and embarrassing. As a result, men (and their partners) want to know why they have PE and, perhaps more important, how to fix it. The fact is, PE has a variety of causes, physical, psychological, and otherwise, which aren't always easy to untangle.
PE is often a chronic, lifelong problem that begins in adolescence. What was once believed to be an anxiety disorder is now thought to include not just psychological factors but biological origins as well. In fact, researchers now believe that there well may be a genetic basis for chronic PE, not unlike congenital heart problems and other conditions or “defects” present at birth.
Additional factors may contribute to or worsen PE. For example, many men develop PE as a result of hurrying to finish during masturbation, perhaps because of guilt or shame (or maybe just because they have a lack of privacy, with siblings, parents, or roommates who barge in unannounced), which creates a pattern that is difficult to break in adulthood. Other men have disappointing early partner sex experiences, which may cause performance anxiety about their body's response and their ability to please a partner, in turn making it difficult to relax during sex.
Other men develop PE after years of satisfactory ejaculatory control. Reasons include stress or anxiety (inside or outside the bedroom), erectile problems, certain medications, and hormonal disorders or other health conditions. In these cases, PE is usually considered situational or acquired, and develops after men have already had previous sexual relationships without ejaculatory problems.
Every man reaches orgasm before he would like to at one time or another during sex with a partner. While that's not necessarily premature ejaculation (PE), trying to quantify how long intercourse should last depends on a lot of factors: Is PE related to a specific length of time, like the widely used definition of two minutes or less of thrusting? Or is PE when a man reaches orgasm before he and his partner want him to?
Ultimately, one couple's PE is another couple's perfect sex. We define PE as a man reaching orgasm earlier than he and/or his partner would like him to, without the ability to control the timing of his ejaculation. It all depends on the sexual style of the two people having sex, how focused they are on intercourse versus other types of sexual activity, and what each person hopes to get out of sex. For some couples, climaxing early is a regular occurrence that is not troublesome. Sometimes men's partners take their rapid ejaculation as a positive sign that they must be very sexually excited by them (and thus very attracted to them). For others, a man's lack of ejaculatory control affects how satisfying sex is for one or both partners. So much of our sex lives is left to our perceptions.
No magic number for length of intercourse defines PE; rather, it depends on how sex is working for the two people having it. If you or your partner are feeling unsatisfied with intercourse, the focus should not be on time frames, but on expanding your sexual repertoire and learning about sex to increase your feeling of control over what happens to you in bed. You can also explore a range of treatments for PE, whether through education, masturbation exercises, medical treatment, or sex counseling, therapy or coaching.
Most men feel a tremendous amount of pressure to last longer during intercourse. Many want to please partners who may take longer to reach orgasm than they do. Still others derive a sense of sexual confidence by how long they can last in bed.
One thing's for certain: If one or both partners are frustrated by intercourse that doesn't last long enough, an adjustment or two can help. Most important is for a guy to tune into his body. We don't mean this in some fuzzy-wuzzy way, but rather that a guy make an effort to pay attention to the sensations in his body, and his genitals in particular, during intercourse. Most men who struggle with early ejaculation are more focused on their partner or other aspects of sex, than how their body feels as they approach orgasm. (For more on this, see Treatment Options for PE [link].)
It's also helpful to monitor negative thoughts, such as: I always come early or I'm doing a bad job right now. A guy should tell himself that everything is fine and think positive thoughts, while continuing to pay attention to his body. He should feel comfortable stopping or slowing down for a few seconds, if he needs to. And if he does orgasm earlier than he'd like to, it's not the end of the world! There are still plenty of other ways to satisfy a partner. Sex doesn't have to end when intercourse does—a couple can continue to explore each others' bodies in exciting, stimulating ways.
Talking about any sex issue can be intimidating, and premature ejaculation (PE) is one of the more sensitive topics for some men and their partners. The good news is that, with a gentle and sincere approach to communication, talking about PE can open up the sexual dialogue, improve your sex life, and bring you and a partner closer together.
If you're a guy who suffers from PE, start the conversation with as much openness and honesty as you can. Reassure your partner that you care about her or his satisfaction; this isn't about being selfish or lazy. Share what it's like to struggle with PE. Say you're nervous or scared that your partner will think you're bad in bed. Taking this approach tends to personalize it for partners, who will respond with more empathy.
If you're a partner who wants to start a discussion about PE, go gently. Tell your man that he turns you on and that he's great in bed, but that you want to explore other kinds of sexual activity. Ultimately, what men with PE need most is some understanding, and a partner who will roll with the punches and finds other paths to pleasure. There are plenty of ways to be satisfied that have nothing to do with the timing of ejaculation.
In most cases, men with PE are anything but selfish. In fact, the typical guy with PE is usually overly sensitive—often to the point of obsessing over his performance. He may struggle with feelings of insecurity or shame because he doesn't last as long as he'd like to during intercourse. He may not share these feelings with a partner, but you can bet he wishes he had more control over his sexual response to please his partner.
Many men struggle with PE throughout their lives. They often keep silent about it or believe that they'll never please a partner. Ultimately, a healthy dose of understanding is what's needed, followed by some healthy communication. There are plenty of ways to enjoy yourself during sex. Men can show they're not selfish by pleasing a partner in other ways after intercourse and partners can help men feel more successful by staying open to other types of sex play. All it takes is a willingness to explore different kinds of sexual activity and an open mind on the part of both partners and, when needed, sex counseling, therapy or coaching, or medical treatment.
As men age, they are more likely to experience delayed ejaculation, erectile problems, or low desire. They may also develop PE as the result of side effects from certain medications; stress or anxiety; or from resuming sexual activity or finding a new partner after a divorce, break-up or the loss of a partner. Many older men who find themselves dating again struggle with the same performance anxiety that may worsen PE in some younger men.
PE is perhaps the most common male sexual problem, and men and their partners want to know how to fix it—now! There's no magic cure for PE, but you can manage it. Step one is realizing PE may be an ongoing battle, and bringing a sense of compassion and playfulness to the situation.
Research shows that men with PE often don't pay enough attention to the physical sensations in their own bodies during sex. They're so focused on their partner or on performing that they miss the telltale sensation in their scrotum or the tingling at the base of their penis that signals they are about to orgasm. So, while it's good to pay attention to a partner's satisfaction, men with PE need to tune into their own satisfaction. When used as part of a comprehensive PE management program, two promising techniques, the squeeze technique and the start-stop technique, can help cultivate this awareness. Like any behavior modification, they take practice and patience.
Some men may benefit from sex therapy, too, which provides coaching and education for treating PE, as well as the opportunity to discuss other fears and concerns as a result of PE.
Medical treatments for PE include certain antidepressants at specific dosages, which have shown promise by delaying ejaculation. Desensitizing condoms with numbing cream inside are available, too. And promising pharmaceutical treatments are on the horizon. Whether you choose one method or several, relax and know that plenty of people are trying with you.
PE isn’t just a physiological problem, it's also a communication problem. The question comes down to this: How do you and your partner want sex to work? The only way you're going to find out is by discussing and experimenting.
There is a whole world of sexual activities that have nothing to do with when a partner ejaculates—or even with an erection. A man with PE can bring his partner to experience pleasure or orgasm before intercourse with oral sex, manual stimulation, or a sex toy. If a partner prefers to orgasm during intercourse, try some vibrator play or oral sex first to get close to orgasm, then finish with intercourse, knowing it won't last as long. Try to approach PE as a challenge and experiment to discover other ways to share intimacy. A man with PE can use the opportunity to ask his partner about what else is satisfying or something that has been left to the realm of fantasy. Partners can help by switching to other types of stimulation, too, that aren't genital-focused or even orgasm-focused. Have some fun with activities we often gloss over, like kissing, sensual touching and massage, taking a bath together or sex toys. Make sex about more than just intercourse and PE is likely to fade into the background, rather than steal the show.
It can take a lot of courage to seek help for PE. Some men may get help on their own, and others may go with their partner for support and to work through the issue together.
If a man thinks something may physically be wrong, it can be helpful to see a doctor. Making an appointment to see a urologist to do some general tests can help narrow down or rule out the cause.
If the cause may be psychological in nature, it's helpful to see a sex counselor or sex therapist. In general, sex counselors and sex therapists tend to get specific training about sexual issues that sabotage sexual satisfaction. It is important to find a counselor or therapist who is certified by the American Association of Sexuality Educators, Counselors and Therapists (AASECT). As, experts with this certification have had training related to both relationship issues and sexual concerns.
A sex coach can also help individuals and couples. They tend to work on issues in the present, and through communication and home activities help get to the root of the issue providing education, support and guidance for an individual or couple to set and reach their goals. In regard to PE, when the cause is not deeply psychological in nature, coaching can be helpful. Since many people can call themselves a "coach," it is best to find one that has a graduate or doctoral degree in human sexuality and certification from AASECT as a sexuality educator, counselor or therapist.
Following is a quick reference guide for the various academic degrees and licenses a mental health professional might obtain:
* Psychologist: Usually has a PhD, PsyD, or EdD in psychology or other mental health specialty.
* Social Worker: An MSW pr PhD in social work.
* Counselor/Therapist: An MA or MS in clinical psychology, counseling, mental health, or sexology.
* Psychiatrist: An MD in psychiatry, generally licensed to prescribe medication. Some, not all, psychiatrists are trained to provide therapy, in addition to prescribing medication. Many people see a psychiatrist in conjunction with a therapist.
* Sex coach: Ideally has an MA, MS, or PhD in human sexuality.