Premature Ejaculation – Questions and Answers.

To be able to delay ejaculation as long as desired, during sexual intercourse, is a wish almost universally held amongst men.

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For some, however, this ability to postpone ejaculation is not always possible. Many men who regularly reach orgasm and ejaculate perhaps within a minute or two of penetration become deeply emotionally distressed. Without claiming miracles, sex therapists are able to provide help, although success in treating premature ejaculation does depend upon the commitment and cooperation of both the man and his sexual partner.

What is premature ejaculation?

Premature ejaculation, perhaps better described as rapid ejaculation or, coming quickly, is the response of those men who reach orgasm very quickly, either during masturbation or sexual intercourse. It is impossible to define precisely the problem of quick ejaculation because, for some couples, coming quickly does not present any difficulties. If a man is able to maintain an erection and delay ejaculation for only two or three minutes after vaginal penetration, this may be quite acceptable to some women, although it is distressing for many women.

However, there are some men who, for various reasons, either ejaculate before they have penetrated the vagina or very shortly afterwards – so that sexual intercourse only lasts a few seconds. It is therefore important to try and restrict the use of the term “premature ejaculation” only to those situations where one or other ( or both) of the partners is clearly upset, distressed or bothered.

How long does sexual intercourse last, on average?

It is very difficult to give an accurate answer to this question. In the first place, the length of sexual intercourse varies from day to day, and secondly, measurement of the passage of time can be distorted when one is sexually aroused. In his surveys, Kinsey found that about one in three men ejaculated within two minutes of the start of vaginal penetration. However, not all studies have produced the same results, and other researchers have suggested that the average man may last for at least twice that time. However, without a stop-watch by the bedside and a decision in advance to time the length of sexual intercourse (a decision that in itself may change things anyway), all estimates are going to be unreliable.

This is, however, an extremely important question, and it is probably safe to say that, except in the young and in those in new relationships, the length of sexual intercourse is not usually much longer than ten to fifteen minutes. For the majority of couples, sexual intercourse is quite a brief affair, usually lasting less than five minutes. In this case, a man who can postpone orgasm for three minutes is hardly justified as calling himself a “premature ejaculator”.

Problems with erectile dysfunction and rapid ejaculation are the two most frequently experienced sexual problems in men. Problems with premature ejaculation probably outnumber problems with erectile dysfunction and coming quickly is generally better tolerated by couples than loss of penile erection. About 25% of men asking for help with sexual problems at sexual dysfunction clinics are complaining of problems with premature ejaculation, although any attempt to accurately estimate the percentage of the male population who ejaculate quickly is difficult.

How do men ejaculate?

The ejaculation of semen ( the milky fluid containing the sperm) at orgasm is a reflex rather like a sneeze or a cough. Like sneezing or coughing there is a vast individual variation in sensitivity to stimulation. Some men have an extremely sensitive ” hair trigger” ejaculatory reflex, whereas other men need far more stimulation before they become aroused and ejaculate. Indeed, some men are unable to ejaculate at all, a problem known as retarded or delayed ejaculation.

The process of ejaculation takes place in two stages. The first stage is completely involuntary. The second stage is partly under the man’s control. Stage one is the contraction of the tubes that deliver the sperm from the testes, where the sperm are made. The prostate gland and a pair of sacs, known as the seminal vesicles, all of which contribute to the semen, which contains the spermatozoa (sperm) also contract during this first stage. These contractions literally pump the seminal fluid (semen) to the base of the erect penis. During stage two the muscles at the base of the penis contract in a rhythmical fashion and shoot the semen up through the urethra running along the length of the penis, until the semen ( and the sperm) are ejaculated into the outside, via the penile urethra at the tip of the penis. These two stages of ejaculation follow each other very quickly.

What causes rapid ejaculation?

There are probably both acquired (learned) and inborn (genetic), causes for premature ejaculation. To put it simply, some men have inherited rapid ejaculatory reflexes, and these men become sexually excited very quickly. However, this is clearly not the entire explanation, because not only are there various early sexual experiences that affect a man’s ability to control his ejaculatory reflexes, but it is also known that men retain a marked capacity to learn how to control the ejaculatory reflex as an adult. This must be the case otherwise treatments for premature ejaculation would not work. There are very successful treatments which will completely stop premature ejaculation.

Many men are able to recall a particular circumstances when they have felt anxious or worried whilst having sex and as a consequence have come too quickly after vaginal penetration has taken place. It is well-known that anxiety increases the likelihood and chances of premature ejaculation occurring. However, some men are unable to postpone orgasm very long, even under ideal conditions when they are not anxious or stressed at all. For these men, apart from the quick reflexes which they have been born with, certain early experiences during childhood and adolescence may play a part. The exact nature of these early experiences is a matter of debate, but any experience that tends to make a man feel guilty or lacking in confidence or anxious about sex is a likely candidate.

Can a man suffer from premature ejaculation and also have problems with erectile dysfunction?

Usually, but not always, men who ejaculate quickly do not have problems with erectile dysfunction. This is because the mechanisms that maintain and control ejaculation are different from those that are responsible for ejaculation. However, occasionally men have problems with both erectile dysfunction and premature ejaculation. One of the reasons for this is that, if a man suffers from premature ejaculation for a long time, the resulting anxiety that he experiences may also lead to erectile dysfunction. A further problem facing a man with severe premature ejaculation is that he does not have enough time to become fully aroused sexually before he ejaculates, so he may also fail to develop a full penile erection.

Is premature ejaculation a sign of sexual immaturity?

The simple answer to this question is: no. Although many men worry about coming quickly, and often feel sexually inadequate as a result, it is not accurate to suggest that premature ejaculation is a sign of sexual immaturity, even if it were possible to define sexual immaturity. Rapid ejaculation is part of the normal range of human sexual responses, and there is nothing to be gained by labelling yourself as sexually immature. The most important thing is to address the problem and seek advice as soon as possible. The Ejaculation Trainer is an excellent treatment plan for premature ejaculation.

Will changing partners have an effect on my sexual response?

Sexual difficulties cannot be considered in isolation, but only in the context of a relationship. While in some cases, a problem may persist with every partner, there are circumstances where a new relationship may lead to a solution to the problem. This may be because the man feels more relaxed or much better about himself sexually with his new partner. He may for example feel more loved,, less rejected, , more confident or more assertive. Or the problem of premature ejaculation may disappear simply because the new partner is not bothered by the fact that sexual intercourse does not last very long.

Does premature ejaculation improve as one gets older?

It is well-known that at the beginning of their sexual experiences many adolescents ejaculate quickly. However, as they get older greater sexual confidence and experience, enables them to control the time before they have an orgasm. However, for some men this control does not develop as readily and they continue to find it difficult to refrain from rapid ejaculation during sexual intercourse throughout their lives.

How do women react to men who ejaculate quickly during intercourse?

Premature ejaculation is not something that usually develops during the course of the relationship. It is usually there at the beginning (except for those occasions when it is caused by stress, fatigue or illness).

These days most couples have had sex before they decide to live together or settle down permanently, and therefore a woman will have been able to decide whether she and her partner are sexually suited. If premature ejaculation is a problem for her, and persists for some time she must not assume that it will naturally sort itself out without treatment or attention. The couple therefore have three courses of action open to them: accept the situation, seek treatment or end the relationship.

A man who usually ejaculates quickly during sexual intercourse can often last a long time when he masturbates. Why is this?

Both ejaculation and erection are reflexes. This means that they do not normally require the participation of the conscious mind. For example a man with a spinal injury who has no sensation in his lower body can still occasionally get an erection and even occasionally ejaculate. When a man is masturbating he is not using all the centres of his brain, the erection and ejaculation that he enjoys are largely ( though not entirely) reflexive. However, when he attempts to have sexual intercourse, and his emotional involvement switches on other centres in his brain, it is this additional emotional arousal that leads to more rapid ejaculation. In addition, when masturbating a man can go at his own pace. He can stop, start, do anything in fact and he is in control and is not under any pressure to please his partner. He does not have to be worried or concerned at all about his sexual prowess or his partners pleasure, or lack of it.

Why are wet dreams more common in men who ejaculate quickly?

Because men who ejaculate quickly during sexual intercourse have a sensitive ejaculatory reflex, this is more likely to be triggered when they are asleep. For example when they are having an erotic dream these men are more likely to ejaculate.

Does having premature ejaculation affect the number of children you have?

The production of sufficient numbers of healthy sperm is not at all affected by premature ejaculation. But men who are unable to last during sexual intercourse do seem to have slightly smaller families than average. This is probably a result of their higher rate of separation and divorce, and not because of their capacity to father healthy children.

Are there any common medical conditions that are likely to cause premature ejaculation.

As far as is known, there are no mental or physical illnesses that result in premature ejaculation. Some medical reports have suggested that infections of the prostate gland may lead to quicker ejaculation, but these are unproven.

Does it helps to delay ejaculation by masturbating to orgasm shortly before sexual intercourse?

Some men use this method successfully to enable them to last longer during sexual intercourse. Alternatively, other men will have intercourse twice within a short period, lasting longer the second time. Although this idea is a good one for those who are relatively young, it is not always possible for the older man because for him the interval between each orgasm becomes too long. However, generally speaking, regular masturbation is a good way of helping those who ejaculate quickly, and this is recommended in in some treatment programs.

What is the most suitable type of psychological treatment for premature ejaculation?

These days the most widely used approach by sex therapists involved those types of treatment based on those developed by Dr Helen Singer Kaplan.

The most effective treatment resource available on the Internet is the Ejaculation Trainer by Matt Gordon.

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