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In terms of pure embarrassment and frustration, premature ejaculation is a unique bane of man’s existence. But it’s a unique thing many of us have experienced. According to the Cleveland Clinic, it’s the most common sexual condition in men under the age of 40. With practice, it usually becomes easier to pace yourself, extending the time between arousal and ejaculation to increase your partner’s sexual satisfaction, along with your own.
- PE (premature ejaculation) is a sexual dysfunction in which a man ejaculates sooner than he or his partner would like.
- It’s a common disorder, affecting up to 30% of men.
- PE can be lifelong or acquired.
- There are several treatment options for PE, including exercises you can do yourself or with a partner, products, or medication.
But what if PE is something that persists for years? And what if you’re one of the many guys who wish they could delay ejaculation and last longer, whether you technically have PE or not? Here, we’ll take a look at what premature ejaculation is and several ways you can prevent it.
What is premature ejaculation (PE)?
Also known as rapid ejaculation, premature climax, or early ejaculation, PE is a sexual dysfunction in which a man ejaculates sooner than he or his partner would like.
But how soon is too soon? That’s something scientists have wrestled with for a while. The first description of premature ejaculation in medical literature came—none too soon—in 1887 (Gross, 1887). In 2014, the International Society of Sexual Medicine defined PE as:
- Ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience (lifelong PE), or a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired PE)
- The inability to delay ejaculation on all or nearly all vaginal penetrations
- Negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy (Parnham, 2016).
However, we realize this definition does not apply to everyone—including those who do not participate in vaginal sex. Perhaps a more appropriate definition would be to boil it down to three things:
- Brief ejaculatory latency
- Loss of control
- Psychological distress in the patient and/or partner
And it’s pretty common: PE affects about 30 percent of the male population, making it the most common sexual dysfunction in men (Parnham, 2016).
“We believe it to be caused by a hyper-sensory neurological connection between the penis, typical the glans, and the brain,” says Seth Cohen, MD, a urologist with NYU Langone Medical Center in New York City. “Where the penis starts to feel pleasure, the brain gets triggered, and ejaculation is an autonomic, reflexive arc. Most people could control it, but not everybody has that control.”
How long should it take you to come, anyway?
The short answer is, as long as you and your partner want. Everyone has different sexual needs, and the desired duration of intercourse is something that’s highly individual.
But it’s also important to manage your expectations. You may find research on the subject a little surprising: Although people brag about “taking hours” or “going all night,” not many of us are actually doing it. In one study, researchers asked 500 heterosexual couples to time themselves having sex—that is, to press a stopwatch at vaginal penetration, then ejaculation—for four weeks. The reported times ranged from 33 seconds to 44.1 minutes, with a median of 5.4 minutes (Waldinger, 2005).
According to a 2019 Twitter poll of 2,380 people conducted by GQ, 61 percent of people who are regularly on the receiving end of penetrative sex wanted that penetration to last 5 to 10 minutes (not including foreplay). Twenty-six percent said they wanted it to last longer than 11 minutes (Benoit, 2019).
In 2016, the International Statistical Classification of Diseases and Related Health Problems boiled things right down, defining PE as “The inability to control ejaculation sufficiently for both partners to enjoy sexual interaction” (Parnham, 2016).
Bottom line: If you’re ejaculating too quickly for your or your partner’s satisfaction, it’s “too soon.” And you can take several steps to change that.
How to stop PE
There are several treatment options for PE, including exercises you can do yourself or with a partner, products, or, if necessary, medication.
The squeeze method
This is a commonly recommended—and anecdotally effective—therapy for PE. Begin sexual activity as usual, until you feel almost ready to ejaculate. Then, have your partner squeeze the end of your penis, at the point where the head (glans) joins the shaft. Hold the squeeze for several seconds, until the urge to come retreats. You can do this several times in one session. Make sure you have a satisfying orgasm at the end—you’re retraining your body to have sex in a new, more pleasurable way, so you want to ensure you don’t feel anxious or deprived.
The stop-start method
Similar to the squeeze technique, the stop-start method is also known as “edging.” It’s something you can practice with a partner or as you masturbate. When you’re masturbating and feel like you’re about to come, back off and pause completely until the urge to ejaculate passes. Then continue stimulating yourself. You can do this as many times as you’d like in one session. Over time, you’ll learn to recognize when you’re approaching “the point of no return,” so you can take a time out to regroup, then continue—and extend—intercourse.
Pelvic floor exercises/kegels
If your pelvic floor muscles are weak, they might impair your ability to delay ejaculation. Pelvic floor exercises (a.k.a. kegels) can help strengthen those muscles. To identify your pelvic floor muscles, stop urination in midstream. To practice Kegels, tighten your pelvic floor muscles, hold the contraction for three seconds, then relax for three seconds. Aim for at least three sets of 10 repetitions a day.
Numbing condoms or creams
Some brands of condoms contain a bit of numbing medication, such as lidocaine or prilocaine, on the inside. This has the effect of reducing sensation, which can make you last longer. Anesthetic creams are also sold that have the same purpose. If you are using these, using a condom can prevent the cream from also numbing the inside of the vagina.
“Men who can tolerate the creams tend to like them because it’s not taking a medication,” says Cohen. “And it really works by numbing the neurological input from the penis to the frontal lobe of the brain.”
Some companies sell over-the-counter, disposable, moist towelettes you apply to your penis before sexual activity; they can reduce sensation and help you last longer. The numbing solution used in these products is formulated to reduce overstimulation without eliminating sensation altogether.
As part of a 2017 study published in the American Journal of Urology, 21 men who reported PE were given 4% benzocaine wipes to use before sex with their monogamous partners. After two months, those men reported “significant improvement” in the duration of vaginal penetration, “greater improvement in distress relating to intercourse, control of ejaculation, and satisfaction with sexual intercourse” compared to a placebo group (Shabsigh, 2017).
Several medications have been found to be effective in delaying or preventing premature ejaculation.
- SSRIs/antidepressants (sertraline, paroxetine, fluoxetine). Some antidepressants known as selective serotonin reuptake inhibitors have the side effect of delaying ejaculation. The more serotonin is floating around in your brain, the longer it can take you to come. “This was discovered during the early clinical trials for SSRIs — that they’re a great way to control premature ejaculation,” says Cohen. “Unfortunately, some of those SSRIs, at higher doses, can lead to decreased sexual desire and other sexual dysfunction.” So if you go this route, it’s important to stay in communication with your doctor to calibrate the right dosage for you.
- ED medication. Premature ejaculation can be a side effect of erectile dysfunction (ED). If you’re finding it more difficult to get or maintain an erection, when it happens, you might rush through the process and end up ejaculating too quickly.
“It’s sort of like how your Macbook knows it’s about to lose battery power completely,” says Cohen. “Immediately it stops you from doing anything on your keyboard, then turns the computer off. It’s the same thing with ED and premature ejaculation — your brain knows you’re going to lose your erection and not be able to penetrate your partner, so let’s just ejaculate now.”
Using medication like Viagra (sildenafil) or Cialis (tadalafil) can make it easier to get and prolong the duration of your erection, so you don’t feel like you’re working on borrowed time.
- Dapoxetine (Priligy) is currently in Phase III clinical trials in the U.S. to be a medication prescribed specifically for premature ejaculation. Currently sold in other countries for that purpose, it works by inhibiting the brain’s transporter of serotonin (one of the body’s natural pleasure-seeking and pleasure-feeling chemicals).
- Modafinil (Provigil). This medication is prescribed for the treatment of narcolepsy, and it’s been used off-label to treat premature ejaculation. An uncontrolled 2016 study published in the journal Urology found that men with lifelong PE who took modafinil reported a “modest improvement” in that condition. Researchers called for more studies (Tuken, 2016).
- Silodosin (Rapaflo). Most commonly prescribed as a medication to treat an enlarged prostate, silodosin has been found in some studies to help prevent PE (Bhat, 2016). It is sometimes prescribed off-label for that ejaculatory condition.
What causes PE?
As we mentioned, PE can be something you’re genetically predisposed to or something you acquire.
When you first start having sex, it can be a little bumpy negotiating the presence of another person when you’re naked and hard. It’s likely that your only previous experience was masturbation, and often the goal in that situation is to ejaculate as quickly as possible. That can create a wrinkle in your sex life with others: You have to retrain your brain a bit to learn that arousal and stimulation can be a more relaxed, prolonged experience. Most guys learn to do that with a bit of practice.
But what if it’s something that persists, years after you’ve become sexually active? Premature ejaculation can be caused by psychological factors, including depression, anxiety, stress, low self-esteem, a poor body image, or relationship problems. Behavioral therapy can help.
Some physical factors could also be responsible, including abnormal levels of some hormones or neurotransmitters (such as testosterone or serotonin), inflammation/infection of the prostate or urethra, or erectile dysfunction. If you’re experiencing PE regularly, it’s a good idea to schedule a physical exam to talk with your doctor about it.
The good news: PE is highly treatable. According to Cohen, over 80 percent of men who come to him complaining about premature ejaculation find an effective solution. “Most of it depends on finding the right dose for them — how many swipes, or how many milligrams of the SSRI — and then how regimented they are to take these medications,” says Cohen. “For the patients who are diligent, I think we have upwards of an 85% success rate. If they’re not and don’t want to, it’s going to be much lower.”
Read more about PE here.