How Can You Treat Premature Ejaculation?

The issue of treatment is a challenging one, especially if you’re in a relationship where you are stressed by your partner’s dissatisfaction with your sexual performance. On the one hand, you want a treatment that’s going to work as fast and effectively as possible.

Some men in this position search out a sexual therapist for one to one sessions, but the obvious disadvantage of this is that such sessions are potentially not only embarrassing but also expensive – ranging from $100 to $300 per hour. And do you really want to go through the experience of finding a sexual therapist, getting to know them, and then uncovering the most intimate secrets of your sex life in the consulting room?

Probably not. So here is a little about the various premature ejaculation treatments available, so you can make some kind of informed judgment about what you want to try – and, more importantly, which PE treatments simply don’t work, and are a waste of time and money.

Broadly speaking, for rapid ejaculators, the treatment methods fall into two main groups: firstly those which involve drugs, hypnosis, pills, lotions and potions, and secondly those which involve sexual therapy, behavioral modification, and dealing with relationship issues. 

Therapy & Non-drug based treatments for premature ejaculation

One common recommendation for treatment of PE is to think of something non-sexual while you make love. But the problem here is that this is even more distracting – a man who ejaculates quickly needs all the feedback which his peripheral nervous system can provide, not less of it, as he is out of touch with the sensory feedback loop that makes him aware of how close he is to ejaculation. He therefore lacks the information needed to change his sexual behavior so that he does not actually reach the point of emission.

Non-sexual touching has also been recommended as a method of desensitization, but as a treatment approach this is now discredited. Non sexual touching can in fact be arousing, and it avoids the essential aspect of any PE treatment – which is to desensitize the man to sexual stimuli so that he is less aroused, able to prolong the length of time he spends on the plateau phase of his sexual arousal cycle, and therefore extend the time take for him to reach orgasm and ejaculate.

Another method of inhibition – that of squeezing the penis just below the frenulum as a man nears the point of ejaculation – is also not generally recommended nowadays by sexual therapists. This is painful, and although it causes a man’s erection to diminish and his arousal to decrease (perhaps not too surprisingly!), its efficacy in treating quick ejaculation remains doubtful.

It is surprising to hear that men were once advised to wear two condoms to reduce the amount of sexual stimulation they were receiving. This is an unsafe sexual practice, as friction between the two layers of latex can lead to the condom developing a tear or a hole. In any event, there are no reports of this ever having successfully treated a man’s PE.

The same applies to condoms containing benzocaine, which is reputed to anesthetize the penis and reduce the likelihood of premature ejaculation. In reality, men who try this treatment approach may find that they end up with a numb penis, do not feel the pleasurable sensations of penetration and the warmth of their partner’s body, and they may still ejaculate just as quickly.

Other approaches to the control of premature ejaculation have included the advice to change positions often during sex (which effectively works because of the interruption to the progressive increase in a man’s arousal); to use Kegel exercises to develop control of the pubococcygeal muscles which propel semen out of the penis – a forlorn hope since these muscles are almost impossible to control voluntarily – and a process of psychotherapy.

Goal oriented psychotherapy is one of the best and most effective treatments in a behavioral approach to control of rapid ejaculation. It may be premature to say it, before further definitive proof emerges, but any man who wishes to develop good ejaculatory control may be well advised to see a sexual/behavioral therapist to learn a behavioral control program, and a psychotherapist to discuss any underlying sexual issues which may be contributing to his premature ejaculation. Such issues include, but are not limited to: anxiety, fear of intimacy, hostility to women, lack of a sense of masculinity or male power, and doubts about body image, penis size and self-confidence.

Premature ejaculation treatment

Obviously it’s crucial for men who have premature ejaculation to accept that they have no voluntary control over ejaculation. But the reverse is true: a point many researchers miss is that men who cannot control their ejaculation may well not understand that it is in fact possible to exert voluntary control over such an apparently involuntary bodily function. In my view they may well be upset about the lack of control that they have in bed over their ejaculation, but they often do not appreciate that it is in fact possible to control ejaculation through voluntary effort.

Historically, premature ejaculation was though of as a purely psychological problem and behavioral therapy was thought of as the best treatment. The so-called “stop-start technique” was the first and classic treatment for premature ejaculation – it requires a man’s partner to stimulate his penis until he is almost at the point of no return, then to stop the stimulation until he knows he is no longer near ejaculation (in other words, until his arousal has dropped below the point at which there is a danger of him ejaculating). The pattern of stimulation and stopping stimulation is repeated until there is a degree of control over ejaculation. A similar technique was put forward by Masters and Johnson in 1970, though they asked the man’s partner to squeeze his frenulum after she stopped stimulating him – presumably because such pressure can cause a loss of erection, so it will obviously take longer for him to get fully aroused again.

The reality, of course, is that many cases of premature orgasm are caused by a lack of sexual confidence, by psychosexual anxiety, and by interpersonal issues such as anger or lack of interest in the partner’s well-being, pleasure or satisfaction (what you might call a kind of sexual selfishness). Although teaching these techniques to delay ejaculation has been a main plank of psychosexual therapy, it may well be much more important in a psychodynamic sense for therapy to be directed at helping a man regain his sexual confidence, reduce his sexual performance anxiety, and more than anything else to resolve any interpersonal difficulties with his sexual partner. Treatment success is rather variable (although the methods on this website are about as successful as you can get), and the reasons for that appear to be that ejaculation is a spinal reflex which is strongly controlled by higher cortical centers – in other words, establishing voluntary control over it is difficult.

Well, that is a matter of opinion. I think that when the motivation to cure premature climax is there, establishing voluntary control is not actually that difficult. Sure, it takes time and practice, but the key thing is motivation. This control can be developed. It is influenced by past experiences and present context, but there are a very few men with what one might consider to be definitive premature ejaculation; that is to say, an ejaculation latency which is so short and difficult to control that they may be considered to have a genetic bias towards early ejaculation.

Needless to say, it has been suggested that rapid ejaculation is an evolutionary advantage: the faster you impregnate a woman, the safer you are, and the more likely are your genes to pass on to the next generation. This may be so, but it doesn’t alter the fact that today premature ejaculation is a social, if not an evolutionary, handicap.  

Premature ejaculation, based upon the Asian Journal of Andrology, 2008 Jan; 10: 102-109

Although conventional psychotherapeutic sex therapy is effective, it is long-term and slow – and you need a partner who is happy to help. This has led to a tendency to prescribe drugs, which, no doubt, represent a simple and easy approach to therapy in the eyes of many men and their doctors. Unfortunately the facts are that all the drugs which are used for the treatment of premature ejaculation were originally designed for other conditions, and they may therefore be inappropriate for this problem. They certainly do not have regulatory approval for this purpose.

Treating Premature Ejaculation With Drugs

The main treatments in this context are desensitizing agents applied to the skin of the penis and antidepressant drugs used “off label” for the treatment of premature ejaculation.

1 Desensitizing drugs

The oldest drug therapy for premature ejaculation is a local anesthetic which is applied to the penis – the idea being that premature ejaculation was caused by hypersensitivity of the penis. However, this has never been proven by experimental investigation and there are few benefits to this approach as a treatment. For one thing, the local anesthetic diminishes penile sensation and pleasure, which seem like high prices to pay for a slightly longer intravaginal time span. Furthermore, unless applied to the inside of a condom, they have the unfortunate side-effect of numbing the vagina, a somewhat distracting effect for the partner of the man concerned. There may be skin reactions, and there may be the delay in intercourse prompted by the need to apply the cream to the penis. However, this approach is still available in the form of a delay condom made by several of the large condom companies, and it may work for some men. There are various medications which have been used for this purpose, and they are listed below.

Lidocaine-prilocaine cream

Lidocaine and prilocaine mixed together in equal amounts to form a preparation which is known as EMLA. This is widely used to treat rapid ejaculation, although accounts of its effectiveness are not widely available. It needs to be applied 20 minutes before insertion of the penis into the vagina; after 45 minutes, penile numbness and loss of erection are common effects. Overall, however, treatment results in a 5.6 fold increase in the length of intercourse (the time between insertion and ejaculation). Most men were very pleased with the treatment, though 16% of men had adverse effects including penile numbness and retarded ejaculation, penile irritation, and one man’s partner reporting decreased vaginal sensations.

SS cream

SS cream, which is made and sold in Korea, is applied to the glans about sixty minutes before intercourse, then washed off. There is an unfortunate smell with the product which makes it less desirable than some other products, due no doubt to the fact that it is made of a cocktail of nine ingredients, including those with local anesthetic and vasodilatatory qualities. It seems to be effective in extending the length of intercourse, although it also produces considerable irritation of the penis (one in five men).

Lidocaine-prilocaine spray

This mixture (known as TEMPE) for the treatment of PE is delivered as a metered-dose spray combination of lidocaine and prilocaine. The formulation is designed to maximize tissue penetration and therefore produce a fast reaction in the penis, enabling intercourse to proceed without a condom. Unfortunately the compound does not penetrate keratinized skin, and its effectiveness on circumcised men is therefore somewhat questionable (circumcised men often have a keratinized glans). Treatment consists of  three applications squirted onto the glans penis a quarter of an hour before sex: this regime produces a significant increase in time between penetration and ejaculation, and is reported to produce a significant improvement in a man’s control over the time when he ejaculates. There are few side-effects, although 12% of men reported numbness of the penis and erectile dysfunction (the latter only being experienced by one man). TEMPE produces an average increase in intra-vaginal time from 1 minute to 4.9 minutes. It is not as effective as EMLA cream but apparently produces fewer side-effects.

Dyclonine / Alprostadil

A mixture of local anesthetic called dyclonine and the vasodilator alprostadil (used in men with erectile dysfunction to stimulate and maintain erection), is being developed – as yet, no data are available for the success rate of the product.

2 Anti-depressants for premature ejaculation treatment

Drug treatments by mouth for premature ejaculation include selective serotonin reuptake inhibitors (SSRIs) and clomipramine, which is a tricyclic antidepressant. There are a few other compounds, like Viagra (PDE-5 inhibitors) and tramadol, which are also included since they are the subject of current research.

Clomipramine

Clomipramine is a tricyclic antidepressant whose effectiveness in the treatment of premature ejaculation was demonstrated as long ago as the mid 1970s. As reported elsewhere on this website, Waldinger has shown that if it is used on a daily basis, clomipramine has the ability to increase the length of time between penetration and ejaculation by 4.6 times. This mirrors the results from sertraline or fluoxetine. Clomipramine must be used between three and six hours before intercourse: clomipramine 25 mg produces a 4 times increase in intra-vaginal ejaculatory latency time. Unfortunately, an adverse side effect is nausea which lasts for two days – the day the drug is taken and the day after. There are also certain criteria which apply to the men who take this drug, and which have been shown to be the conditions which make it most effective (i.e. they are satisfied with sex as demonstrated by a self-rating of five on a seven point scale, and they ejaculate twice or more each week).

SSRIs for premature ejaculation treatment

SSRIs are not approved for the treatment of PE, although they are commonly prescribed. They delay ejaculation in between 30 and 50% of men, and at the moment, there are four varieties which find a sue in this way: fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citralopram (Celexa). Other SSRI’s are not effective at increasing the duration of sexual intercourse; the producers of Dapoxetine – a related compound – have tried (but been denied) formal approval for the drug to be listed as a treatment for this sexual dysfunction.

The delaying effect of paroxetine on ejaculation was first recorded in 1994 and has been confirmed many times since. The absence of regulatory approval may well relate to the fact that a drug should not be marketed for the effectiveness of its side-effects rather than its main treatment purpose (which is, of course, depression).

Having said that, this set of drugs is pretty well tolerated by men with premature ejaculation, who seem to have a different side effect profile than men with depression on these drugs. However, one has to ask if these are desirable side-effects: yawning, nausea, perspiration, fatigue and loose bowel movements! Even if, as is claimed, these adverse effects gradually disappear with use, ingesting these antidepressives seems like one of the most dramatic ways possible to try and prevent premature ejaculation! Furthermore, some men using these drugs to gain a longer period of sex will experience much worse symptoms, which include SSRI discontinuation syndrome, diabetes, bleeding, and so on.

It seems ironic that all of this can lead to a claim that these drugs are known to be efficient in controlling rapid ejaculation. But there are still researchers asking whether they should be taken daily or on-demand (i.e. when sex is planned)!

Dr Gerald Brock, a prominent Canadian sexual health doctor and renowned urologist, has made the observation that prescribing SSRIs for premature ejaculation treatment is now becoming more common in Canada. In the absence of specifically approved treatment methodologies and drugs approved for this purpose, SSRIs such as sertraline and paroxetine are now offered to patients as well as some non-SSRIs such as clomipramine.

 

Many men do not seek treatment for this potentially embarrassing condition, and many others are not offered good treatment when they do…….so are prescription drugs an appropriate therapy anyway?

SSRIs & side effects

Dr Brock has observed that SSRIs can be effective, but like many others working in the field points out the side effects. For one thing, they have long half-lives – a measure of how fast the drug decays in the body – and of course they are not designed for premature ejaculation ejaculation. The side-effects can include nausea and fatigue. Much worse, though, these drugs can apparently cause ejaculation failure and even complete impotence. The Annals of Pharmacotherapy has reported that citralopram withdrawal can actually cause a man to ejaculate faster!

 

Clearly, therefore, drug treatment is only part of the answer. Dr Brock states that a three-pronged approach is needed: this is an important medical issue and needs careful treatment and the men who have it deserve to be taken seriously. This three pronged approach involves education, so any stigma attached to seeking treatment is removed; then the recognition that sexual therapies and psychotherapy can be effective in helping to cure PE; and finally, the carefully considered administration of SSRI prescriptions, perhaps with psychological therapy.

Needless to say the drug companies are working hard in finding a side-effect free drug to treat PE, though as yet they do not seem to have made much progress.

Do drugs really help cure premature ejaculation – an effective treatment?

Yet there are some experts who think drug therapy should be more widely used. An article in Current Opinion in Investigational Drugs called for increased use of SSRI therapy, on the grounds that its overview of these drugs had established that paroxetine was the most effective treatment for PE; they also observed that daily intake gives better ejaculation control (by which we mean delay between penetration and ejaculation) than treatment on an ad hoc basis. (This means of course that the drugs are permanently in the patient’s body, which has implications for tolerance and raises concerns about possible side-effects.)

A study reported in The Journal of Clinical Psychopharmacology concluded that the time between penetration and ejaculation could be extended from one minute or less to about two minutes in men who had received treatment with paroxetine, fluoxetine, and sertraline. In my opinion, the risks of drug treatment far outweigh the rewards for an improvement of such a short time – especially when more conventional sexual-therapy-based methods can effectively provide complete control. The problem seems to be that we are in a society where the drug treatment of PE potentially rewards the drug companies with massive profits and the patients with little effort.

 

UroToday.com defines PE, quite correctly, as the recurrent approach of orgasm and ejaculation with little or no sexual stimulation, shortly before or after penetration and certainly before the sexual partners wish for it to happen. The journal then observes that while the established view is that PE is a psychological condition, recent opinion suggests that disturbances of serotonergic 5-hydroxytrptamine (5-HT) neurotransmission might be a causative factor – and hence drug therapies which target the 5-HT system might be an effective treatment. Francisco Giuliano has studied the efficiency of Dapoxetine in the treatment of premature ejaculation and published his results in the July 2007 European Urology Supplements.

Dapoxetine hydrochloride is a selective serotonin reuptake inhibitor (SSRI), but it has the benefit of having a short half life, which means it stays in the body for a much shorter time. It’s been developed specifically for the treatment of men with PE. “Older” SSRI’s work by increasing the level of 5-HT neurotransmission but the majority of SSRI’s such as fluoxetine, sertraline, and paroxetine (all of which can increase the time delay between intromission or penetration and ejaculation) don’t reach the maximum level in the bloodstream for several hours after they have been taken. This means that men who wish to try this remedy for premature ejaculation cannot take these SSRI drugs just before sex (as is possible with Viagra in cases of erectile dysfunction). By contrast, Dapoxetine inhibits serotonin reuptake and takes only one hour to reach maximum concentration in the bloodstream. In addition, it is eliminated quickly from the body and it therefore has the profile of an on-demand medication which gives it both greater commercial possibilities and greater effectiveness for the man who, together with his doctor, wishes to adopt this as a treatment for premature ejaculation.

The studies which demonstrated the potential effectiveness of Dapoxetine involved over 2600 men who were given between 30 and 60 mg of Dapoxetine between one and three hours before sex. The average age of the men taking part in the drug treatment trial was forty years – surprisingly old, for I have always had the impression that men lose their tendency to premature ejaculation as they get older. It would therefore seem likely that these men were suffering from both long-standing and sever premature ejaculation. Indeed, almost two-thirds of the men reported life-long problems with premature ejaculation, and about a third of the men has developed premature ejaculation after a period of normal sexual relationships (i.e. satisfactory vaginal intercourse).

The researchers measured the time between intromission and ejaculation and found that although  a placebo did lead to an increase in the length of intercourse, it was nowhere near as significant as the increased length of intercourse with dapoxetine. At 30 mg dosage, intercourse increased from an average of 0.92 minutes to 2.78minutes. With 60 mg of dapoxetine, it increased from an average of 0.92 minutes to 3.32 minutes. This improvement was maintained over the twelve weeks of the study. Of course, the issue of side-effects always comes up: but the Dapoxetine produced relatively few side-effects, which included nausea and headache. Nausea occurred in 8.7% of men given 30 mg and 20.1% of men given 60 mg. Headaches occurred in 5.9% of the men given 30 mg and 6.8% of the men given 60 mg. Unfortunately 4% of men taking the lower dose had sufficiently severe effects to require the cessation of treatment, as did 10% of men given the higher dose. These are rather high figures for a drug which seems to have limited use as a premature ejaculation treatment and only produces a relatively short increase in vaginal intercourse duration.

Giuliano F Eur Urol Supp. 6(13):780-6, July 2007

A drug developed for treatment of premature ejaculation

The New Scientist has reported the outcome of this study of the effectiveness of Dapoxetine treatment on nearly 2000 men who were diagnosed with either moderate or sever premature ejaculation. Before taking the drug, these men had an average time before ejaculation of less than one minute after penetration. Again, they were given either a placebo “treatment” or 30 or 60 mg of dapoxetine, which was taken between one and three hours before intercourse.

After twelve weeks of taking the drug treatment, the average time before ejaculation had gone up from less than a minute to 2.8 minutes for the lower dose and 3.3 minutes for the higher dose.

Even better, the authors of the study suggested that the men’s subjective view of how well they could control their ejaculation and how satisfied they were with sex had improved markedly, as had their partner’s level of satisfaction.

No license for drug treatment of premature ejaculation

Dapoxetine was developed for controlling premature ejaculation, but although the researchers have claimed it to be safe and effective, the FDA has not given it a license. The side effects include nausea, diarrhea, headaches and dizziness. And the other problem is this: according to Marcel Waldinger, a neuropsychiatrist at Leyenburg Hospital in The Hague, existing SSRIs have already found a place in the treatment regime for premature ejaculation, and work with greater efficiency. He says that the best way to prevent PE is by continual use of existing SSRIs. he observes that these drugs produce an increase in time between intromission and ejaculation of about nine times, while Dapoxetine only increases the time by a factor of three. According to Waldinger, one also has to ask about the motives of the drug companies in developing a drug specifically to treat PE.

Waldinger has studied the time that men last between penetration and ejaculation on average: his findings make interesting reading. The study was carried out in 2005 and he discovered that – in the general population – not just among men seeking treatment or cure for premature ejaculation – the average length of intercourse was just  5.4 minutes in The Netherlands, the UK, the US and Spain. In Turkey the average time to ejaculation was 3.7 minutes.

So where does this leave us? Men who identify as having premature ejaculation, and who seek treatment for it, may actually be in the normal range of sexual activity for men in their general population. This does not mean that treatment should be denied, for as we have seen, the definition of PE these days is tailored specifically to include a factor of the man’s subjective satisfaction (or lack thereof) with his sexual performance. But the danger is that the drug companies create a pathology out of a normal condition so that they can sell drugs to deal with it. And most men will sometimes experience a rapid ejaculation – it is normal.

This of course brings back into play the difficulty of definition: PE has been described as the most common male sexual problem, affecting between a fifth and a third of all men. But what does that mean, if it is so common? Isn’t it then a “normal” condition? Waldinger concludes by observing that he believes only men who have experienced lifelong PE should receive drugs. As he (in my opinion correctly) observes, lifelong PE is a much rarer problem, and probably only affects 1% to 5% of men. New Scientist 8 September 2006 and The Lancet (volume 368, p 929)

More scientific reviews of drug treatment of premature ejaculation

What follows is a summary of treatment of premature ejaculation adapted from Medscape.

SSRIs have been administered to increase ejaculatory delay; because they are associated with inability to ejaculate and erectile dysfunction. Unfortunately, continual administration of SSRIs is linked to dry mouth, nausea, drowsiness, and reduced libido. Dapoxetine hydrochloride (DPX) has been studied and indeed has undergone Phase III trials. DPX is a serotonin transport inhibitor (STI) which has a pharmokinetic profile suitable for “on-demand” usage in the treatment of PE. Unlike other oral agents, DPX works quickly and is effective from the first dose. [Editor: as previously mentioned, FDA approval has not yet been forthcoming.] The worst side-effects of SSRIs is that they not only cause decreased libido but they can cause erectile dysfunction.

Another category of drugs which have been studied as possible candidates for the management of premature ejaculation are Phosphodiesterase-5 (PDE-5) inhibitors. The somewhat tenuous connection with quick climax is their ability to prolong erections. It’s been established that PDE-5 inhibitors are useful in the treatment of men who have premature ejaculation secondary to erectile dysfunction, and that they can be used in association with other drugs such as SSRIs.

Anesthetic substances which can be administered to the surface of the penis have been tested in the treatment of premature ejaculation. [Editor: though some studies have shown an increase in ejaculatory delay times, evidence from my own experience with men who have premature ejaculation is that these creams, whether administered to the surface of the penis or contained in a condom, do not have much impact on PE, but they do remove sensation, thereby making sex even less satisfactory for both partners.]

Clomipramine: at 25 – 50 mg per day increases sexual latency from 1 minute to 3 to 6 minutes

Fluoxeline: at 5 – 60 mg per day increases sexual latency from 1 minute to 2 to 9 minutes

Paroxeline: at 20 – 40 mg increases sexual latency from 1 minute to 3 to 10 minutes

Sertraline: at 25 – 100 mg increases sexual latency from 1 minute to 3 to 6 minutes

The higher the dose, the longer the ejaculatory delay. But at high does, there are unpleasant psychotropic side-effects. These drugs stay in the body for a long time, and they cannot be given on-demand. As soon as the drugs are reduced, the man’s inability to control his ejaculation returns. The summary of this treatment regime, therefore, is that it is “woefully inadequate”.

Obviously the ideal drug for controlling premature ejaculation is going to interfere with the signal from the brain to the penis in a way that allows on-demand treatment (i.e. you take it just before sex), be fast-acting with a short half-life, and deal with the specific serotonin receptors that deal with ejaculation.

It’s worth making the observation at this point that the behavioral therapies are effective but they do require a co-operative partner. The simple fact is that premature ejaculation is underdiagnosed and undertreated. None of the current drug treatments are FDA-approved.          

Video About Premature Ejaculation

Premature Ejaculation

In the next few minutes I’m going to show you how you can overcome premature ejaculation and become the man you really want to be in bed.

To start with, it’s important to understand that premature ejaculation is a very normal and natural problem — it affects about one man in three, so you certainly don’t need to feel any shame about it.

Now I know that’s easy to say, and if you come very quickly after starting to make love, it might be a bit of a problem with your partner. She’s probably not going to be too happy, and for that matter, you’re probably not completely satisfied with your performance in bed either.

You see, one of things that I understand from the men I talk to who have this problem is that premature ejaculation can really make a man feel inadequate in bed.

And of course the opposite’s true as well: if you’re a man who has control and choice over when he comes during sex, perhaps so much so that you can even take your partner to orgasm before you ejaculate, it can make you feel like a really powerful man in bed. And – for that matter – out of bed as well.

So exercising control in bed, overcoming premature ejaculation, is really important for many reasons. And one of the questions I’ve often asked myself is why more men don’t do something about it, when it’s so important for sexual pleasure.

The answer probably lies in what Woody Allen once said: to paraphrase, there’s no such thing as a bad orgasm, it’s just that some are better than others.

And when you’re a man, and you enter a woman, you probably feel a very strong instinctive urge to thrust, hard and fast, until you reach the point of ejaculation — and that’s very satisfying. The problem is, it’s not quite so satisfying to her, of course. Another source of information about sexual satisfaction is Orgasm Arts by Jason Julius (see a review here).

What I also know from the work I’ve done with men over the years is that very few women will complain about premature ejaculation, although I have heard of some women being so upset about it that relationships have come to an end.

But you shouldn’t be deceived by the fact your partner says “It’s OK, don’t worry, it doesn’t matter.”

The fact that a woman doesn’t complain about you coming quickly during sex doesn’t mean it’s okay. In fact, I can tell you that the great majority of women are totally peed off with their men about their lack of control.

So what can you do about it? A lot of solutions have been offered on the Internet. Perhaps one of the most common is anesthetic gel or so-called “delay cream” or lotion. You can get that as a spray-on anesthetic for the penis, or you can get it as a lotion, or you can get it in condoms which are supposed to delay ejaculation.

And there’s an interesting problem here, isn’t there? Sex is supposed to be something that you enjoy, and I don’t see how you can enjoy it if your penis is numb and you can’t feel anything.

A lot of guys actually also tell me that because the excitement they feel during sex is more in their mind than their body, they still ejaculate quickly – it’s just that sex is ruined because they don’t feel anything.

I’ve also spoken to several men who used these compounds that they bought on the Internet and they’ve experienced some intense burning sensations – redness and soreness on their penis… in some cases they’ve experienced severe pain….

In fact, I had an email from one man the other day asking for help because his penis had been left more or less insensitive after using a really strong anesthetic lotion that he bought on the Internet. This will not help his ability to get to orgasm! Check out Lloyd Lester’s program here.

My advice to you is to steer well clear — for another thing, your partner is not going to enough thank you if she ends up with a vagina that can’t feel a thing because you sprayed your cock with anesthetic lotion. Just a thought.
You might also have heard of the idea of PC muscle control. The PC muscle, or pubococcygeal muscle, is the one that contracts during orgasm, and the stronger those contractions, the more intense the feelings that you have as you come.

There’s a completely false – and sadly very widespread – belief on the Internet that by contracting this muscle at the point of orgasm, you can stop yourself coming.

I can tell you that this is completely false. It’s impossible to stop yourself coming by contracting this muscle. What you will do, if you try, is weaken your ejaculation and ruin your own orgasm. So don’t bother trying this and if you see anybody who’s recommending this steer well clear again — it doesn’t work.

However there is a way to use the PC muscle during sex to control how quickly you get aroused. ….. you can slow this down, so that it takes you longer to reach the point of no return. That’s the point at which you will ejaculate, come what may.

What you can is contract your PC muscle briefly and breathe in a particular way at the same time….. If you do this correctly, your erection softens a little bit and your arousal goes down so that you’re able to last longer before you come – it’s very handy during intercourse if you want to impress your partner.

Now, in a minute I’m going to give you a link to a website where you can get full details of a complete premature ejaculation treatment program that gives most men who try it complete control over their ejaculation – that means they can actually choose when to ejaculate during sex.

When you buy that program you’ll be able to see exactly how to use all the techniques I’ve been talking about.

As you’ve probably noticed one of the things that contributes to premature ejaculation is feeling anxious about sex.

A lot of guys say to me that they don’t feel anxious but they still come quickly. However I think a lot of men somehow lack confidence during sex, and there’s an underlying level of anxiety behind a lot of premature ejaculation.

And it’s not surprising men are anxious about sex, because when you think about it there’s so much pressure on us around sex.

We’re expected to initiate, we’re expected to lead during sex, we’re expected to show the woman a good time – and so on.
… and if you happen to be a man who’s got performance anxiety, or even a man who’s just concerned about how well he’s doing in bed, you’re going to feel anxious, for sure.

And that’s a problem because, as far as the body is concerned, the anxiety you feel adds to your sexual arousal and takes you towards the point of no return faster, and that means if you’re feeling anxious you’re very likely to ejaculate before you want to. You can see excellent information about how to control premature ejaculation here.

I’m sure you can imagine that men who are completely confident about their masculinity, and have no doubt that they’ll be able to please a woman in bed, and know they can satisfy her in the way that she wants are not going to feel anxious at all, and it’s no coincidence that they tend to be the men who can last longer in bed.

So one of the really important things about overcoming premature ejaculation is reprogramming your mind to give you more confidence.

You can do this by using the latest NLP and behavioral change techniques — and this is a really powerful way to reduce your anxiety and become more confident so that you go into sex without the expectation that you are going to ejaculate sooner than you want.

It breaks the vicious circle of expecting to come too soon, feeling anxious about it, and then coming too soon because of the anxiety.

In fact I think this is one of the most powerful ways to stop yourself ejaculating too quickly.

There is a lot more to this premature ejaculation treatment program than I’ve been able to describe in this video, so the best way to find out more about premature ejaculation control is to click on the link on your screen.

I just want to add one thing about pills and potions as a cure for premature ejaculation.

Don’t be taken in by the con merchants on the Internet who are selling you pills supposed to give you greater control of your ejaculation.

There just aren’t any drugs that will do that except SSRI antidepressants, which you can only get on prescription from a doctor.

Do you think it’s a good idea to take heavy duty pharmaceuticals designed to alter your mood — I mean these things are designed as antidepressants — to control premature ejaculation? Well, no, it just isn’t safe – they have some horrible side effects.

But really the point is that by using the techniques I’ve already mentioned you don’t need drugs anyway ….. the truth is – you’ve got everything you need to control premature ejaculation within you right now.

All you need is to use these simple techniques and you’ll be a great lover, able to show your masculine power when you’re in bed with a woman.

Just What Is Premature Ejaculation – And Why Does It Happen?

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One of the peculiar features about premature ejaculation is that it is likely to have existed in the human male throughout our entire evolutionary history. The question is whether or not it’s always been a problem…  and of course that’s an unanswerable question.

What we do know is that in recent times, the increased level of awareness about the possibility of sexual pleasure has ensured that both men who wish to pleasure their women in bed, and women who know what they want and expect from sex, have developed the belief that premature ejaculation can interfere with with sexual fulfillment. Indeed, it’s a simple fact that when the man can delay his ejaculation and extend intercourse, a couple are likely to experience lovemaking as more intimate and rewarding. Whether a woman can reach orgasm through intercourse or not is an irrelevance: both men and women like the man’s ejaculation to be controlled until both the man and his partner believe that the time is right for him to ejaculate.

Let’s Put Premature Ejaculation In Context

One reflection of the changing status of women in sexual relationships is that the first reported case of premature ejaculation was discussed in the medical literature as recently as around 1900. Then, the predominant belief was that rapid ejaculation was simply a representation of a man’s unresolved emotional conflicts. In keeping with the psychoanalytical thought prevalent at the time, the speed with which a man ejaculated was interpreted to mean that he unconsciously wanted to minimize the woman’s pleasure by giving her no chance of reaching orgasm. This was the beginning of an interesting and challenging debate about the nature of human sexuality in general and premature ejaculation in particular.

Of course a fundamental question in that debate was (and still is): what does “premature” mean? For who, exactly, is a “premature ejaculation” too quick? If, as the thinking around the turn of the 19th century suggested, premature ejaculation was the result of a conscious emotional conflict, then it naturally followed that psychoanalysis would be the right treatment… unfortunately there was absolutely no evidence of any improvement in men’s ejaculatory latency (the time between penetration and ejaculation) due to the application of psychoanalysis.

There were no significant developments until 1943, when Bernhard Schapiro, who’d worked extensively with men who complained about ejaculating too quickly, wrote a paper which suggested that premature ejaculation was merely a representation of some kind of psychosomatic problem. In other words, just as some people would suffer a bad back when subjected to stress, some men experience premature ejaculation when under stress. Schapiro attributed an early ejaculation to some kind of inherent weakness in the reproductive system, which allowed the psychosomatic problem to manifest in this way.

Schapiro’s work was most remarkable because he was the first medical man to describe two types of premature ejaculation which have now become known as lifelong and acquired.

Lifelong premature ejaculation is the sort of sexual dysfunction a man experiences from his first sexual experience onwards, whereas acquired premature ejaculation is – as the name suggests – acquired later in life and is sometimes accompanied by erectile dysfunction. You can read more about the definitions of premature ejaculation here.

Perhaps understandably, little was published on the subject for another 13 years until Dr. James Semans published a paper in 1956. In this, he turned from looking at a psychological approach to understanding the causation of premature ejaculation to a practical method of treating it which he called the stop-start method. In brief, as you may already know, this method involves the stimulation of a man’s penis by his partner until he reaches the point of no return – that is to say, the point at which he knows is going to ejaculate and nothing will stop it – at which point the man removes his partner’s hand and and stimulation stops until his level of arousal has diminished.

In technical terms, the point of no return is marked by what are known as “pre-ejaculatory sensations” or “premonitory sensations”. It is these which tell a man when he’s about to ejaculate, and it’s notable that men who ejaculate too quickly for their or their partner’s liking often lack awareness of these sensations, finding that their ejaculation happens as they often describe it, “almost spontaneously”, “coming from nowhere”, or “happening without warning”.

Treatment For PE May Be Easier Than You Think

To return to Semans’ therapeutic technique: when the man feels that his pre-ejaculatory sensations have diminished or stopped altogether, and his arousal has dropped, his partner begins to stimulate his penis again. The procedure moves on from dry stimulation with no lubrication, to masturbation with lubrication, which more closely resembles the environment of the vagina, and then to vaginal containment (i.e. the insertion of the penis into the vagina without movement). The next stage is one of limited thrusting with the woman on top, with the man stopping his movements every time he approaches the point of ejaculation. And finally, the couple achieve full intercourse with normal thrusting.

This procedure of graded stimulation with pauses to allow the man’s arousal to drop can be very effective in curing premature ejaculation. However, it requires both self-discipline – that is to say, the discipline to overcome the urge to thrust and ejaculate as quickly as possible, which is extremely powerful for most men – and usually also some kind of counseling or therapeutic “discussion” to eliminate the negative emotions associated with premature ejaculation.

Semans’ work didn’t attract a great deal of attention at the time, possibly because most of the therapists who tried his approach didn’t incorporate discussions with the man and his partner into their therapy. However, if you read Semans’ original account of his work, it’s clear that he engaged in extensive “counseling” of his clients. This may be the “fixative” that ensures the stop-start treatment is successful. Without support, men and their partners who try this technique tend not to sustain any improvement in intercourse duration for more than a few weeks, if they even achieve success in the first place.

The fact that a counseling or therapeutic approach of some kind is a necessary adjunct to behavioral training was confirmed in 1970 when Masters and Johnson published a technique called the squeeze technique. In actual fact the squeeze technique is really the stop-start technique, with the addition of a squeeze:  during sexual activity, whether that’s manual stimulation or intercourse, the man or his partner also squeeze the man’s penis between thumb and forefinger. The squeeze is applied to the man’s penile shaft just under the coronal rim on the dorsal surface and on the frenulum on the ventral surface.

The Squeeze Technique, The Stop-Start Technique & Counselling – A Complete Package To Stop Premature Ejaculation

This technique actually reduces a man’s desire to ejaculate very significantly, and it may also reduce the rigidity of his erection slightly. It’s a very effective way of allowing a man to continue making love for longer. When applied in real life situations, the woman or the man himself squeeze the penis just before the man reaches his point of no return, in the way described above for about four seconds; the couple then wait another 30 seconds or so until stimulation begins again.

Stimulation may be masturbation or intercourse, but is always a graded progression of sexual interaction from manual stimulation without lube (masturbation, in other words) through to full intercourse, although intercourse itself is specifically prohibited until a man has developed the ability to significantly delay his ejaculation. Once again, vaginal containment without thrusting is a significant element of this process. It allows a man to get used to the sensations of having his penis inside the moist and warm environment of his partner’s body without responding to that stimulation with a reflex, spontaneous or rapid ejaculation. You can read about the stop start technique here, and the squeeze technique here.

To be effective, vaginal containment needs to be carried out for several minutes, possibly for 10 minutes or even longer, during which time the man moves only enough to sustain his erection. In general, men who try this technique of vaginal containment report that there is a moment when they experience a distinct change in the sensations they are experiencing: it’s hard to describe exactly what this is, but in cognitive terms, it’s probably best described as anunderstanding and acceptance that this penetration of the woman by the man is actually normal, it doesn’t necessarily need to lead to rapid ejaculation, and that it is both enjoyable and something that can be tolerated without a spontaneous reaction of uncontrolled ejaculation.

In feeling terms, the physical sensations reported by men shift from being “sharper”, more arousing, more acute, to a duller, more general warmth. I interpret this to mean that there is a drop in the level of sexual arousal a man develops when he is inside his partner. When you think about it, this is actually a representation of normal mature male sexual behavior. In some ways it is a physical metaphor for a kind of transition from adolescent boy-sexuality where even the prospect of having intercourse with a woman is too exciting to cope with (resulting in a rapid ejaculation), to a more adult-masculine sexuality, where a man takes on the rightful role of a mature male who expects to be able to engage in intercourse with a woman on equal terms and with complete ejaculatory control.

Once again, of course, part of this transition to mature male sexuality is about dealing with the emotions that surround premature ejaculation. In my experience it’s never a purely physical condition: it’s always accompanied by some kind of emotional issue. This is usually anxiety, especially performance anxiety about satisfying a woman. Another manifestation is anxiety about the very act of intercourse – in other words, some kind of fear of failure or of letting the partner down in some way. You can read more about the effects of premature ejaculation here.

What Are The Respective Roles Of Men And Women In Controlling Premature Ejaculation?

Information about the treatment of premature ejaculation is available here.

A key factor here for me is that when the man feels this fear, he is somehow taking responsibility for the woman’s sexual pleasure. Now, although the belief that somehow the man has a “duty” or responsibility to pleasure the woman (aka bring her to orgasm) during sex is commonplace in our society, it’s actually wrong.

Culturally, a man may feel a responsibility for a woman’s sexual pleasure, but socially and emotionally, a woman’s ability to achieve orgasm is more or less her own responsibility. We would not assume a woman’s job was to give a man an orgasm, would we? Indeed, the reversal of the idea seems ridiculous.

Certainly, a sexual partner can help with stimulation and can provide sexual pleasure, but for a woman to assume that it’s a man’s responsibility to “give her” an orgasm, or to “take her” to orgasm, or whatever, is clearly quite perverse. What’s more challenging, of course, is that men take on this responsibility and then develop a fear of failure because of it, a fear of not providing “her” with an orgasm. In many cases, men tell me that they actually fear a partner’s anger or annoyance if she doesn’t have an orgasm.

In this way, sex becomes a challenge for the man because he’s not able to fully focus on receiving his own pleasure. During sex, part of his mind is consumed with what he takes to be his responsibility to pleasure his partner, and since couples in this situation rarely have a very good level of communication about what they’re thinking and feeling during sexual activity, and women often fail to provide guidance to their male partners to tell them what they want, the stage is set for sexual conflict and failure.

It’s almost as though the woman expects a man to be a mind reader, and to be able to provide her with sexual pleasure regardless of whether or not he’s sufficiently knowledgeable and skilful to do so. Such a situation can produce high anxiety, frustration, and resentment, and no doubt guilt and shame too, all of which can  contribute to premature ejaculation. (The reason this happens is this: although emotional arousal and sexual arousal may feel different, they have a very similar effect on the man’s nervous system: they are both arousing. This means that a man who is experiencing high levels of emotion will most likely be well on the way to his point of no return even before he sexually engages with his partner.

By contrast a man who begins sex in a relaxed frame of mind, without any particular stress or heightened emotional arousal, will take longer to get to his point of no return, the point of ejaculatory inevitability.

Returning to Masters and Johnson’s technique, it’s interesting to note that as long ago as 1970 they were suggesting that in most men premature ejaculation was the product of anxiety, and was not a natural condition, but a learned activity. As an example of this, they mentioned that behavioral traits of early ejaculation might be learned during the adolescent years, when sex is often furtive and hurried, and frequently conducted in uncomfortable situations where there was a lot of anxiety about being discovered – such as the back seat of a car! Clearly the implication of this observation is that premature ejaculation treatment should incorporate not only bodily training to delay the man’s physical responses to sexual stimulation, but also some kind of therapy or counseling to help him reduce his performance anxiety. (For information on lasting longer, click here.)

In the decades since Masters and Johnson did their pioneering work, a number of different therapies have been tried for premature ejaculation, ranging from Gestalt therapy to Transactional Analysis and psychodynamic psychotherapy. But there has been very little scientific investigation of the effectiveness of different techniques using well-designed controlled studies. To take but one example, while the suggestion that hurried adolescent sexual experiences might well “train” a man to ejaculate quickly seems both logical and intuitively correct, when Waldinger applied evidence-based research techniques to this question, he found no evidence whatsoever to support the idea. In other words – common sense may seem appealing, but it may not help us understand exactly what causes premature ejaculation!

The squeeze method is the most effective form of treatment for premature ejaculation, a fact which has been confirmed several times. Why, then, do so many therapists report that the benefits do not last? Well, what differs between Masters and Johnson’s application of this technique and other practitioners’ work seems to be the closeness of the relationship they had with their clients. Masters and Johnson reported improvements in ejaculation latencies which lasted indefinitely; once again this appears to be because they established intimate and close connections with their clients in a residential setting. Such intimacy was not a feature of the work done by other therapists, who seem to have regarded the physical training alone (without emotional support of some kind) as sufficient to cure premature ejaculation.

For delayed ejaculation treatment, check this out. If you have a relationship issue which might benefit from some kind of relationship expertise, check out these dating and relationship tipsfor men. They have the ability to transform how you feel towards your partner, and she towards you.

Text Your Ex Back

Text Your Ex Back

Posted on May 15, 2013 by admin

I wanted to feature a program I came across recently called Text Your Ex Back by Mike Fiore. I think one of the great things about the Internet is the way in which it can bring together information from so many different resources and blend it into a single whole. I’m thinking particularly of information about intimate and sexual relationships. Years ago, if you broke up from your partner, the information available to you will be limited to what your friends and family to say on the matter. Sure, of course you could go and see a counsellor or therapist, but who wants to pay that kind of money to get over a relationship breakup, whether cause by sexual problems like premature ejaculation or not?

What Mike Fiore has done in his program  Text Your Ex Back is to provide an information system which just about everybody who has broken up with a partner, and genuinely wants them back, should be able to follow. Now, I want to make it clear at this point that I’m not in favour of manipulation or any kind of manipulative technique that preys on the psychology of a vulnerable person. So I recommend Text Your Ex Back only because it seems like a very clean and clear form of communication that you can use to reopen the lines of communication with your ex-partner and begin to rebuild the relationship. I must say that this is not the same kind of relationship you had before  – if that relationship had been working, you would never have broken up.

Instead, what Text Your Ex Back can do is to give you a means to get new communication going so that you can get the attention of your ex-partner and explain to them why it would be beneficial for you both to get back together in a relationship.  (And bear in mind that because break-ups are often caused by sexual incompatibility, you may need to use this program to restore your relationship if you don’t get to grips with your premature ejaculation! No, seriously.)

So how are you going to do this? Well, the answer is to use subtle and well chosen text messages which convey your feelings to your partner (oops, sorry, ex-partner) in a way that engages their attention at a level that’s appropriate to the stage of rebuilding the relationship you have reached. There is a whole series of what I’d describe as “graduated” text messages, each of which is designed to develop trust, establish intimate connection, develop attachment, deepen the relationship, and finally generate sexual attraction.  In a short piece of text like this,  it’s hard to explain exactly how this works, so I suggest you have a look at my Text Your Ex Back review which explains everything in great detail.

How To Prevent Premature Ejaculation Permanently

Premature ejaculation is horrible, I know that.

And the desire to last longer in bed can make you turn to any kind of quick fix which offers the prospect of a few extra minutes’ intercourse. But quick fixes don’t help in the long run. For example, you can delay your orgasm with a spray or lotion that numbs your penis. But you lose most of the sexual feeling (and pleasure), and next time you have sex without the anesthetic lotion you’re right back to where you started!

The only way to cure premature ejaculation in the long term is to use the methods which a sex therapist would use. Basically, you learn how to slow down your body’s response to sexual arousal, so that you can stay below the “point of no return” for as long as you want. (The point of no return is the point at which you know you are going to ejaculate, regardless of what happens next – and it’s a point you reach too soon when you ejaculate prematurely!)

When you have learned how to stay below the point of no return, you can literally enjoy sex for as long as you want with no danger whatever of coming too soon. When you choose to ejaculate, you simply thrust harder and faster, taking yourself over the point of no return – and enjoy a very satisfying and pleasurable orgasm! 

Sex without premature ejaculation is so much better; much more pleasurable, much more rewarding for your partner. To achieve this, I recommend the program that I wrote based on my own experiences curing men of PE as a sex therapist, because I know it works, long-term. It features an attractive real-life couple who show you exactly how to use the techniques, with clear, close-up photos of all the exercises and techniques you can use to control your ejaculation. And it’s easy, too: it’s not a simplistic quick fix – it’s a long-term, viable solution, a way of preventing premature ejaculation permanently.

Like I said elsewhere on this website, most women could come through vaginal sex if only their man could last long enough. Sometimes I wonder why women put up with premature ejaculation – it can really spoil sex for a woman. Your partner wants your penis in her vagina – she loves it when you penetrate her. (Just like you love penetrating her.) But once you’re in there, she wants you in there for a good session of lovemaking – not a thirty second lovemaking race against time before ejaculation! 

So what are you going to do about your premature ejaculation? Find a solution? Well, you’re in the right place!

Now, are you ready to go on the most exciting journey of your life – a journey to sexual fulfillment? A sexual future without premature ejaculation?

Treat Premature Ejaculation Effectively and Quickly! 

First, I’d like to tell you a little about what happened to me when I had PE. But let’s start with a definition.

Premature ejaculation is defined in several ways. But the best definition is this: premature ejaculation is defined as an ejaculation that occurs too soon, making you and your partner unhappy with the duration of your lovemaking.

When I was going through my own problems in this area, my partner and I decided the best way to deal with it – until I found a permanent cure – would be to have loads of foreplay. And since my girlfriend especially enjoys receiving oral sex, we made this the main event. When she’d enjoyed two or more orgasms, I would enter her, thrust for two minutes and “enjoy” my orgasm. I was completely incapable of stopping premature ejaculation. And you know what – we’d probably have been content with that for ever were it not for one thing….

One night, after we’d made love and were cuddling, she started to cry. Eventually she told me why. Her previous boyfriend had been able to go on in bed for twenty minutes or more. And every time they enjoyed long vaginal intercourse like this, my girlfriend had experienced powerful vaginal orgasms which then sparked her boyfriend’s orgasm – so they enjoyed a massive, earth-shaking, mind-blowing, simultaneous orgasm. 

This made me – with my weak, two-minute lovemaking, and no ability to last any longer in bed – feel even worse than I already did. And then she cried some more. “I want,” she said, “that experience again. Preferably with you.”

My heart lurched. Could sex with someone else really be so much better that she’d leave me for a better lover? I knew one thing – no matter how much we loved each other, she wasn’t happy about my inability to overcome premature ejaculation. And I knew I had to find a solution – fast!

But Is It Really Possible To Learn How To Stop Premature Ejaculation? 

You may well be asking some questions: What does it mean that “you have no control over your ejaculation”? How could you ever have control over your ejaculation? Isn’t it an involuntary process, one that we simply we can’t control? And just what treatments are available to cure premature ejaculation?

In fact, it’s my opinion that there are actually very few men in the world who can control their ejaculation for long enough to give their female partner complete sexual satisfaction. Indeed, I’d go so far as to say that rapid climax is common to almost all men, and it reduces sexual pleasure for all sexually active couples by depriving them of long-lasting intercourse and the possibility of female orgasm during intercourse, as well as more powerful orgasms for the man. By contrast, ejaculation control certainly improves a man’s self-esteem and self-confidence: in my experience, a man who has control of his ejaculation shows greater confidence in all areas of his life.

If you have any other physical condition like acid reflux or hiatal hernia it is well worth while sorting them out before you try to enjoy vigorous sex. The reason for his is two fold. First, your mind will not be fully on what you are doing, and you will therefore not be with your partner during the shared experience of sex. Secondly, you may actually do more damage to your health if you engage in vigorous activity, which has been demonstrated to promote acid reflux. You can see the reference about the influence of exercise on GERD here. The main body of that site gives excellent information on the nature of GERD and heartburn. Check this out here.

This might be because a happy sexual relationship leads to a fulfilling and intimate relationship in other areas, or it might be that premature ejaculation is profoundly shaming for a man who wants to please his woman in bed. Now, having said all of that, I do recognize that there are some couples who are quite satisfied with short periods of vaginal thrusting, perhaps where the woman doesn’t like long-lasting intercourse because she becomes sore.

For such couples, male ejaculation within minutes of penetration may not be a particularly big deal, but it’s certainly true that even in situations such as this, sexual harmony is definitely increased when the man takes the trouble to ensure that his partner is satisfied sexually before he enters her. Furthermore, most men don’t realize that the longer foreplay and intercourse lasts, the more powerful will be the resulting orgasm, so there is a very strong case for extending the duration of sexual activity even if it doesn’t involve full penetration and intercourse for more than a couple of minutes at the end.

Controlling Premature Ejaculation With Pills

So Do Pills Work As A PE Treatment?

I’m uncomfortable with the possibility that drug therapy is, in the end, all about drug company profits. SSRIs are fairly heavy-duty pharmaceuticals, and they have major side effects. The whole proposition that some kind of SSRI can promote long-lasting sex is an interesting one. To start with, the average time for which intercourse lasts for the majority of men is unclear anyway. One thing we can say with some degree of certainty is that the time between penetration and ejaculation is definitely around three minutes for the majority of men, and only a very few manage to achieve intercourse which lasts longer than five minutes.

Pornography on the internet has not served us well in this respect, because the majority of men who perform in sex films seem to be able to thrust for a long time before they ejaculate. It’s not that they’ve found some mysterious premature ejaculation remedy which the rest of us don’t know about: in fact they have all got symptoms of delayed ejaculation, which effectively means that they can thrust for a very long time without ejaculating. This, however, is a sexual dysfunction just as difficult and challenging as premature ejaculation, and it’s certainly not, if you read the accounts of the men who suffer from it, any advantage whatsoever in establishing a harmonious or successful sexual relationship.

And what of the methodology? Well, scientific research that depends on two lovers measuring the time between penetration and ejaculation during intercourse with a stopwatch is not actually very scientific. Nonetheless that seems to be the basis on which the drug companies, or the scientists who work very closely with them, have based their conclusions that SSRIs can actually extend the duration of sexual intercourse by between 50% and 100%.

I’d like to leave aside the fact that it seems like a ludicrous proposition for a couple to measure the time of intercourse using a stopwatch. Instead, let’s focus on the claimed improvements. (Although I do want to mention one compelling thought: if a woman is prepared to take a stopwatch and measure the length of time for which a man can thrust inside her vagina before he ejaculates, how involved in the sex act is she? And if she is so detached from what her partner and she are doing, it suggests to me that they do not have a very good relationship, and in that case it would not surprise me that the man is indifferent to the length of time for which he can maintain intercourse before he ejaculates.)

One of the major researchers in the field is Dr. Waldinger. He’s done a great deal of research (and has indeed made the observation that for as long as drug companies fund research and premature ejaculation cures, there’s not likely to be a huge amount of objective and realistic research, because of the subtle pressure that the commercialization/medicalization of premature ejaculation exerts on researchers. This undoubtedly influences the outcome of what they’re doing in the laboratory … or indeed in the bedroom).

Premature ejaculation is regarded as a problem that affects mostly teenagers or young men, but nothing could be further from the truth. It affects all men, of all ages, of all social classes, and all psychological types. It’s associated with relationships which are stable as well as relationships which are in difficulties; it’s associated with men who care about their partners as well as men who don’t, and there’s no obvious emotional profile that applies to the men who suffer from PE.

A Drug That Might Cure Sexual Dysfunction

But, and it’s a big but, the social pressure that seems to exist on men to take drugs to control their sexual performance (for the rest of their sexual lives, mark you) is a very questionable and bizarre thing indeed.

Dr. Sidney Wolfe, director of the Citizen’s Health Research Group in Washington has made this point very clearly when he talks of the idea that prescribing Dapoxetine for men with premature ejaculation is a good idea. He asks why men would wish to take a drug for the rest of their lives, commenting that this is a  “massive hype.” Johnson & Johnson have not yet received a license for Dapoxetine as a prescription cure for PE in the USA.

By the way, the study’s findings were that prescribing this SSRI extended intercourse from an average of one minute to just under three minutes. Those of us who believe that psychotherapy and behavioral training is actually a much better treatment for PE than taking a drug, may see this as good news. It’s an insignificant improvement…..

In the biggest research project as of April 2005 (unsurprisingly supported by Johnson & Johnson), 2,600 men tested the effect of Dapoxetine on the duration of intercourse. If I told you that it appeared to double or even triple the  length of intercourse, you’d probably regard this as a successful trial of a drug that has enormous potential. What would you say if I now tell you that three minutes (yes, that was the extended length of intercourse after men started taking the drug) does not make for a successful session of intercourse for most women?

The study also revealed strong placebo effects, and very little increase in sexual satisfaction for the participants. So are drugs a genuine treatment? While it might be a little harsh to describe the research as a complete waste of time, I think the majority of men would not wish to take drugs to treat rapid ejaculation when their side effects include anxiety, depression, nausea and sweating, amongst many others, and there is such a paltry increase in the duration of intercourse.

What remains true, as it always has, is that if you’re looking for information about treatment for premature ejaculation, you can find it easily, and the techniques which work are very effective if you’re prepared to put in a certain amount of effort while applying the relevant behavioral techniques to train your body to respond to sexual arousal in a more controlled way.

Premature Ejaculation Control – A Necessity, Not An Option

For men of all ages, premature ejaculation is rapidly becoming an issue of major importance. Although previously confined to the bedroom, and not talked about, lack of ejaculatory control is fast becoming a matter of discussion on internet forums, TV, and in magazines. Men are prepared to discuss the subject amongst themselves in a way that would have been inconceivable 20 years ago. So what’s brought about this dramatic change in the open discussion of something so personal – the inability to control ejaculation during sex, and last long enough to satisfy your partner?

I believe that part of the reason for more widespread discussion of premature ejaculation is that women are no longer prepared to accept a sex life that’s less than fulfilling. The internet has really liberated people from the taboos around discussing sexual matters – after all, even if you’re experiencing guilt and shame around sex, it’s easy to adopt a false name and go on an Internet forum to discuss the matter. And once a group of women get together and start discussing the comparative merits or demerits of their sex lives, the subject is sure to turn to premature ejaculation before long.

The bad news is that while discussing this subject may be easier than it used to be, treating premature ejaculation is still very much more an art rather than a science. One reason for this is that apart from a lot of research into pharmaceutical products like Dapoxetine as a way of relieving the tendency to ejaculate quickly, very little has changed in the arena of premature ejaculation treatment in 50 years. What worked in the days of Kinsey and Masters & Johnson still works. Unfortunately, one reason that quick ejaculation is still so widespread is because men show no greater a desire to work on ending the problem now than they did fifty years ago.

And this is probably quite understandable, because for a man, sexual intercourse is very rewarding even if it’s extremely short-lived. As somebody once said to me, “An orgasm is an orgasm – there aren’t any bad ones, it’s just that some are better than others.”

While I don’t support his point of view, because such a selfish male attitude unquestionably deprives women of sexual satisfaction, the fact is that men simply don’t seek out or apply the many effective ways there are to cure premature ejaculation, and the problem remains unsolved for the majority of men who have  limited staying power.

Let’s also remember that curing rapid ejaculation is not just a matter of finding a solution for the man’s tendency to ejaculate too quickly. It’s also about empowering him to pleasure the woman so that she gets the maximum satisfaction from sex too. Orgasm By Command is a program which enables men to do just this, giving their partners pleasure and satisfying them in many different ways so that a female orgasm is guaranteed. You can see it here – I highly recommend it, because it may well transform your sex life.

A Cure For PE? Or Even Just A Treatment That Works?

This is ironic, considering that rapid ejaculation can dramatically lower a man’s self-esteem, and even more ironic, considering that effective PE treatments and various cures are easily available. Fundamentally, PE represents the male approach to sex: taking what he wants selfishly, and grudgingly giving the woman what she wants – intimacy, connection, and possibly an orgasm during lovemaking.

I’m not criticizing men for this, because there is a cultural pressure that fails to address the need for female sexual satisfaction. Nonetheless, if you’re a man who lacks ejaculatory control, it’s incumbent on you to find a treatment program that will actually cure the problem. It isn’t even about the fact that women very frequently achieve orgasm during sexual intercourse if a man can thrust for long enough; it’s more about the fact that the short-lived sex breaks the intimacy that develops when a man ejaculates too soon.

This can be very distracting and unsettling for a woman, who usually wants to relish the sensation of connection with her partner, both emotionally and physically. Since most men understand this at some level, even if they don’t act on that knowledge, and since women put up with it, perhaps resentfully, perhaps grudgingly, it’s very obvious that any company that comes up with a simple and effective premature ejaculation treatment method is on to a real money winner.

And that of course is why the pharmaceutical companies have become interested in the problem. The medicalization of PE (which effectively means turning a social problem into a medical problem), means that a drug company has a “legitimate” reason to conduct research into the compounds that may be available for resale — for which of course you can read “the compounds that would make the drug company massive profits”. Read the story of Dapoxetine here – up to 2005, anyway.

In fact certain drug companies have gone to extraordinary lengths in recent years to win over scientists to their cause, sponsoring research into the development of drugs that might be able to control premature ejaculation. As you may know, if you’ve read anything on the Internet about  PE, the most common line of research is into the possible use of SSRI antidepressants as a way of curing this problem.

SSRIs affect the level of serotonin in the brain: the lower the level of serotonin, the lower the level of sexual arousal, and the slower a man is to ejaculate. Now, this may seem very straightforward and simple, and you can see why it would be a popular solution for a lot of men. However these drugs are not licensed in the USA for use wither “off label”, or indeed on label, as a treatment for premature ejaculation. Also, there are some very significant side effects.

Of the major drug companies, Johnson & Johnson have been very active in promoting Dapoxetine as a compound likely to cure PE, and they’ve spent a lot of time and effort building a body of scientific research which seems to demonstrate the effectiveness of SSRIs in this context.

Some observers have made the point that it is no wonder that premature ejaculation has been recast as “PE”; an innocent sounding set of initials which might take away both the social embarrassment and the shame that are associated with the overt admission that, as a man, you cannot last long enough in bed to feel satisfied with your sexual performance. Now, as a sexual therapist, I’m all for removing the shame around sexual issues, but I’m definitely not for the promotion of false hopes.

What makes the promotion of pharmaceuticals more perverse, at least in one way, is the fact that effective treatments for fast ejaculation have been around since the 1950s: these are the squeeze technique and the stop start technique.

Certainly they take a bit of effort, but they do work, and their effects are long-lasting – with a little ongoing application. As I said above, it’s sad that men are not prepared to take the trouble to put in the effort to cure premature ejaculation using several tried and tested techniques, but instead wish to take a pill as a quick and easy solution.

There’s something here for me about responsibility: when a man needs to control his ejaculation, and uses a behavioral training technique like the stop start technique, he’s actually forced to take personal responsibility for the fact that his sexual performance is not “up to par”. When he takes a pill, there’s some sense in which his own responsibility for controlling his ejaculation is diminished. And I understand the desire for simple and easy solutions to sexual problems. However, the truth is that overcoming one’s irresistible and compelling desire to ejaculate, in other words overcoming the instinctive desire to thrust deep and hard and ejaculate as quickly as possible, requires a clear intention on a man’s part and a mature attitude to curing his quick ejaculation. It also needs the self-discipline that is associated with learning the techniques of effective ejaculation control through using the appropriate treatment.

Still that’s the culture of the of the 2000s: a pill for every ill! The idea that a pill can actually give you control of your ejaculation is a very tempting one; it means instant self-esteem, in means instant self-control, and it means instant sexual satisfaction for your partner.

The Mechanism Of Orgasm and Ejaculation In Men

Physiology of Ejaculation

As you probably already know, ejaculation is a two-stage process, consisting of emission and ejaculation. During the emission phase, sympathetic nerve cells induce contractions of the smooth muscles of the epididymis and vas deferens so that sperm moves into the prostatic urethra; the seminal vesicles and prostate gland also contract, thereby producing seminal fluid that mixes with sperm. Additionally, secretions of the bulbourethral glands are added to the mixture of fluids that becomes semen.

This process is experienced as the point of no return, the point of ejaculatory inevitability, the point at which ejaculation will happen no matter what the man does next: it is followed by the expulsion phase in which the semen is expelled from the penis by contractions of the muscles of the pelvic area.

As Marcel Waldinger says, “the preganglionic sympathetic nerves involved in the emission phase originate from the intermediolateral columns of the spinal thoracolumba cord and travel via the sympathetic chain and hypogastric nerve (post ganglionic) to the pelvic plexus (the inferior hypogastric plexus) or via the sympathetic chain and pelvic nerve to the pelvic plexus. The pelvic plexus the sympathetic nerves are mediated by the cavernous nerve to the vase deferentia.”

During emission the bladder neck muscle contracts so as to prevent semen from entering the bladder, a process known as retrograde ejaculation. It’s apparently pressure on the walls of the posterior urethra which initiate ejaculation, a process mediated via the pudendal and pelvic nerves. This explains why extensive foreplay, which produces more secretions in the male sexual glands, triggers a more forceful ejaculatory reflex when sexual stimulation has reached the trigger point.

Overcoming Premature Ejaculation Is Actually Not So Difficult!

Rapid ejaculation is common in all men, not just young men who have not learned the art of ejaculatory control. As you know, in all men there is a point in the sexual arousal cycle where ejaculation becomes inevitable; the problem for men who ejaculate too soon is that they reach this point far too quickly, ejaculating perhaps upon genital to genital contact or maybe even in the first stages of physical contact.

Of course such rapid ejaculation is extremely disappointing to both man and woman, but it’s very frustrating indeed for a woman who has not had time to achieve orgasm.

And when a man is unable to delay his ejaculation and displays the same pattern of premature ejaculation time and time again, he not only feels completely unable to control his sexual responses, but also suffers the fear and anxiety of disappointing his partner, and experiences a degree of sexual shame, but also loses a sense of pride and confidence in his sexuality.

This anxiety and shame can have several consequences: it may lead to erectile dysfunction, it may lead to sexual avoidance (true especially if he is regularly criticized by sexual partners for his poor sexual performance), and it may lead to an increasing cycle of anxiety – reinforcing premature ejaculation – causing more anxiety – every time he attempts to have sex.

Controlling Premature Ejaculation

As I said earlier, controlling premature ejaculation is actually fairly easy. In practice treatment works much better if both partners are involved and the couple have good communication skills. This is because a mutual sense of responsibility and willingness to explore the emotional and sexual issues is almost a prerequisite for a complete cure; moreover, having an open-minded attitude about new sexual techniques that may help change the man’s pattern of sexual response is also beneficial in slowing down his ejaculatory response to sexual stimulation.

The difficulty comes when there are some fundamental problems between a couple which have not been resolved – this could include anger, resentment, or more particularly psychological issues related to one individual within the partnership, such as the man’s deep-seated fear of women (or vice versa). In these circumstances professional help may be necessary to improve communication skills or to unravel the deep psychodynamic issues which lie at the heart of this dysfunction.

There is little agreement about the definition of rapid ejaculation. Neither is it clear how various aspects of the condition are linked together. Two researchers surveyed the degree of ejaculation control of over 100 male university students, asking them to self-report on ejaculatory latency (time before ejaculation after penetration) and their belief about how much control they had over their ejaculation. They found that these two data sets were only modestly related, sharing, on average, only 10% of the variance.

The problem is that we don’t know how reliable the men’s description of their own sexual and ejaculatory behavior actually is! The problem of the reliability of self-reports of men’s lovemaking habits has been looked at by a few authors.

In one study, the reliability of men’s reports of the time they take to ejaculate was examined by comparing how long they said they lasted during sex and examining them in a laboratory to see how long they actually lasted before ejaculation – but the conditions are so different, so this really adds very little to our understanding of the condition. Truth is, the ejaculation speed of men with premature ejaculation is not likely to be the same in the lab and in bed with a sexual partner, nor is it likely to give much indication of how long they can last during lovemaking.

In short, to know whether or not we are on the right lines when looking at men’s estimates of the length of time they last during sexual intercourse, we need to ask their partners some questions and see what they have to say on the subject.

Regular or long-term partners are able to provide information about how long the man can last before he ejaculates, or whether he ejaculates before he penetrates his partner. Once you have this data you can compare what the partner says about these matters with the man’s report of how long he can last, whether he knows how to control premature ejaculation, and his ability to control its timing.

You can also assess whether or not he is worried about ejaculating too rapidly, and establish his anxiety about how much control over ejaculation he actually has. Learn more about how PE affects a relationship here.

Most research has split men into rapid ejaculators and non-rapid ejaculators based on what the man says about his own sexual performance. But some scientists have included objective measures of rapid or premature ejaculation (i.e. how long he lasts before he comes) as well as asking the man about how he sees his ejaculation (i.e. normal or premature).

They found that about one man in five claimed to have a problem with premature ejaculation. With the help of seven criteria which could be used to predict when a man would report that he had a problem ejaculating too quickly, they soon found that there were several components to self-identified rapid ejaculation: a behavioral component (how fast the man ejaculates), an affective component (what he feels about it), and an efficacy component (what he does about it). They also studied what a man’s partner thinks about her man’s speed of ejaculation.

The Psychological Factor

Which brings us to the other important part of quick ejaculation: how the man feels. When a man thinks he ejaculates too quickly with no control, he’s usually upset about it: he feels shamed, humiliated and like a sexual failure. So rapid ejaculation may therefore become a trigger for internal criticism and negative self-talk. This sets up a vicious cycle: the negative feelings after sex eat away at a man’s self confidence, which make him more anxious about ejaculating too early next time. More anxiety means more performance pressure, which makes it more likely that he will ejaculate “too soon” next time… and, sure enough, he does!

Enhance Your Endurance – How To Beat Premature Ejaculation

Even the most experienced lover may find that he ejaculates too quickly every once in awhile. Because it is so common, we can assume early ejaculation is almost a natural condition. Consequently some men need to learn the art of lasting longer in bed, to enable them to achieve maximum sexual pleasure for themselves and fully satisfy their lover while having sex.

However, curing rapid ejaculation is not just about sexual fulfillment for the woman . As already mentioned, consistently coming too rapidly can ensure that a man has a low sexual self- esteem. Not to mention the fact that nearly all women who constantly have sex with a man who ejaculates prematurely are sexually irritated and unhappy, even if they have orgasms by genital masturbation or oral pleasure. That’s because women actually crave the intimacy of extended lovemaking.

However you view it, therefore, it can only boost a couple’s sexual relationship when a man has the ability to last longer in bed than the typical duration of love-making( which happens to be about three or four minutes ). Bear in mind when a man makes all the effort to boost his staying power, and finds out the best way to last longer in bed, the woman will always come to feel more cherished and appealing due to the fact he’s trying to please her. That means she will be more serious about sexual intercourse!

I’ve actually worked with lots of men who have premature ejaculation difficulties for several years, and I know it can be very hard to manage simply because no matter how good your intentions are, when you make love it’s very difficult to focus on lasting longer in bed. Sadly, this can reinforce your tendency to ejaculate quickly.

Having said that, when you know how to do it, managing fast ejaculation is much easier than you ever thought possible. What follows could make all the difference to your ability to control your tendency to ejaculate too soon during lovemaking, and the great thing is that these tips are both simple and effective. This

To begin with: you need to be 100 % committed to last longer in bed. It’s all very well declaring that you don’t like ejaculating rapidly, but we all know that the good feelings which come with a powerful orgasm and ejaculation can be so intense that it just doesn’t seem worthwhile learning how to make love for longer. Actions are what are important here, not what you say. So getting your head in the right place is essential: if you don’t want to last longer for your own pleasure, do it for your partner’s sake, because when she’s happier in bed your whole relationship will improve dramatically. This is something you have to decide for yourself.

The second step in the process is to learn to relax whilst you actually make love. Having sex makes the muscles of your body tighten, and your body becomes more aroused- you know this is happening when your breath becomes shallow and your breathing becomes faster. But all of these things actually speed up your progress towards orgasm, so anything you can do to counteract them will slow you down.

And in fact it is actually possible to keep your body relaxed and slow down your breathing even if you happen to be experiencing the exhilaration of sexual intercourse. The easiest method to avoid tension is to keep a small part of the mind focused entirely on the degree of muscle tension you happen to be experiencing, and to keep track of your breathing so you can slow down and take deep breaths if necessary. So every time that you sense that you’re getting more tense, take time to slow down, and consciously relax all your muscles . And again, if you notice your breathing is getting shallow and fast, slow it down and take deep breaths. They may sound like simple steps, but these two tactics will help you to last much longer during sexual intercourse.

Third: ensure that you are sensitive enough to the signals your body is giving you to understand how near you are to having an orgasm. The majority of men who want to last longer in bed have little awareness of how near they are to the point of ejaculatory inevitability ( that’s the point where you recognize you will ejaculate and nothing can stop it happening ). And so, when you actually have awareness of how aroused you are, you have the power to slow down the rhythm of sex or stop making love altogether until your arousal is dropped to a safe level.

Ensure that you have at least half an hour to yourself and that you will not be disturbed before beginning to masturbate with a slippery lubricant such as olive oil. Repeatedly bring yourself towards the point of ejaculation, but stop before you get there. While you pleasure yourself, maintain an awareness of how aroused you are, and ensure that you notice the signals that indicate your approach to the point of orgasm, but stop before you ejaculate. It won’t be long before you find you have much greater ability to maintain a high level of arousal without ejaculating. No matter how rapidly you reach the point of orgasm when you start this exercise, keep going, keep bringing yourself to the point of orgasm in backing off . Use self- discipline so you don’t ejaculate, and you’ll rapidly find that you can take more stimulation without ejaculating.

The object of this exercise is to discover ways that you can use to stimulate yourself to half an hour without having an ejaculation. Make sure that you bring yourself to a point where you feel you might ejaculate and then back off several times before you finally reach orgasm. Although it’s a simple exercise extremely powerful, and it will enable you to make love for at least5 minutes with your partner before you ejaculate. Even better, if you do this whilst enjoying intercourse with your partner, your staying power will increase dramatically, and your ability to last longer will impress both you and your partner.

Rapid Ejaculation No More

The greatest problem for males when making love is early ejaculation. It’s hard to determine premature ejaculation, but specialists usually agree that a man who ejaculates in two minues of of starting to make love to his partner may well be neither pleasuring her nor obtaining greatest sexual satisfaction himself. In this article, I’ll describe some easy methods that ought to allow you to last much longer during sex.

There are many other problems that can crop up whenever a man routinely refuses to face his fast ejaculation: these include unspoken anger, stress within the romantic relationship, and lack of interest in sex on the part of the woman, and perhaps even the chance of one partner having an affair. The truth is that most women enjoy sexual intercourse with or without orgasms simply because they feel emotionally connected to their partner.

The typical duration of intercourse is only about three minutes, which is nowhere near sufficient for real sexual satisfaction. Enhancing this, and lasting longer during sex, will always boost your sexual relationship. Keep in mind that when a man puts in the effort to boost his staying power, and finds out how to last longer in bed, the woman will always feel more appreciated and desirable due to the fact he’s taking the time to please her. This means she will be more enthusiastic about love-making!

Even so, it can be a challenge to deal with premature ejaculation. It’s all too easy when you get into bed, and you’re beginning to get excited, to find your intentions to control premature ejaculation simply come to nothing. That’s when low self- esteem can begin to develop.

Even so, there are some simple approaches that can help you improve your performance in bed and last much longer during sex. I want to provide you with three uncomplicated ideas in the following paragraphs which you can apply instantly and should make a vast difference to your stamina.

The vital thing is to be completely 100 Percent certain you really do want to last longer in bed. It’s all very well saying that you don’t like ejaculating quickly, but we all know that the good feelings which come with a powerful orgasm and ejaculation can be so strong that it just doesn’t seem worthwhile learning how to make love for longer. Actions are what are important here, not what you say. So getting your head in the right place is essential: if you don’t want to last longer for your own pleasure, do it for your partner’s sake, because when she’s happier in bed your whole relationship will improve dramatically. This is something you have to decide for yourself.

The second step in extending your staying power is learning to be relaxed during intercourse. Of course a lot of tension can build up in the excitement sexual intercourse, that’s only natural. The trouble is that, particularly for a man, muscular tension and excitement in the body( of which shallow breathing is the most obvious sign) speeds up progress towards orgasm dramatically. One way that you can prove this to yourself is to make love in the man on top position and then to try sex with the woman on top. In the first case you’re much more tense, and you’re likely to ejaculate much more quickly.

You can keep control during sex by ensuring that you remain focused on what’s going on in your body, relaxing your muscles every time they become tense, and slowing down your breathing every time it comes faster . Also make sure you slow down the rhythm and pace of your movements during intercourse. Equally, every time you find your breathing is quick and shallow, take a deep breath, pause, and re- establish a slower rhythm.

Third: ensure that you are sensitive enough to the signals your system is providing you with to understand how near you are to ejaculating. A major cause premature ejaculation is that a man simply has no knowledge or understanding of how near he is to the point of no return – that’s to say, the level of arousal at which his ejaculation will become inevitable. And so, when you actually have awareness of how aroused you are, you have the power to slow down the rhythm of sex or stop making love altogether until your arousal is dropped to a safe level.

Ensure that you have at least half an hour to yourself and that you will not be disturbed before beginning to masturbate with a slippery lubricant such as olive oil. Repeatedly bring yourself towards the point of ejaculation, but stop before you get there. While you pleasure yourself, maintain an awareness of how aroused you are, and ensure that you notice the signals that indicate your approach to the point of orgasm, but stop before you ejaculate. When you begin this exercise, you may discover that you not have much control or awareness, but with practice you will find that your awareness increases dramatically- and very quickly! Before long you’ll find that you’re able to bring yourself much nearer the point of ejaculation without having an orgasm, and that you’ll be able to keep yourself there for longer.

What you’re aiming for is to be able to continually stimulate yourself for up to half an hour without ejaculating, perhaps bringing yourself close to to the point of climax four or five times before eventually enjoying your orgasm. On its own, you should find that this technique extends your ability to make love to around five minutes – but if you do something similar while you actually make love to your partner, you’ll rapidly develop the ability to last much longer during sex.