All posts by adminJH3

Uncategorized

Ejaculation – Fast or Slow?

Effects Of Male Sexual Dysfunction On Men And Women

In 2005 Donald Patrick and a number of colleagues conducted an observational study into the effects of premature ejaculation on men and their partners. This was published in the Journal of Sexual Medicine, volume 2, issue 3, in May 2005.

Patrick makes the observation that whilst premature ejaculation is the most common male sexual dysfunction, estimates suggest that only a small number of men who regard themselves as having PE actually receive any treatment for this problem.

Considering that up to 50% or more of the male population ejaculate too quickly, by their own admission (the figure offered by Patrick is 20 to 30%, but we believe it to be higher) this is a very significant number of men who are tolerating the condition.

It’s obviously the very personal and intimate nature of PE that causes both men and doctors hesitancy in discussing this subject, and this also probably contributes to men’s lack of awareness of how they might deal with the problem.

As we’ve seen on other pages of this this website, there are several factors which may also affect the understanding and analysis of PE, including the lack of an accepted definition, and the controversy around treatment methodology.

We have also seen how definitions of premature ejaculation are based on factors such as personal distress, difficulty between the partners, the level of sexual satisfaction, the time between penetration and ejaculation, and the lack of control that a man subjectively feels he has over his sexual responses.

The effect on the partners is an area that has been less well studied than the effect on the man concerned.

There is no agreed standard for the time between penetration and climax which could be used as a definition of PE. Indeed, there is no standard which is agreed upon for defining delayed ejaculation either – so premature and delayed or slow ejaculation become simply two aspects of the same problem.

Indeed, studies have used intervals of anything between 1 and 7 minutes as a definition of “premature”.

Previous studies have demonstrated that it’s extremely important to take account of what the man and his partner feel about the experience that they’re having.

Factors that are relevant to both partners in a relationship would include the level of satisfaction that they feel around the man’s control, the level of satisfaction they feel with sexual intercourse, and the perception of their overall situation.

Patrick’s study was designed to characterize men with and without premature ejaculation in a large sample from the community. Of course this revealed nothing about how well men could control premature ejaculation during sex with their partners.

And it revealed nothing about sex with their partners, how satisfied their partners were with orgasm frequency or the nature of their partners orgasms. In particular, whether or not the women were able to enjoy female ejaculation as part of sexual pleasure.

The researchers used both measures that could be observed – the IELT or time between penetration and climax – and subjective measures such as reports by the man and his partner about satisfaction, distress, difficulty and severity of the condition. This was especially true in cases of delayed ejaculation. You can read a treatment protcool for this condition here.

No treatment was offered to any of the people in this study, since the objective was purely around descriptive observation of the men’s condition. The study lasted for four weeks and was conducted at 42 centers in the United States.

The couples who took part were paid approximately $400. They were required to make three visits to the centre where they were interviewed at approximately 2 week intervals.

All of the men involved in the study were more than 18 years of age, in long-term heterosexual relationships and, by their own admission, monogamous. Also, the fact that they were required to have been in a relationship for six months should have avoided any potential effects of a new sexual partner on the man’s IELT and other subjective responses to intercourse.

All the subjects underwent a review of their medical history, collection of relevant personal information, and the assessment by a clinician of their ability to control female ejaculation.

The investigators used the standard DSM IV criteria to determine the effort they had made to overcome the problem.

The definition of PE used was: persistent or recurrent ejaculation occurring with little or no physical stimulation, on or shortly after penetration, and before the man wishes it; causing distress or interpersonal difficulty; and the fact that the PE must not have been due to the direct effects of alcohol or other drugs or any other substance.

Studies Into The Effects Of Rapid Ejaculation

Any subjects who reported decreased libido or any other form of sexual dysfunction, and any men whose partners exhibited those characteristics, were ineligible to take part in the study, as were those men who were taking various medications including SSRIs, medication for erectile dysfunction, and any anesthetic ointment treatment to control premature ejaculation.

On the first visit the man and his partner were given a stopwatch and instructed how to record the time between penetration and climax: the man’s partner was asked to operate the stop watch, starting it when the man penetrated her vagina, and stopping it when he ejaculated or withdrew without any ejaculation.

During the course of the study, the couples were asked not to engage in any new sexual techniques, so that their established sexual behavior and routine would not be affected by novelty.

On the second and third visits to the investigation centre, the man was asked to complete various subjective surveys of his ejaculation control, satisfaction, distress and interpersonal difficulty.

His partner was not expected to take part in the second and third visits, but was given a questionnaire to be completed and returned to the investigators at the end of each period of the survey.

As far as the subjective measures of sexual pleasure and satisfaction were concerned, there were five questions which were rated on a scale of 0 to 4.

The first question concerned control over ejaculation, specifically his ability to prevent premature ejaculation. Both the man and his partner were asked what level of control over ejaculation during sexual intercourse the man had achieved, on a scale of 0 to 4.

The second question concerned satisfaction with intercourse and again both the man and his partner were asked where their satisfaction with sexual intercourse over the past month could be rated on a scale of 0 to 4.

The third question related to the severity of the man’s premature ejaculation, and both the man and his partner were asked independently to assess the severity of the condition on a scale of 0 to 3.

The distress caused by PE was the subject of the fourth question, and the men and their partners were asked how distressed man was by how fast he ejaculated during sexual intercourse.

Again his responses were analyzed on a scale of 0 to 4. And the final question was around interpersonal difficulty. Both the man and his partner were asked to what extent the speed with which the man ejaculated during sexual intercourse caused difficulty in the relationship. The answer was rated on a scale of 0 to 4.

Intra-vaginal ejaculatory latency time – IELT – was defined as the average duration of intercourse taking into account all attempts to have intercourse since the last visit to the survey centre.

Those men who ejaculated before they’d even penetrated their partners were given an IELT of 0 minutes. Using statistical analysis, including t-tests, correlation analysis, and chi-square tests, plus Spearman’s rank correlation coefficient, the subjective and objective scores were analyzed with respect to the differences between men who claimed to have had lifelong premature ejaculation and those who claimed that PE had started later in life.

There were 1587 men and their partners involved in the study, of whom the doctors diagnosed 207 as having premature ejaculation. Therefore, 1380 men who did not meet the criteria laid down in DSM IV were assigned to the group of men who were supposed not to have PE.

The majority of subjects completed the survey, although 13 men in the group with PE did not do so, while 38 men in the group without PE were lost to the study at some point. The average age of men in the study was 35.4 years, and the majority were white men living with their partner.

Obviously men with a long IELT of 30 minutes or more could be said to have delayed ejaculation and might benefit from delayed ejaculation treatment. All therapeutic approaches to ejaculatory difficulties aim to stop premature ejaculation and produce a more normal timescale for lovemaking.

erection problems

Dealing With Sexual Problems

Causes of Male Erection Problems

There are two broad categories of men’s erection problems:  physical (or bodily), and psychological. In the early days of sex therapy, psychological erection failure was thought to be the most common. Indeed, some experts (Masters and Johnson, to be exact) suggested that up to 90% of men who had erection problems were in fact experiencing a psychological form of the problem. And it’s my belief that this is till a major problem for men today. You see, we are faced with many issues and problems that can cause men to feel a weakness in their psychological structure around sex. These are often wrongly held beliefs that lie out of consciousness, and which are therefore hard to identify and remediate. But this may also be why so many therapists turn to the physical issues which can cause erectile failure without looking ta the psychological issues first.

I am thinking of the shadow unconscious here. The energy held in repressed emotional wounds from childhood which lie hidden in the unconscious and which determine so much of our relationship with the future sexual partners we choose. It follows that dealing with – ie healing the emotional issues from the past – can really have an impact on our sexual performance, and pleasure, in our adult lives.

If you want to get a greater understanding of what his means in reality check out this book on the human archetypes and shadow. This book on shadow work is available in the UK as well from this supplier. 

But things are different now! Forty-plus years on from the time when few treatments could deal with physical issues, we know that psychological problems are not the only issue. A huge number of erection problems are caused by bodily problems, that is to say, physical problems that lie in the body.

Naturally, as you may already have realized, any problem that affects the penis will of course have a massive impact on the man who owns it. So how do you separate the causes of erectile dysfunction into emotional or psychological and physical?

If you’re a man who has – even once – experienced the loss of erection during sex, then you will know how worried you were the next time that it might happen again – and how much it affected you. Read more on this here.

Before we start to consider the factors that affect erection problems, it would be helpful to consider the mechanism of erection. That way we can see how the interaction of physical and emotional or psychological factors may cause a man to suffer a loss of erection.

The penis’s erectile tissue obviously has to fill with blood, and any problem that affects this mechanism – and the penis’s ability to fill with blood – will affect a man’s erection capacity. It follows that any problem with arterial blood flow can affect a man’s erection, as can any problem with the mechanism which blocks the veins that drain blood away from the penis.

These two mechanisms have to work in conjunction to produce a firm erection. In medical language, the latter is known as failure of the venous occlusive mechanism.

Blood vessel problems

When the small vessels which carry blood to the penis dilate to allow an erection to take place, they expand to something between 10 and 15 times their normal diameter. Any occlusion can cause major problems with the erectile mechanism. Even a small blockage can do this, and it’s not so unusual. Arterial blockages can be caused by cigarette smoking, hypertension, high cholesterol levels and injury to the groin or pelvic area.

Often men who have occlusion in this area will also have problems with blockage of arteries elsewhere in the body. There’s a saying among doctors that the erection problems start two years before the heart attack. But unfortunately the same is true in reverse: heart problems can precede erectile problems.

Blockage of a single artery in the penis can occur because of injury or trauma – this is the most common cause of penile arterial problems in young men.

Arterial problems can also occur in men with diabetes: unfortunately, they can suffer both nerve damage and arterial damage. Plaque buildup on the internal walls of the arteries further reduces their diameter. And men who have high levels of cholesterol have a clear risk of arteriosclerosis which will block the arteries of the penis. The extra lipid builds up in the wall of the artery and eventually causes a significant degree of blockage.

And high blood pressure – due to the arterial stenosis which accompanies the problem, rather than the high blood pressure itself – can be a cause of erectile dysfunction.

Failure of the venous occlusive mechanism

Equally as common as the arterial problems that we mention above, failure of the venous occlusive mechanism can allow blood to drain away during an erection rather than be held in the erectile tissue. This will prevent the build up of pressure necessary for an erection to occur. This can be a problem with young men who have always had erection problems all their lives – some surgeons offer surgery designed to repair the fault.

Another cause of erection problems worth mentioning is Peyronie’s disease, in which non-elastic scar tissue develops along the inside of the erectile chambers of the penis. This can even become calcified and line the tunica albuginea in such a way that the tissue cannot be compressed adequately as the penis erects: this in turn prevents the veins being squeezed shut, thereby allowing the problem of venous leakage to develop.

By contrast, if the trabecular smooth muscle and the vascular spaces of the penis are unable to relax sufficiently, the sinusoidal expansion will not be enough to permit adequate blood into the penis for an erection to develop. This can happen if a man is over-aroused (i.e. emotionally excited) when he has excessive adrenaline in his body. 

Finally, cigarettes cause generalized arterial blockage and may also affects the cavernous smooth muscle so that it cannot dilate. Overall, though, the outcome is the same: the penile veins are not compressed enough to produce the heightened intracavernous arterial pressure which lies behind the erection problem.

Video – causes of erection problems

erection problems

Erection problems and anxiety

Erection Problems and Anxiety

If you’re having problems getting an erection or keeping an erection, you are probably experiencing a great deal of anxiety around sex. This will not be helped if you feel your arousal level increasing and decreasing as your lovemaking progresses.

Hopefully sensate focus exercises will help you to get in touch with the physical sensations that you experience during sex, so you are more aware of what your body is dong and your state of arousal at any point during your lovemaking.

There is also a series of exercises whose purpose is to reduce your anxiety even further, and in particular, to stop you responding with anxiety to any decrease in your arousal or the loss of your erection. This will break the connection between your anxiety and your erectile dysfunction. Your anxiety causes a large part of your impotence, and this will help break the connection.

At the same time, these exercises will help you to become more sensitive to your level of physical arousal. In short, you will become less sensitive to losing your erection, less anxious about penetration and sexual situations, and more sensitive to the physical sensations which give you pleasure during sex.

The exercises are designed in small steps; please don’t jump ahead. Take it slowly and over time you’ll find that you make big advances in your ability to stay relaxed and keep your erection. (If you take it too fast, you’re likely to be disappointed and experience setbacks in treating your impotence.) If you’d like to read a full version of the article about these exercises, you can see a book which deals with erectile dysfunction here.

And, by the way, if you happen to have both premature ejaculation and erection problems, you have to deal with the erection problem before you tackle the premature ejaculation problem.

 

Anxiety is a part of everyday life; most people experience some degree of anxiety sometime in their lives. Anxiety can be useful – it keeps us alert and provides a means of being ready to cope with stressful events or situations. But men’s sexual anxiety is different – it counteracts the relaxed state needed to enjoy great sex: it affects our performance in bed, often by preventing an erection. And though it’s a massive problem, affecting at least one man in ten, it is hardly ever discussed openly among men, because it is seen as such a shameful thing to have to admit you can’t get an erection. If you have some degree of sexual performance anxiety, you’re probably worried about whether or not you’re going to get an erection, or whether you’ll lose it when you start to have sex.Sexual performance anxiety can strike in all these situations. Why? generally because you’re focusing on your final goal, which is either having an orgasm or enjoying sex by taking your partner to orgasm, rather than on everything else you’re going to be doing with your partner (e.g. being intimate, being sensual, being loving and communicating).If you focus more on your relationship and the sensual experiences that you’re enjoying, instead of the orgasms you might or might not have (and the ones she might or might not have, too!) you’re likely to be much less anxious.

Your success at the following exercises to cure your erection problems depends on your ability to be relaxed and accept what is happening without any anxiety about how you are performing.

If you start watching and thinking and worrying about how you’re doing, you’re going to find pretty quickly that you step out of the relaxed attitude that is needed for you to “stay in the moment”.

You’ll probably get tense and start to monitor your performance, and the more you do that, the more you’ll worry. In that case, it won’t be long before you begin to experience the anxiety which has led to your erection problems in the past, and then it may not be much longer before your erection disappears!

Ask your partner to watch for any signs of developing tension, and if she sees them, have her remind you to use your relaxation techniques to get back into a less self-critical, more self-accepting place, where you just enjoy what is happening without spending time thinking about it.

And remember, it’s not part of the deal that you focus completely on your partner and try to please her! This is not a way to cure impotence. You are working towards equality of enjoyment, between you and her, and as much time should be spent focusing on your needs as on hers.

Do the exercises in the order they are set out here, and DO NOT have intercourse before you are sure you’re ready. While you’re practicing, you can bring your partner to orgasm by means of masturbation or oral sex.

Do the exercises when you feel in the mood for them: the partner exercises three times a week, and the masturbation exercises twice a week.

 

Learning to enjoy your partner’s touch to your penis and testicles – without becoming anxious

Here is the key you need to make this work. Read this carefully and absorb it: an erection may come and go during sex, but it will always come back. This in itself is not erectile dysfunction. If you feel your erection faltering, it is not a problem! It will come back! Just don’t focus on your erection, focus on the sexual experience you are having. Stop worrying about how aroused you are and start enjoying the sex. 

A first step to treating erection problems and impotence

You’re used to masturbating with porn, perhaps, or with fantasies which you create in your mind. This time, however, you’re going to do it differently. You’re going to bring yourself off without any stimulation except your hand. And, while you’re doing it, you’re going to focus on your body and check out what feels good, what doesn’t feel so good, and what you might like to ask your partner to do in the future.

The first thing you need is a quiet time and space where you can relax, without being disturbed or interrupted. Lie naked on your bed in a warm room and begin to explore yourself, with lube if you prefer it, slowly and easily. This is not a test, it’s not a race to get yourself off, and it’s not a challenge or comparison with what’s happened before. All you are doing is learning about the pleasure your body can give you. And, of course, checking out that given time and the right kind of stimulation, you will get aroused and you will get erect.

Try various ways of stimulating yourself, various strokes, various pressures, various movements of your hand on your penis and testicles. At first you may find that it is difficult to get an erection.

If you then find that you’re beginning to fantasize, slow down, relax, reduce your anxiety by breathing deeply, and start stimulating yourself with your hand once again. If you find yourself fantasizing, just tell yourself that you’re there to find out how it feels when you just use your hand, and bring your attention back to what you’re feeling in your body.

You may not be surprised to find that it takes you longer to get aroused than it would without any fantasy. You might even find that your erection is not as full as you’d like; well, that’s to be expected.

Don’t despair, don’t give up, and do repeat the experience twice a week. What you’ll find as time goes by is that you come to enjoy the physical sensations more, and your erection gets harder and more reliable. You may need to repeat this experience a few times before you get a hard and full erection. If you have real trouble, use fantasy to get started and then as you get hard, focus on your physical sensations.

Now, here’s the crucial thing: as you get near to orgasm, stop stimulating yourself and relax until your erection has gone away almost completely. As you wait for it to go down, relax and reduce any anxiety you feel by using the relaxation techniques we described earlier.

When your anxiety is reduced, and you’re relaxed, start masturbating again until your erection has returned. Carry on until you’re near orgasm once again, then stop and relax as before. The third time you do this, continue masturbating until you ejaculate.

The whole point of this treatment for erection problems is that you’ll see that your body will respond again if you lose your erection, that in fact you can get back to a state of full arousal if your erection subsides temporarily during sex.

It may take a while, but if your persist, you should be able to develop the confidence that your erection is actually quite reliable.

But what if, despite your best intentions, you don’t get erect? If you feel that you really are impotent, the first thing to do is to keep trying. The second is to use fantasy: whatever the cause of your problems, whether you are not in touch with your body, or your anxiety is too high, you don’t want to go on for too long without a success!

You can adapt the exercise by using fantasy until you are near orgasm, at which point you should focus once again on your physical sensations.

 Once you have some success in this process and more confidence about your control over your erection, you can begin to relinquish fantasy and rely more on pleasurable physical sensations to get yourself aroused. You will by now have some clear ideas about what touch you like and what turns you on and gives you the greatest physical sensation.

developing more stamina in bed, gaining control in bed

Controlling Premature Ejaculation Part 2

Holding Back Premature Ejaculation 

hat’s so difficult about holding your ejaculation back when making love?

I’d say a guy who reaches the point of ejaculation inside two and a half minutes of entering his partner is probably coming too soon. And he’s unlikely to be obtaining the highest levels of sexual pleasure for himself, and he’s most likely not pleasing his partner sexually very much, either.

So, in the following paragraphs, I’ll explain some simple tactics which could help you to delay ejaculation and last longer in bed during intercourse.

Of course other things come up (forgive the pun!) when you lack the ability to hold back on your ejaculation: for instance, you might feel shame, lower masculine self-respect, a sense of failure as a lover, and you’re probably very well aware of the dissatisfaction of your sexual partner. Truth is, most women like sex, and it seems the time they want it to last for is around 15 minutes.

However, the average time for which intercourse actually lasts is around 9 minutes. Oh dear. And the average time among premature ejaculators is less than 3 minutes. How do you compare with that?

Some lovers decide they will deal with rapid ejaculation in a sensible way, most likely by making sure that the woman has an orgasm before penetration. And it is true that sexual intercourse and lovemaking can take many forms! Think oral sex. Think mutual masturbation.

Yet, although this can satisfy some couples, it still means that the woman has not experienced the intimacy of extended penetrative lovemaking. This is a sensation which many women actually crave, and which many say can be as rewarding as orgasm itself.

In short, to improve the quality of your life and your relationship in every way, both sexually and in every other way, you need to know how to delay your ejaculation and last longer in bed.

The average length of sexual intercourse will not satisfy most women, even if they’ve achieved orgasm before intercourse starts.

Women want to know their man has the power to last longer in bed so that they can enjoy the sense of intimacy and connection which making love gives them.

Simple advice to improve your staying power and sexual stamina.

A vital part of learning to last longer in bed is that you discover how to be more relaxed while having sex. (For those who have problems with the psychology of sex and relationships, finding a coach or therapist can be helpful.)

Having sex makes the muscles of your body tighten as you become more aroused. You know this is happening when your breathing becomes shallower and faster. Together these changes speed up your progress towards orgasm, which makes it essential to counteract them.

Surprisingly, it is possible to remain relaxed and keep your breathing deep and slow even as you become wrapped up in the excitement of sexual arousal.

The simplest way to avoid tension is to keep a small portion of your mind focused entirely on the amount of muscular tension you are experiencing, and to keep track of your breathing so you can slow down and take deep breaths if necessary.

So every time you sense that you’re getting more tense, take time to slow down, and consciously relax all your muscles. Ejaculation delay, delay, delay. Think about it!

And again, if you notice your breathing is getting shallow and fast, slow it down and take several slow, deep breaths. These two simple strategies will actually enable you to delay your ejaculation for a surprisingly long time.

Another important principle of ejaculation control is that you know when you’re going to come. Many men who want to avoid premature ejaculation are unaware of how aroused they are, so that their ejaculation surprises them.

Become more aware of how aroused you are and you can control your progress towards orgasm by slowing down the rhythm of sex, resting gently inside your partner and giving your arousal time to decrease.

And practice on your own: masturbate with a slippery lubricant such as olive oil; repeatedly bring yourself towards the point of ejaculation, but stop before you come. While you do this, watch how aroused you are, and stop masturbating before you actually shoot your load.

Don’t just delay ejaculation, but enjoy the sensuality of the self-arousal too. The first few times you try this, you may find that it’s necessary to stop well in advance of the point of no return; with practice, you’ll be able to bring yourself much closer to the PONR and remain there for longer.

More information:

https://www.ncbi.nlm.nih.gov/pubmed/22827115

If possible, bring yourself near to the point of climax four or five times before finally taking pleasure in your climax. Simply by using this technique you will rapidly discover how to delay ejaculation and make love for at some extended time.

You can then adapt a similar technique for full intercourse, slowing down or stopping your stimulation when you become too aroused.

Vaginal Intercourse & Premature Ejaculation

Prolonged vaginal intercourse is a desirable thing for most men.  Imagine  not ejaculating the minute you enter her! OK, so what do you do to achieve this? 

Start, as always, with sexual caresses and gentle foreplay. Satisfy your partner sexually if she wants it. If you are going to enjoy intercourse, at the point where you are ready to enter her, lie on your back.

You’re going to have sex with your partner on top while you lie on your back. You can put your penis at the entry to her vagina or just inside it, and see what that feels like. If you feel like you are about to ejaculate, ease off or away until the sensation passes.

Remember the idea is to maintain your level of arousal for as long as you choose without coming. Your partner must be wet so you can get into her easily. If she’s not aroused enough, go back to some sex play that gets her lubricating freely.

When you’re sure you’re in control of your arousal, with your partner on top, put your penis inside her vagina and rest there without moving. 

Think about how it feels. If everything has gone well, you will be able to enjoy this most wonderful feeling without coming. If, by some mischance, you do ejaculate the minute you’re in her, it isn’t a disaster. Don’t get uptight and apologize or mentally beat yourself up!!

Just enjoy the ejaculation, let yourself go fully into it, and make the most of it. Then, when things have calmed down, go back in your exercises to the point where you last had good control. Don’t despair! Just work through it again, perhaps taking more time over the exercises before you ejaculate.

If all goes well, and you are now in her and comfortably in control of your ejaculation, guide her up and down with your hands on her hips until you are comfortably aroused but not going to ejaculate. Keep it that way by adjusting the speed and depth of your partner’s movements. Don’t move yourself!

Stop her moving and rest if you get too close to coming. You can even take your penis out of her vagina and rest if you feel this to be more helpful in developing your self-control. Resume when your arousal has decreased.

Your desire to ejaculate will decrease at this point, and when it has done so, guide her into resuming her movements, once again pausing when you get near the point of ejaculatory inevitability. It is important that during the first three repetitions of this sequence you do not thrust.

And it’s probably obvious to you that the longer you both go on practicing this before you ejaculate, the more control you are developing. However, on the fourth repetition, let yourself go, focus on how it feels and thrust until you ejaculate. Enjoy!

The crucial thing is that you try and focus on what you’re feeling all the time, so that you know when you’re about to ejaculate and can stop her moving before it happens. 

If you find your arousal increasing too much you can also close your eyes so you don’t see your partner’s breasts. If you’re really having problems of self-control, you can stop your partner moving altogether and wait, resting inside her, until your arousal decreases and you’re back in control.

There’s a small possibility that you may lose your erection as you try these exercises. If so, this guide to overcoming ED may be helpful.

The last step is for you to actually begin thrusting. Do this gently at first, so as to work out how aroused you get and how quickly you move towards orgasm. The essential point to remember is that you are in control: you can control the speed and depth of your thrusting to regulate your arousal. At some point you will find a balance between movement and arousal and you’ll then be able to continue thrusting for as long as you want to without ejaculating.

delayed ejaculation, developing more stamina in bed, gaining control in bed

How to control premature ejaculation

Ways to control premature ejaculation

You might already be sensing that you have some control over the timing of when you ejaculate. But slow down your partner as she masturbates you, or stop her altogether. That way, you can discover a new level of control over what previously seemed to be your unstoppable progress towards orgasm. (Read about this here.)

The next step is to learn how to accept more stimulation without rushing towards your orgasm. 

Gentle massage, caressing, stroking and touching are the first steps of the exercise. When you have a erection, your partner stimulates you more by using a lubricant (such as Probe, Astroglide, or massage oil) on your penis, and she can also give you oral sex as she masturbates you. Once again,  you need to keep track of where your arousal is going, and to stop your partner when you begin to feel you’re approaching the moment of ejaculatory inevitability. 

Make sure you lie still and don’t tense your muscles. The lubrication, and the more intense stimulation it produces, will teach you a further level of control beyond any you have at the moment.

If you really feel yourself on the absolute edge of ejaculation, get up and walk around. This may stop the ejaculation and give you time to get your arousal level down. Wait a few minutes before you ask your partner to resume masturbating you.

Over the course of a week or two, you will learn to tolerate higher levels of arousal without coming. The aim of the exercise then becomes to keep yourself near the point where you would have to ejaculate, but without doing so. For example, if on a scale of 1 to 10, 10 meant that you were going to come, then you would aim to keep yourself at 7 or 8.

As your partner masturbates you, focus on your arousal level, and when you get to 6 or 7, tell her to ease off or slow down, so you can keep your level of arousal high without ejaculating. If you suddenly lose it and ejaculate, well, just put it down to experience and try again next time!

After working on this with your partner – say 2 or 3 times a week for 4 weeks – you will find that you can more easily stay aroused without ejaculating. One problem may be that you lose your erection in the face of repeated stimulation and cessation of stimulation. There’s a  useful guide to dealing with erectile dysfunction here. 

What’s more, if you can stay aroused for 15 minutes or so before your partner brings you off, you’ll find that the intensity of your orgasm is much greater and more intense when you do ejaculate! (The UK version of this guide to erection problems can be found here.)

You need to make this more gradual approach to ejaculation a habit pattern, which is best done by practicing 3 times a week. When you practice over and over, it will become the normal response in your body – just as your quick ejaculation is your normal response right now. 

The next step in ejaculation control

Next, you can enhance this work by sliding your penis along the lips of her vulva without entering her. This must be fun and relaxed, so don’t put pressure on yourselves and make it a strain. Just enjoy the whole thing. Start with the kissing, cuddling and caressing which by now will be familiar to you. Satisfy your partner if that’s what you both want. Then, turn your attention to your penis! 

You begin, as always, by lying on your back, with a good erection. Your partner will use lots of slippery lube and then climb over you as if you were going to make love in the “woman on top” position.

Instead of you putting your penis in her vagina, though, she will slide your penis back and forth between the lips of her vulva. You don’t move. Yes – that’s right: no thrusting, no hip movements, nothing. You literally lie back and enjoy it. And you keep your eyes shut, and your hands off your partner, so that you can better concentrate on how you are feeling.

This will all be very exciting and no doubt you’ll feel your arousal going up. But you’re learning to keep your arousal under control, so you need to monitor how excited you are, stop her moving, and ask her to lift her vulva off your penis, when you feel you are approaching the moment of ejaculatory inevitability. 

Once again don’t slip into the all-too-easy place where you think, “Oh, it’s alright, just this once. I’ll be able to get control back next time.” That’s not the point! Your self-discipline here is important to make the whole process of controlling your ejaculation actually work. 

When she stops, rest for as long as necessary to reduce your arousal level to the point where she can safely get back on your penis and slide her vulva along it again. You don’t really want to lose your erection, just to rest for long enough so that your arousal goes down somewhat and you don’t ejaculate. 

Repeat this whole stop-start sequence 5 or 6 times, then continue to orgasm. Enjoy it!

You’re going to do this for three weeks, and with each week that passes, you can introduce more stimulation into the routine. 

So, in the second week, open your eyes and put your hands lightly on your partner’s hips. This will add to your arousal, but by now you will have greater control, so you will still be able to stop your partner moving in time to prevent your ejaculation. If you want, as you approach the point of ejaculatory inevitability, close your eyes and take your hands off your partner. This may lower your arousal and help you concentrate on telling her when to stop. 

In the third week, keep your eyes open and touch her body. Fantasize a bit if you want. At this point you are aiming to keep her sitting on you with your penis between her labia when she stops moving. The idea now is for you to develop more sophisticated control, so that you can stop yourself ejaculating while you are still receiving some stimulation.

At first this stimulation will be the warmth and wetness of your partner’s vulva resting on your penis. But as you develop your self-control, you will find that you can control your arousal so well that you don’t feel the urge to ejaculate even while she continues to move slowly and gently on you.

But all the time, you need to keep your awareness of your arousal, and monitor where you are on the road to ejaculation. 

In our next post we will complete the steps needed to gain greater ejaculation control.

delayed ejaculation

A Note About Delayed Ejaculation

Difficulties With Male Orgasm & Ejaculation

Delayed ejaculation (DE) is the name used to describe a man’s inability to ejaculate in a reasonable time during intercourse or masturbation.

Sometimes men with this challenge are completely unable to ejaculate during sex with a partner,  and sometimes they have great difficulty doing so.

Most men with DE really want to achieve both orgasm and ejaculation. It’s a mystery to a man in this position why, when he has lots of sexual stimulation and an erection perfectly adequate for lovemaking, he can’t ejaculate.

To make things even more confusing, men with delayed ejaculation can climax during masturbation, even though it may take a long time.

So this is, primarily, a problem that involves sex with a partner.

What’s It Like For A Man To Be In This Position?

The majority of men who have this condition do not find it a pleasant experience in any way: in fact, it can be extremely frustrating.

Men with delayed ejaculation (also known as retarded ejaculation) are unable to “come” during sex and sometimes feel frustrated and anxious, and lose their sexual self-confidence, and sometimes feel bad about themselves….

Their female partners often become depressed or irritable, since they are deprived of sexual fulfillment, and they may see their man’s problem, his inability to ejaculate, as a reflection on their sexual attractiveness.

And of course this often goes on for a long time, so the potential for mutual conflict and recrimination can make things worse, especially if one or both of the couple want to have a baby.

In fact, in the end, the woman may threaten to leave unless the man does something about his sexual dysfunction. And it’s often a woman’s threat to end the relationship that prompts the man to seek treatment. I know of several couples who have actually broken up because of this issue.

Finding a treatment for retarded ejaculation (or RE for short – the terms “delayed” and “retarded” are used interchangeably) is sometimes seen as difficult, but in truth we have so little information on the condition that we don’t really know how many seek treatment, and how many men are cured by the various treatments available.

The good news, however, is that with the right approach, a man who is sufficiently motivated to overcome the challenges associated with the treatment of retarded ejaculation has a good chance of enjoying “normal” sexual function again (or acquiring it in the first place, if he’s experienced delayed ejaculation all his life). 

Some sexual therapists see delayed ejaculation as one of the less important sexual problems which can affect a man, but in my experience it causes far more problems than rapid or early ejaculation.

As for erectile dysfunction, I’d say that and DE cause a similar amount of distress, and they are certainly at least as troubling as each other, albeit in a very different way.

Imagine (maybe you don’t need to – maybe this is you!) being a young couple, healthy in every way, and wishing to have a child, where the man cannot climax during sex.

The idea’s a bit odd, isn’t it? It goes against everything we assume about the nature of male-female sexual relationships, and so the most important  question is: what causes it?

It seems that both psychological and physical issues contribute to delayed ejaculation, but the precise way it develops is not at all clear.

Happily, treatment can be effective despite our lack of understanding of the condition, and so if you happen to be one of the men who knows all too well the frustration it invokes, do not despair!

Delayed ejaculation or retarded ejaculation, call it what you will, is often regarded as somehow related to anorgasmia in women. But in fact it is really a completely different condition. It’s certainly not caused by a lack of sexual desire, because a man with DE usually has a normal libido.

Whether or not he wants sex with the particular partner he is in bed with is, of course, another question. That’s a question closely related to the diagnosis and treatment of this condition – is it partner-specific, or does it occur with every partner?

If you don’t wish to read any more now and you simply want to go straight to the solution, see the information and link in the right hand column of this page.

Theories About The Origin Of Delayed Ejaculation

Some psychodynamic theories of DE suggest it’s caused by fear of loss of control, or by hostility and anger, or by too much reliance on fantasy during sex for arousal. There’s often a disconnection between sexual arousal in a man’s mind and physical arousal in his body.

Another common factor is a man learning to masturbate, perhaps as a teenager, in a particularly forceful way – rubbing against the bed is common – and this seems to inhibit his ability to reach orgasm with gentle stimulation such as “normal” masturbation or sexual intercourse – the theory being that he just does not get enough stimulation from these techniques to reach orgasm.

And sexual therapist Bernard Apfelbaum believes that delayed ejaculation involves a low level of arousal – in other words, he thinks a man who thrusts for hours during sex without reaching orgasm and ejaculation is simply not sexually aroused, even though he has a hard and long-lasting erection.

Much of the treatment for DE has centered on psychodynamic psychotherapy, simply because there are no drugs available which can be used.

Psychotherapy tends to look for explanations of current conditions in a man or woman’s emotional and psychological history. And it’s not hard to understand how a man’s inability to ejaculate with a specific partner might represent a “withholding” attitude towards her.

His lack of ejaculation could be an external symbol of internal hostility, resentment, or anger. Non-partner-specific delayed ejaculation might be the result of more generalized shame, anxiety or guilt around sex in general. Here’s a very helpful book about delayed ejaculation.

I believe that some of my clients with delayed ejaculation have indeed held a great deal of hostility to women in general or their partner specifically, or feel a lot of shame and guilt around sex in general.

Video about delayed ejaculation

But there’s still an interesting question to be addressed, and that is why these emotions manifest in this way in only some men who have ejaculation issues. There is no doubt that many men have feelings of anger and hostility towards women, and/or shame and guilt around sex, but they have NO difficulty engaging in intercourse and ejaculating normally. So is there another factor at work? The answer, as you may have expected, is probably “yes”.

It seems that men with delayed ejaculation often have a very low level of sexual arousal, despite having a hard and often prolonged erection.

This situation appears to develop because a man is, at a very deep emotional and psychological level, trying hard to please his partner, to fulfill her needs, and to satisfy her in a way that probably goes beyond sex alone.

But there are other explanations of delayed ejaculation too, the primary one being that a man learned to masturbate in a very idiosyncratic way which involved extreme pressure and force on his penis.

Having conditioned himself only to ejaculate in response to very vigorous stimulation, it becomes impossible in later life to get the necessary stimulation he needs to ejaculate from the act of intercourse.

A third explanation is even more prosaic: it is that a man simply prefers the feeling of his own hand to that of his current partner’s, or any partner’s, vagina.

And so of course the most important question is: what treatment methods are available?

The answer is that there are many ways of treating DE, and which one of them will be successful depends on the individual circumstances in each case.

Where there are clear issues of blurred boundaries, or, worse, childhood sexual abuse, then deep psychotherapy is probably the answer, so that a man can re-establish a sense of trust towards women, and an ability to maintain his own boundaries in the face of his partner’s needs, wishes, and demands.

This might be the right approach when a man seems to have a compulsion to “serve” his partner, or when it appears that his main aim during sex is to pleasure his partner, or when he seems unable to take any time or pleasure for himself.

A man like this can be encouraged, through a gradual process of psychotherapy, to let go and take time and space for himself so that he can enjoy sex to the full.

When he can let go of his emotional constraints, he will probably also be able to release physically during the act of intercourse. “Release” is a good word here, since it implies equally to the release of semen and the release of psychological inhibition.

Uncategorized

Law Of Attraction and Sex Problems

Premature Ejaculation & Law Of Attraction

You may well have heard of the Law of Attraction and manifestation, the did you know that it can be used – or at least, the principles involved in it – can be used to cure premature ejaculation?

Now hang on before you go swanning off to another website thinking this is some new age hippy thinking….. This is based on sound psychological principles of affirmation, positive reinforcement, goal setting and visualization.

Read what Free Affirmations has to say on the subject of premature ejaculation.

You can rewire your mind and last longer in bed by using these specially designed positive affirmations. They will help you to overcome problems with premature ejaculation and retake control of your sex life!

Sexual response is so closely related to mental activity that, if you can gain a measure of control over your core thought processes, you can effortlessly last longer while still enjoying immense sexual pleasure.

Imagine just letting go and having sex for as long as you want, and not having to exert intense mental effort to stop yourself from ejaculating!

You can achieve this by using these affirmations every day to naturally develop a strong degree of mental and physical sexual control.

I imagine quite a lot of you would like to know what those affirmations might be! Well, here they are…  

Present Tense Affirmations
I am a great lover
I am in control of when I ejaculate
I always last a long time in bed
My sexual stamina is amazing
I can please my lover for hours and hours
I always maintain sexual control
I am conquering premature ejaculation
I make love to my partner slowly
I always take the time to slow down and enjoy sex
I am an extremely romantic lover

Now I dare say you’re wondering whether or not it can really be the case that simply using affirmations like this can help you achieve greater control in bed. Well the truth of the matter is that affirmations can always have a massive effect on human behavior, so there’s absolutely no reason why you should doubt the power of affirmations to control one aspect of human behaviour – premature ejaculation.

Masturbation and Law of Attraction

 

So the essential question here, as you probably realized, is precisely how can the law of attraction play into sexual energy? This information should help you understand the connection between sexual energy, emotional energy, and the emotional fuel required to send out your desires and wishes into the universe for them to manifest.

Even so it’s a tentative and sometimes quite challenging area of debate – many people find sexuality difficult to talk about, even now, in what are regarded as times which are very “open”.

Because the reason for this is undoubtedly sexual shame which is embedded in our culture in a very profound and amazingly deep way.

Sexual Shame and Law of Attraction

You’ll see that in the video above this guy asks whether or not is necessary to have a sexual partner to achieve happiness. It’s an interesting question, dont’cha think? Although everything the one of us probably assumes that a sexual partner is a great thing to have, it actually isn’t necessary to achieve a state of happiness.

Happiness comes from the internal workings of the mind, which ultimately, in the high state of evolution, something that only you would have control over, not allowing other people to influence you into responding in a certain way which is against your best interests.

Now you will observe that The Law of Attraction is certainly a mechanism by which you can achieve something approaching individual autonomy. And you can be free from the responses and emotions generated in response to other people’s actions, thoughts and feelings. Then you are certainly becoming an independent entity with much greater spiritual power, and much more ability to manifest anything you want.

So does that mean that becoming an adept at using the Law of Attraction to manifest reality is  something that removes you from the need for human interaction?

Not at all. What the Law of Attraction and spiritual evolution combined to do is to give you much greater power over your own destiny, but they don’t alter the fact that you will receive emotional reward and satisfaction from being in relationship with the human beings.

In many ways, evolving spiritually is something that everybody with an aspiration “to be the fullest person they can be” should be doing! You see, spiritual evolution means that you’re less at the behest of other people’s emotional needs and demands, which in turn means that you have more emotional energy to satisfy your own needs.

Whether that be controlling your premature ejaculation, becoming a spiritually adept individual, becoming great lover, generating wealth and prosperity… Whatever… The fact that you have more spiritual energy available to you because you’re not disbursing it on emotional defences means that you will be more in charge of your own life in every single respect, including your sexual performance.

 

 

premature treatment

How Can You Treat Premature Ejaculation?

Treatment And Cure Of 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.

That’s essential for mutual sexual pleasure, which is important in maintaining intimacy and developing a better relationship between you both, both sexually and emotionally.

So 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. They range 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.

Also, we tell you 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. The first is those which involve drugs, hypnosis, pills, lotions and potions. And the second involves sexual therapy, behavioral modification, and dealing with relationship issues.

Therapy & Non-drug based treatments 

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. And a man who ejaculates quickly needs all the feedback which his peripheral nervous system can provide, not less of it.

That’s because 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.

That 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 slowed a man’s premature ejaculation.

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. They will 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).

And another tip is to use Kegel exercises to develop control of the pubococcygeal muscles which propel semen out of the penis. But this is a forlorn hope since these muscles are almost impossible to control voluntarily.

Finally, some psychotherapy or cousneling may help.

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 he might also wish to see a psychotherapist to discuss any underlying sexual issues which may be contributing to his premature ejaculation.

Such issues include 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 many researchers miss the fact that men who cannot control their ejaculation may well not understand that they can exert voluntary control over such an apparently involuntary bodily function as ejaculation.

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 this was 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.

unhappy man sitting on edge of bed
Premature ejaculation may be natural or it may be a medical condition. It may occur every time or from time to time.

Treatment success is rather variable (although the methods on this website are about as successful as you can get).

This is because ejaculation is a spinal reflex which is strongly controlled by higher brain (cortical) centers – in other words, establishing voluntary control over it is difficult.

At least, that’s what people say. I say, that’s a matter of opinion. Because when a man’s motivation to cure premature ejaculation is high, establishing voluntary control is not so difficult.

Sure, it takes time and practice, but the key thing is motivation. And also finding the right teacher. Some men have reported great success by seeing a Tantric sex therapist, who are able to teach a way of controlling the flow of sexual energy so that the man is in control of his sexual responses.

Ejaculation control can be developed. The speed of ejaculation is influenced by past experiences and present context. (Few men have 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.

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 all the drugs which are used for the treatment of premature ejaculation were originally designed for other conditions. They may therefore be inappropriate for this problem. They certainly do not have regulatory approval for this purpose.

 

orgasm

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.

Then, 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.

This 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.

How To Overcome Premature Ejaculation

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.

Some men are unable to delay his ejaculation and displays the same pattern of premature ejaculation time and time again. This makes them aware they cannot completely control their sexual responses, and also makes them anxious about disappointing their partners.

Some sexual shame, as well as a loss of self-esteem, pride and confidence in their sexuality may also develop.

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 Your 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 premature 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.

However 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 as it is bed with a sexual partner, nor is it likely to give much indication of how long they can last during lovemaking.

In short, instead of looking at men’s estimates of the length of time they last before ejaculating 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. You can also work out if he knows how to control premature ejaculation, and whether he is able to control the timing of his ejaculation.

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.

These are 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!

Uncategorized

Drug Treatment To Delay Ejaculation

Drug Category: Selective serotonin reuptake inhibitors

Their action is linked to reducing uptake of serotonin in the central nervous system. SSRIs have weak effects on norepinephrine and dopamine neuronal reuptake. They do not antagonize adrenergic, cholinergic, GABA, dopaminergic, histaminergic, serotonergic, or benzodiazepine receptors; this means they have fewer adverse anticholinergic effects than the family of tricyclic antidepressants.

SSRIs cause sexual side effects, including delay in sexual orgasm for both men and women; while delayed in reaching orgasm caused by an SSRI is an adverse effect in women, the same may not be true in men. Indeed, it can help to overcome too-rapid orgasm. Sertraline (Zoloft), paroxetine (Paxil), and fluoxetine (Prozac) are helpful SSRIs for treating premature ejaculation.

The optimal treatment for premature ejaculation is unknown, but single dosing before sex works for some men, while daily use of the medication may be necessary for others. The daily dose may be increased gradually until a therapeutic effect is achieved. If one SSRI doesn’t help, using a second alternative is reasonable. After 6 weeks at maximal dose with no improvement, no further treatment is recommended.

The Art Of Delay In Ejaculatory Control

Pathophysiology of PE

Premature ejaculation as a psychological problem does not involve any known disease of the male reproductive tract or any so far discovered problems of the brain or nervous system.

Could the problem lie somewhere in the male reproductive system (i.e., penis, prostate, seminal vesicles, testicles)? The answer is that we do not really know.

But when PE happens before satisfying intercourse is completed, both the man and his partner will be dissatisfied both emotionally and physically.

Premature ejaculation has often been spoken of as a psychological problem.

As you may have seen, some experts have suggested that young men are conditioned by societal pressures to ejaculate in rapid order because of fear of discovery when masturbating or during early sexual experiences.

But although this may become a habit, it’s hard to imagine it is actually an ingrained physiological response which cannot be changed later in life.

Therefore, some researchers have suggested there may be a physical cause, such as differences in nerve conduction rates or hormonal differences between men: even hyper-excitability or oversensitivity of the penile nerves has been suggested. This would stop down-regulation of their sympathetic nervous system pathways and inhibit delay of orgasm.

In some cases premature ejaculation represents other issues: e.g. a cardiac patient may fear a myocardial infarction during sex, and so develop premature ejaculation.

But it is logical from an evolutionary point of view that males who ejaculated rapidly would have more success when mating and fertilizing a female than those who needed prolonged mating time.

Therefore, the genes of a male who came quickly would stand more chance of passing his genes on to the next generation – and also, a male who took a long time to mate might well be killed because of his vulnerability during intercourse.

Frequency of premature ejaculation

Premature ejaculation occurs in between 30 and 70% of men. The percentage is similar in all age categories: of course, erectile dysfunction becomes more common in older age groups.

Since many men do not discuss rapid or premature ejaculation with their doctor, probably because of embarrassment or a sense of hopelessness around a cure, or even because they are satisfied with the quality of their ejaculations (no matter how quickly they occur), the proportion of men who have premature ejaculation in their lives is almost certain to exceed conventionally accepted figures of 30%.

Race and premature ejaculation

No firm data exists on the subject.

Age and premature ejaculation

Premature ejaculation is most common in younger men (in an age group between 18 and 30 years) but is far from uncommon in men aged 45-65 years, where it is often associated with erectile dysfunction.

developing more stamina in bed, gaining control in bed, human sexual response

How To Enjoy Better Sex

Enjoying Better Sex

One of the more distressing and interesting pieces of information to emerge from the study of sexual dysfunction in recent years has been the discovery that erectile dysfunction is becoming more common in young men.

It turns out that although erectile dysfunction is more common in older men – as you might expect – it’s also surprisingly common in younger men. About 40% of men in their 40s have erectile dysfunction – an astonishingly high number.

Yet a study in the Journal of Sexual Medicine suggests that almost 26% of men under 40 have erectile dysfunction – and half of them have it in a very severe form.

This is quite amazing! We think of young men are sexually potent, constantly looking for sex, constantly needing sexual outlets, and always ready with an erection.

Yet if the data in this study is to be believed, then this fundamental problem needs to be addressed for the sake of the emotional and mental health of the young men concerned.

But why should this be so? Why should there be such a high predominance of erectile dysfunction in young men?

Assuming that causes of erectile dysfunction like diabetes which occur in older men are going to be less predominant in younger men, we are forced back to the conclusion that in fact, this epidemic of erectile dysfunction in young men must be caused by psychological issues.

It seems obvious to me that we are living in a society which is much more stressful than it used to be. It’s also possible that there is much more drug abuse than they used to be in society. In any event, both stress and drug abuse are recognized causes of erectile dysfunction, so if younger men are more predominantly stressed or more frequent users of drugs per capita of population than older men, then that could well be part of an explanation.

And yet, and yet… There’s no problem without a solution, and nowhere is that more true than in the arena of sexual dysfunction, where so much time and effort – let alone money – has been spent on remedies for sexual dysfunctions of all kinds that a solution, no matter how difficult the problem, is within almost everybody’s grasp.

The interesting thing about erectile dysfunction is that about 20% of the 18 million men in America currently affected by erectile dysfunction take prescription drugs – and of course these are well-known as a very effective treatment.

The most common are Viagra and Cialis. But the interesting thing is that a very significant minority of men who take these drugs still don’t get an erection. And when you look into this, it turns out this is because the fundamental basis of the erectile mechanism is psychological rather than physical.

Having said that, the experts also found that men are physically active have better erectile function: a calorie restricted diet and greater physical activity have been found to restore erectile function in even severe cases of ED.

Having said all of that, what about women? Surely there level of sexual dysfunction must also reflect the stress which society inflicts on us all these days?

For women, it turns out that low libido, or low sex drive, is the predominant sexual dysfunction. In fairness, it should be mentioned that there are plenty of sex experts who think low libido for women is perfectly normal, and not in actual fact any kind dysfunction at all.

The viewpoint that low sexual desire is a problem which needs to be solved with a medical solution is a reflection of how sexual activity can be medicalized. (What that broadly means is that drug companies and the medical profession can take ownership of psychological and sexual issues – mostly because there is profit to be made, rather than suffering to be averted.)

But there is a real problem here: in 2008, in a survey of over 30,000 women in the United States aged 18 or over, almost half of the women reported sexual problems. A full 10% of them complained about low sexual desire (aka hypoactive sexual desire disorder or HSDD) needless to say, one doctor described this as “a real diagnosis”.

In the sense that millions of women who go through the menopause may experience low sexual desire, I believe we are all less likely to think of young women as possibly subject to sexual dysfunction of this kind.

Yet women’s libido is a complicated issue. I think we all know that, both men and women alike! And Women Come First, a book by Ian Kerner, suggests that men can do a lot to get women in the mood by spending adequate time on foreplay. That in fact, low sexual drive in women may not be a problem. It may merely be a symptom – of inadequate sexual attention from men!

And interestingly enough, when you dig down into this, you’ll find that sometimes it isn’t the lack of sexual desire that’s the problem, but it’s about the women’s anxiety – their emotional response to the fact that they don’t feel much sexual desire.

Interestingly enough, however, almost 40% of women diagnosed with HSDD report depression. The question that would occur to most therapists here is – well, which came first, the depression or the low sex drive? In actual fact, the two probably go together in a feedback loop which ensures constant reinforcement.

We also recognize these days that contraceptive pills can cause low sex drive. In general, it’s probably much more functional to ask a woman what she needs to become orgasmic than to start offering medicalized solutions which do little to address the specific problems of an individual, but much to address the profits of the doctors or drug companies.

Yet it’s a common complaint among experts in the field that the pharmaceutical companies are producing diagnostic tools for “low sex drive” because they want to medicalize what might actually be a normal human condition.

As one therapist rightly observed, many people today – both male and female – feel a lot of pressure to be sexually active, perhaps too much pressure, leading them to a place of false expectation. Indeed, it could be that what we are expecting women to experience as a normal sex drive is in fact in reality hypersexualisation.

In other words, it’s possible that women are just being pressured into expectations about sex that are completely unrealistic. Combine those unrealistic expectations with hard, possibly stressful jobs, and you begin to build up a very different picture. “A lot of women say the best part of traveling is the hotel room with the giant bed and the clean sheets and no children crying and a husband who wants something from them,” said Steinhart. “Truthfully, women have always been this way.”

And there is now a widespread recognition that stress – that’s to say, the stress of working longer hours, and the threat of job insecurity – is exhausting for people. And why wouldn’t it be? It makes people – both men and women – feel older than their age, it diminishes libido, and in the end people under this much pressure are probably too tired to care whether they have sex anyway.

The good news, of course, is that such a reduction in sex drive doesn’t need to be permanent. We all recognize that our sexual drive and sexual energy tends to fluctuate throughout our lives.

gaining control in bed, making sex better

Human Sexual Response (4) – Resolution

The Resolution Phase

One major function of the orgasm becomes clearly visible in both men and women soon after it subsides.

Orgasm initiates the release of muscular tensions throughout the body, and initiates the release of blood from the engorged blood vessels.

The first notable occurrence in women during the resolution phase that follows orgasm is the immediate return to normal of the areolas surrounding the nipples.

Indeed, their rapid subsidence gives an observer the impression that the nipples are undergoing a further erection – though they are in fact only becoming more visible as the swelling around them subsides.

The increased prominence of the nipples is a sign that the woman has in fact experienced orgasm. This sign appears so rapidly that it might almost be assigned to the end of the orgasmic phase rather than to the beginning of the resolution phase. Another sign of orgasm is the rapid disappearance of the sex flush in women who have had the flush during orgasm.

Accompanying the disappearance of the sex flush, a filmy sheen of perspiration appears on many women. In extreme cases it may cover a woman’s entire body from shoulders to thighs. In other cases the perspiration may appear only on the soles of the feet and the palms of the hands, and there are other variations.

About one-third of the women have this tendency to perspire following orgasm.

About one-third of men also perspire at this time, but the reaction is more often limited to the soles and palms.

Neither this perspiration nor the sex flush is related to the degree of muscular effort prior to or during orgasm. Yet women often show a marked flush phenomenon over the entire body during plateau and orgasm, and during resolution may be completely covered by a filmy, fine perspiration.

Within five or ten seconds after a woman’s orgasm subsides, several other changes can be noted.

The clitoris promptly returns to its unstimulated position, overhanging the pubic bone; however, five or ten minutes may elapse, or in extreme cases half an hour, before it shrinks to normal size. Soon after this the orgasmic platform relaxes so that the outer third of the vaginal barrel increases in diameter.

The ballooning of the vagina begins to diminish, and the uterus begins to shrink. The cervix descends into its normal position, and the passageway through the cervix enlarges perhaps to make easier the ascent of the sperm cells into the uterus.

These processes continue at various rates for various periods of time; as long as half an hour may elapse following orgasm before the entire female body is restored to its erotically unstimulated state.

If a woman who has reached the plateau phase does not experience orgasm, the resolution phase takes much longer – an hour or so in many cases.

In men the most obvious sign of the resolution phase is the prompt loss of erection of the penis and its shrinkage back to its unstimulated size.

This shrinkage occurs in two stages. The first is quite rapid, but leaves the penis still noticeably enlarged. The remainder of the shrinkage is often a much slower process.

The male sex flush, like the female, rapidly disappears. The return of the scrotum and testes to their unstimulated state may be either rapid or slow. If the male nipples have erected, many minutes may elapse before they return to normal.

In both men and women, the pulse rate, blood pressure, and breathing rate gradually return to normal.

A significant feature of the male resolution phase is the “refractory period” that accompanies it.

During this period. a man cannot again become sexually aroused or have another erection. In some men this period may be quite brief; one young man under laboratory conditions was able to achieve three orgasms in ten minutes, for example. But in most men it lasts for many minutes at least; and it tends to increase in duration as a man grows older.

Women do not have a similar refractory period. Indeed, if effective sexual stimulation is renewed immediately following orgasm, many women can promptly reach a second orgasm.

A series of half a dozen or even a dozen orgasms without intervening resolution phases is not unusual for some women; during such a series, some women do not fall below the plateau level of arousal. This “multi-orgasmic response” is described further below.

No single sexual experience proceeds in precisely the way described, just as no individual human being precisely matches the characteristics of the “usual”, or “average”, or “typical” human being. Thus the above description should not be considered a model or norm toward which men and women should strive.

On the contrary, it is simply a description of what often or usually happens. The sexual responses of any individual man or woman will almost certainly fail to show some of the characteristics described above, and will show features omitted from the description. It is usual and normal to vary from the norm.

The same responses occur, in very much the same order, regardless of the type of stimulation (oral pleasure, masturbation, sexual intercourse) that evokes them.

Some responses, it is true, may tend to occur a little more promptly, or to be a bit more intense, when evoked in one way rather than another. Some individuals no doubt respond more readily to one kind of stimulation than to another. Psychologically, the experiences may feel altogether different. But the basic pattern of sexual responses in the human body remains the same.

orgasm

Human Sexual Response (3) – Orgasm

The Orgasm

A major feature of the female orgasm is a series of rhythmic contractions of the outer third of the vaginal barrel and the engorged tissues surrounding it. These rhythmic contractions are muscular contractions.

The first few contractions occur at intervals of four-fifths of a second. Thereafter the intervals tend to become longer, and the intensity of the contractions tends to taper off.

A mild orgasm may be accompanied by only three to five contractions, an intense orgasm by eight to twelve. In an extreme case, actually recorded on an automatic recording drum in the laboratory, twenty-five rhythmically recurring contractions of the orgasmic platform followed one by another over a period of forty-three seconds.

The onset of orgasm as experienced subjectively occurs simultaneously with an initial spasm of the orgasmic platform preceding the rhythmic train of contractions by a few seconds.

Along with this series of contractions of the orgasmic platform, the uterus also contracts rhythmically. Each contraction begins at the upper end of the uterus and moves like a wave through the raid-zone and down to the lower or cervical end.

The more intense the female orgasm, the more intense are these contractions of the uterus. Labour contractions prior to childbirth move similarly downward along the uterus in a wavelike progression, but are much stronger. Other muscles, such as the anal sphincter muscle, may also undergo rhythmic contractions.

The male orgasm is rather similar in several respects. The central occurrence is a series of rhythmic contractions timed, as in the female, at intervals of four-fifths of a second. Following the first few contractions, in the man as in the woman, the intervals between contractions tend to become longer and the intensity of the contractions tapers off.

As in the case of women, men may subjectively identify the onset of orgasm a few seconds before the occurrence of the first observable contraction.

The ejaculation of semen, which occurs during the male orgasm, is a complex process. Prior to orgasm, fluid containing millions of sperm cells from the testes has collected in the sacs known as seminal vesicles and in a pair of flask-like containers known as ampullae. These organs contract rhythmically, expelling their contents into the urethra.

At the same time the prostate gland contracts rhythmically and expels prostatic fluid into the urethra. A bulb in the urethra near the base of the penis doubles or triples in size to receive the fluids. These changes constitute the first stage of ejaculation. The subjective feeling of orgasm occurs during this first stage.

During the second stage, a series of rhythmic contractions of the urethral bulb and of the penis itself projects the semen outward under great pressure, so that if it is not contained, the semen may shoot as much as two feet beyond the tip of the penis. In older men, the contractions may be somewhat less vigorous, and the pressure of expulsion somewhat lessened.

The urethra may undergo a series of minor contractions for several seconds after the contractions of the penis as a whole are no longer perceptible.

For men who have delayed ejaculation, there will be neither the achievement of orgasm nor the ejaculation of semen. The condition is of uncertain origin, though it can be treated with application of sensate focus techniques, and it usually responds to an improvement in a couple’s relationship, which suggests that the origin of the condition is primarily emotional.

Men with premature ejaculation have an abbreviated arousal phase, and are thereby deprived of considerable sexual pleasure. Fortunately, premature ejaculation is an easier condition to treat than delayed ejaculation, and many suitable training programs are available which can assist a man in discovering how to last longer in bed.

Whole body orgasms, maybe with ejaculation, during which the entire body is subsumed with sexual energy, may last for much longer. The spasms of bodily muscles during this kind of orgasm may be alarming if you don’t know what they represent, but they are very pleasurable for the person who is experiencing them.

One way in which men can enjoy a whole body orgasm is to continue thrusting after ejaculation. Although the glans may be initially very sensitive, this sensitivity soon diminishes, and it is possible for a man to stimulate himself to a second orgasm, just as a woman may have a second orgasm with ejaculation if there is continued stimulation of her clitoris.

The best sex positions to achieve this are the man on top position, which allows for deep, straight thrusts, and rear entry, with the man reaching around his partner to play with her clitoris.)

In both men and women, the events occurring in the genital organs during orgasm are accompanied by changes in the rest of the body. Pulse rate, blood pressure, and breathing rate reach a peak. The sex flush is most pronounced. And muscles throughout the body respond in various ways.

The face, for example, may be contorted into a grimace through the tightening of muscle groups. The muscles of the neck and long muscles of the arms and legs usually contract in a spasm. The muscles of the abdomen and buttocks are also often contracted. Of special interest are the reactions of the hands and feet.

Often a man or woman grasps his partner firmly during orgasm; the hand muscles then clench vigorously. If the hands are not being used in grasping, a spastic contraction of both hands and feet known as “carpopedal spasm” can be observed.

Men and women are usually quite unaware of these extreme muscular exertions during orgasm; but it is not unusual for them to experience muscle aches in the back, thighs, or elsewhere the next day as a result.

plateau phase

Human Sexual Response (2) – Plateau Phase

The Plateau Phase

Human sexual response is divided into four phases – excitement, plateau, orgasmic, and resolution – for reasons of convenience.

There is no sharply defined moment in time when one phase ends and the next begins – and this is particularly true of the relatively vague boundary which separates the excitement from the plateau phase.

In the male full erection of the penis is ordinarily completed during the excitement phase. The only additional changes in the penis during the plateau phase are a slight increase in diameter of the “coronal ridge” at the base of the glans of the penis; and in some men on some occasions, a deepening of the reddish-purple colour of the glans.

The testes increase in diameter about 50 per cent over their unstimulated size; and they are pulled up even higher into the scrotum by a further shortening of the spermatic cord Indeed, the full elevation of the testes is a sign that a man has reached the “point of no return”, and that his orgasm is imminent. If the man’s nipples did not erect earlier, they may erect now.

In both men and women, the rate of breathing increases during the plateau phase, and there is a further increase in pulse rate and blood pressure.

The sex flush may now appear, or may become more marked and widespread if it appeared earlier. The tension of both voluntary and involuntary muscles is heightened; and there may be almost spastic contractions of some sets of muscles in the face, ribs, and abdomen.

The sphincter muscle, which holds the rectum closed, may tighten up; indeed, some men and women tighten up both this muscle and the muscles of the buttocks as a deliberate means of heightening tension.

In the female breasts, there is a further swelling of the areolas surrounding the nipples. This is often so marked as partially to mask the erection of the nipples; they may look shorter as a result. But in fact, there may be a further swelling of the nipples under the areolar mask.

If coitus is prolonged, a few drops of moisture may emerge from the Bartholin’s glands imbedded in the woman’s outer lips, as noted above. A few drops of moisture may also emerge from the male urethra.

This fluid probably comes from Cowper’s glands – the male equivalent of the female Bartholin’s glands. The fluid is not semen; but it is important to know that large numbers of active sperm cells are sometimes found in it.

Thus there is at least a possibility that a woman may become pregnant following the secretion of these preliminary droplets. That’s true even with the withdrawal of the penis before semen is actively ejaculated. 

There are many changes in female sexual anatomy with increased arousal.

The most dramatic change in women during the plateau phase is the appearance of the “the orgasmic platform.” This is the engorgement and swelling of the tissues surrounding the outer third of the vagina.

As a result of this swelling, the diameter of the outer third of her vagina is reduced by as much as 50 per cent. It thus actually grips the penis, and the erotic stimulus experienced by the man is notably increased.

The appearance of the orgasmic platform, however, does not necessarily mean that a woman is ready for orgasm during intercourse.

A man has to know how to arouse a woman, and indeed if he wants to help a woman climax, he must be sensitive to her level of arousal.

Accompanying the appearance of the orgasmic platform is a further elevation of the uterus, and a further ballooning of the inner two-thirds of the vagina.

The uterus also becomes enlarged during this phase; it may even double in size in women who have had babies.

Among women who have not had babies, the size increase is less impressive, but it is noticeable in many cases.

Erect penis in a man's pants
Both penis and clitoris become erect during sexual arousal

Another dramatic change during the plateau phase is the elevation of the clitoris.

In the process of elevation, the clitoris rises from its normal position overhanging the pubic bone, and seems to become retracted.

It is drawn further away from the vaginal entrance.

The clitoral shaft is shortened by as much as 50 per cent following elevation, and it may seem to be lost altogether, or harder to find.

It continues to respond to stimulation, however, either directly applied to the mons veneris, or indirectly through the thrusting of the penis into the vagina.

The outer lips of the vagina of women who have had babies may become even more engorged during the plateau phase than during the excitement phase; and even in women who have never had a child there may be some swelling of the outer lips if erotic stimulation has been prolonged.

The inner lips change colour late in the plateau phase, from bright red to a deep wine colour in women who have had children, and from pink to bright red in women who have not.

This colour change is important, for it is a sure sign that orgasm will occur – usually within a minute or a minute and a half – if effective erotic stimulation is continued.

When a woman fails to reach orgasm despite prolonged stimulation, she also fails to show this tell-tale colour change of the inner lips.

While these many changes, occurring in many parts of both male and female bodies, may seem complex and different from one another, all or almost all of them, as noted earlier, seem to fall into two main classes.

First, the engorgement of blood vessels and other organs, and second, an increase in muscle tension.

Both the male and female achieve readiness for orgasm, it seems likely, when these two processes of increased engorgement with blood and increased muscular tension reach adequate peaks.

The plateau phase is the period during which a woman experiences mounting sexual tension, until she can leap into the orgasmic phase of sexual expression.

human sexual response

Human Sexual Response

Human Sexual Response (1) –

The Excitement Phase

The very first sign of sexual arousal in men, of course, is erection of the penis – a marked increase in its size, and a rise in its angle of protrusion from the body.

man and woman on bed, man becoming aroused
The first sign of male sexual arousal is erection

Erection may be triggered by stimulation of the penis itself or by a sexually stimulating sight or by an erotic train of thought.

It occurs within a few seconds, regardless of the nature of the stimulation.

During erection a small penis may double or more than double in length. In a large penis, the lengthening is less marked. Thus there is less variation in length among erect than among flaccid penises.

Erection is due to the engorgement of the penis with blood; indeed, as we shall see, many of the most important sexual responses occurring in both men and women are the direct result of this kind of engorgement.

More blood flows into an organ than flows out of it; the result is engorgement or vasocongestion.

This change in blood supply, occurring not only in the penis but also in other male and female organs, is the primary reflex action to sexual stimuli.

The secondary reaction is a contraction of various muscle fibres, muscles, and groups of muscles.

The first sign of sexual response in women may seem to be different from either engorgement or muscular contraction; it is the moistening of the vagina with a lubricating fluid.

This lubrication occurs quite promptly – within ten to thirty seconds of the onset of sexual stimulation.

The lubrication appears with equal promptness whether the stimulus is direct stimulation of a woman’s genital region, or of her breasts, or is an erotic train of thought.

Bartholin’s glands do sometimes contribute a few drops of a lubricating fluid to the vaginal entrance – but only late in the response cycle, following prolonged sexual activity and following copious lubrication of the vagina from a “sweating reaction” occurring on the walls of the vagina. 

As sexual excitation continues, these drops coalesce to provide a lubricating film, readying the vagina for the entrance of the penis.

The increase in the size of the penis and the “sweating” of the vaginal walls may seem completely different responses, but they may have a common cause.

More blood enters the tissues around the vagina than can leave, producing vasocongestion.

Both the walls of the smaller blood vessels and the walls of the vagina are “semi-permeable membranes”; they hold fluids back under some conditions but let them seep through under others.

The droplets of moisture that appear on the surface of the vagina during sexual excitation, it seems probable, have seeped out of the congested blood vessels.

Thus engorgement with blood is the cause of both the male erection and vaginal lubrication.

The appearance of vaginal lubrication very early in the female response cycle is a point that deserves attention.

Some sex manuals state, and some men no doubt believe, that the appearance of vaginal lubrication signals a woman’s readiness to engage in sexual intercourse.

Increased lubrication of the vagina
Female arousal is signalled by increased lubrication of the vagina

This is true in a sense. The woman is beginning to respond, and lubrication does ready the vagina for the entrance of the penis.

Entry prior to the appearance of adequate lubrication can be difficult and uncomfortable, or even painful.

But, as we shall see, many more changes must follow before a woman is fully aroused erotically and emotionally ready for sexual penetration and orgasm. Important changes occur, for example, in the clitoris.

This organ is located just above the entrance to the vagina. Like the penis, it is a shaft with a bulb or “glans” at the tip.

Both the shaft and the glans vary in size from woman to woman. The size and location of the clitoris bear no relation whatever to a woman’s sexual responsiveness or her ability to achieve orgasm.

The glans of the clitoris is packed with sensitive nerve endings.

The stimulation of the glans thus contributes greatly to heightening a woman’s sexual response. Direct contact with the clitoris is not necessary in order to stimulate it.

The glans is covered with a hood or prepuce; and this hood is attached to the inner lips (minor labia) of the vagina.

Thus during ordinary sexual intercourse the rhythmic thrusting of the penis through the inner lips produces a rhythmic friction between the clitoral hood and the glans.

In addition, the clitoris is responsive to purely psychological stimuli, such as an erotic train of thought. In the laboratory, changes in the clitoris can be directly observed during purely psychological stimulation, even though the clitoris and other genital organs remain untouched.

Changes in the clitoris can also be observed following stimulation of the breasts.

The first of these changes is the swelling of the clitoral glans. In some women on some occasions, the glans may actually double in size.

In other women, the swelling may be so slight that it can only be observed with the help of a device which enlarges the object viewed by forty diameters or so.

The amount of swelling, however like the size and location of the clitoris – is not related to either sexual responsiveness or to ability to achieve orgasm.

The swelling of the glans of the clitoris, like the swelling of the glans of the penis, is no doubt the result of engorgement of the blood vessels inside it.

Simultaneously with the swelling of the clitoral glans, the clitoral shaft also increases in diameter.

The time at which these changes occur depends upon the nature of the sexual stimulation to which the woman is responding.

If her mons veneris – that is, the area surrounding her clitoris – is being stimulated directly, the engorgement of the clitoral glans and shaft may occur quite promptly after the appearance of vaginal lubrication.

If the stimulus is breast manipulation or an erotic train of thought, the clitoral response generally takes somewhat longer.

A series of changes also occurs in the female breasts during this initial or “excitement phase” of erotic response. The first of these changes is an erection of the nipples. This erection is caused by contraction of muscle fibres.

Often one nipple erects first and the other follows immediately, or after a considerable delay.

In addition, the nipples increase both in length and in diameter as a result of blood-vessel engorgement similar to the engorgement of the penis and clitoris.

The pattern of veins ordinarily visible on the surface of the breasts becomes more distinct, and veins previously invisible may make their appearance during this engorgement process.

The female breasts also increase in size late in the excitement phase; this is a sign of heightened sexual tension preliminary to the transition to the next phase of sexual response.

The swelling of the breasts is more noticeable in women who have not breast-fed babies. Late in the excitement phase, too, the areolas – that is, the rings of darker skin surrounding the nipples – become engorged and swell.

Response of the male breast is less consistent.

However, at least partial nipple erection was observed in three-fifths of the men participating in studies. It generally occurred late in the excitement phase.

The outer lips (major labia) at the entrance to the vagina respond in several ways during the excitement phase. In an unexcited state, they generally meet in the mid-line of the vagina, protecting the inner lips and the other structures within.

During excitation they open a bit, and may be displaced a bit upward, toward the clitoris.

These changes are likely to occur quite late in the excitement phase. In women who have not had a baby, the outer lips also thin out and flatten themselves against the surrounding tissues.

In women who have had several babies, and especially in those who have developed varicose veins in their outer lips, the outer lips become noticeably distended and engorged with blood instead of flattening.

In extreme cases there may be a two-fold or even three-fold increase in size, so that the outer lips come to resemble a sort of curtain surrounding the vaginal opening. In these cases, too, the lips tend to open outward toward the sides as erotic tension increases, so that they do not interfere with the entry of the penis.

The inner lips (minor labia) also tend to swell during the excitement phase; indeed, it may be the swelling of the inner lips that produces the opening-out of the outer lips, an invitation for the entry of the penis.

The vagina, too, responds. It can be thought of as a cylinder or “barrel”, which remains in a collapsed state in the absence of erotic stimulation. Studies have established that the outer third of this barrel reacts in one way and the inner two-thirds in a very different way during the successive phases of sexual response.

As sexual tension mounts during the excitement phase, the inner two-thirds of the vaginal barrel begins to expand, and then relaxes again. Slowly the demand to expand overcomes the tendency to relax, and the clinically distended vaginal barrel of the sexually responding woman is established.

The cervix and uterus are pulled up and back at about this time, producing a “tenting” of the vaginal walls surrounding the cervix. The net result of these and other changes is a dramatic “ballooning” of the inner two-thirds of the vagina.

I am struck as  I write this by the somewhat detached almost “magician-like perspective” that this scientific approach lends to something as sensitive and delightful as lovemaking. We must never forget the fact that at the end of the day two people in love may be swept along by their feelings and emotions rather than the mechanics of sex!

The diameter at the widest point of the ballooning may be three times the diameter of the erotically unstimulated vagina; and the total length of the vaginal barrel may be increased as much as a full inch. (The swelling of the inner lips of the vagina also contributes to this lengthening.)

The ballooning is accompanied by a change in the appearance of the vaginal walls; the wrinkles, or “rugae”, are smoothed out and the colour of the walls changes from a normal purplish red to a darker purple, indicating engorgement of the surrounding blood vessels.

In addition to these responses in the sex organs and breasts, there are many indications that the entire body, in both women and men, is participating in this gradual process of sexual arousal.

In both women and men, the voluntary muscles tend to tense up, and there may also be some contraction of groups of involuntary muscles.

The pulse rate speeds up, and the blood pressure rises. Most remarkable of all, perhaps, a “sex flush” often appears upon the skin.

This sex flush appears first on the upper portion of the abdomen, then spreads up over the breasts. It often takes the form of a measles-like rash. The time of appearance is variable. In most men, and in some women, it does not appear until later in the response cycle, and in some it does not appear at all.

But about three-quarters of the women, and one-quarter of the men, exhibit the sex flush prior to orgasm on at least some occasions. So if a man wishes to know if he has given a woman an orgasm, this is not a reliable indicator.

Changes are also noted in the male testes and scrotum during this first phase of sexual response.

There is a tensing and thickening of the skin of the scrotum; and the whole scrotal sac is elevated and flattened toward the body.

The spermatic cords, by which the testes are suspended, shorten, so that the testes are pulled farther up in the sac.

Just as the nipple of one breast often becomes erect before the other, so one of the testes often rises before the other.