Premature ejaculation
There is little agreement about the definition or cause of premature ejaculation. And no one really understands how the treatments work, but be that as it may treatment of premature ejaculation is 95% to 98% percent effective. Of all the sexual dysfunction, one can acquire, this is the best to have. Masters and Johnson suggested that ejaculation occurs prematurely if the woman does not reach orgasm during intercourse at least 50 percent of the time. The problem with this definition is that some women reach orgasm very rapidly, while for others orgasms never occur during intercourse. Kaplan proposed that a lack of voluntary control of orgasm defined premature ejaculation. However, the average male has little if any real control as to the timing of his orgasm. Like coughing or sneezing the ejaculation reflex is at best only partially under voluntary control. The Psychiatric Association defines premature ejaculation as "ejaculation with minimal sexual stimulation or before, upon, or shortly after penetration and before the person wishes it." However, a couple who engages in 45 minutes of unrestrained feverish manual and oral-genital foreplay, followed by one minute of pleasurable intercourse, would not be considered by us to be cursed by premature ejaculation.
Premature ejaculation is typically a younger man's problem, the majority of cases involving men under the age of 30. Premature ejaculation is common in young men in their first or very early sexual experiences and might be considered perfectly normal. The estimated occurrence of premature ejaculation found in population studies have varied between 10 percent and 30 percent of men surveyed, Differences in the definition of premature ejaculation probably explains this wide variation. With increased sexual experience, most men get over their initial premature ejaculation spontaneously. Premature ejaculation does not appear to be caused by any medical conditions or physiological factors. Most authorities consider premature ejaculation to be typical of young, sexually inexperienced males who‘ve not yet learned to slowly modulate their arousal to lengthen the pleasurable process of making love. Men who have sex only infrequently are also more prone to ejaculate prematurely because sensory levels in the penis are intensified by infrequent sexual activity.
Whatever the definition or causes of premature ejaculation might be, the treatment is quite effective. The "pause” and the “squeeze" procedures developed by Masters and Johnson, are highly effective. Success rates of 90 to 98 percent can be realistically expected.
In the pause procedure, the penis should be manually stimulated to fairly high arousal. The couple then pauses until his arousal subsides, then stimulation is resumed. This is repeated often as possible before stimulation is carried on to ejaculation. Thus the man experiences much more total time of stimulation before ejaculation. The squeeze, like the stop-start, requires intermission of stimulation, adding that as stimulation stops, the woman firmly squeezes, but not to the point of pain, the penis between her thumb and forefinger, below where the head of the penis joins the shaft further reducing arousal. Following a few weeks of this the man is able to experience more continuous penile stimulation without ejaculating. Next, the couple progresses to penetrating the penis into the vagina but without intense thrusting movements. If the man rapidly becomes highly aroused, the penis is withdrawn. The couple waits for arousal to subside, and penis is reinserted. When good tolerance for inactive containment of the penis is achieved, the procedure is repeated with active thrusting. Generally, two to three months is sufficient for a couple to be able to enjoy prolonged intercourse without further need for pauses or squeezes. Ironically, successful treatment of premature ejaculation by these methods may transfer the male partner to becoming multiple orgasmic.
Drugs and medications that block the sympathetic nervous system may have the effect of delaying ejaculation. These include anti-anxiety, antidepressant, and major tranquilizing medications; sedatives; some medications used to treat high blood pressure; and some antihistamines. Because of serious side effects, the use of medication in treating premature ejaculation is not recommended, especially when the effectiveness of the behavioral retraining procedure is usually so successful. If, however, you find the above methods unsuccessful we suggest you consult your physician about other medical or psychological treatment.
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