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Anxiety

6 Months for Couples to Cure Premature Ejaculation Together

A focused treatment protocol.

Prostock-Studio/iStock; used with permission
Source: Prostock-Studio/iStock; used with permission

So much of premature ejaculation is really about anxiety and the problem is the more you worry about it the worse it gets. Sex problems disconnects you from your partner – which only further increases anxiety. The easiest way to start to solve the problem is to approach it as a couple problem – get on the same page. Whatever you are going through in your body impacts your partner’s sexual relationship with you but teaming up can solve everything.

Facts: Technically, premature ejaculation happens in less than one minute before or after vaginal intercourse. Three to seven minutes of intercourse is often considered satisfactory. Ten to thirty minutes might actually be considered too long by female partners. While this is certainly not what the porn industry indicates, for real couples - the average length of time for satisfactory sexual intercourse is about 8 minutes.

Attachment Meaning: While a woman probably doesn’t climax through sexual intercourse (only about 15% do), the act is pleasurable and emotionally intimate. When her partner climaxes too quickly, they both may be denied the sexual and emotional connection of a more sustained intercourse. If a man turns away from the sexual experience because of shame, their emotional connection and her sexual pleasure is interrupted. Female partners often have to have their feelings of frustration heard and validated before they are ready to move on to treatment. Unfortunately, her disappointment may come through as frustration or anger causing him more shame. She may have interpreted his resistance to treatment as "not caring" rather than understanding how humiliated he feels. Because this problem has become entrenched between them, the emotional impact of it has to be explored on both sides so as a couple they join together and figure this out.

Cure Premature Ejaculation:

· Generalize arousal to the whole body. Men often are focused on the performance of their penis which adds more pressure and anxiety increasing the likelihood of him climaxing with little sexual stimulation. Having longer foreplay adds to both partners pleasure, assuring the man that he can be a satisfactory lover by spending time highly arousing his wife. And longer periods of lower level stimulation for him - in witnessing her increased arousal, allowing his erection to wax and wane, feeling his body’s response to skin-on-skin contact - lower the pressure on his erection as well as ejaculation as his sole pleasure.

· Focus on the erotic aspects of the moment. Contradicting the folklore solution of thinking about the multiplication tables or thinking about something completely adverse, the cure for premature ejaculation has to include increasing eroticism and decreasing anxiety. Men need to feel more sexual pleasure and less pressure. Expressing feelings of desire for his partner verbally, turns her on and increases her sense of sexual attractiveness to him and increases her wish to partner in solving the problem.

· Secure your partner’s cooperation in treatment. This can be tricky if there have been years of disappointment and nagging to get the problem fixed! A knowledgeable sex therapist who has training in couples dynamics can help each partner share their fear and disappointment in vulnerable ways to escape the blame-withdraw communication pattern so typically expressed. Then, practice this 6-month treatment proceeding to the next month as long as there is increasing ability to delay ejaculation.

o Month 1 – “Go for Broke!” Break all the rules and try to have an ejaculation quickly. After years of holding back – just giving into the body’s path can free a man from constant anxiety that he climaxes too quickly. Plan for her to climax as well before or after his climax with oral sex, vibrators or manual stimulation. One problem so frequently experienced in heterosexual lovemaking, is the whole experience is over when he comes. Change this. Mutual pleasure is the goal during treatment not mutual orgasm or length of time thrusting.

o Month 2 – Add foreplay for him. Women need at least 20 minutes of general foreplay before genital stimulation to mentally enter the sexual experience, leave their to-do list behind and let their body warm up. Adding in back rubs, naked cuddling, and lots of full body touching for him too – ironically spreads his arousal to his whole body as he becomes aware of pleasure in touch rather than focusing pressure on his penile performance. This shift is often welcome as it syncs the male with the female needs for longer arousal periods.

o Month 3 – Practice edging with manual stimulation. I suggest to my couples that the man should reach a level of excitement of 4-5 on a scale of 1-10 and then they should stop stimulation. Let his body completely relax possibly switching to stimulating her. Know that it is fine if he completely loses his erection and they have to start over for him after her climax. After one experience of “stopping” – with mutual consent, the man should climax either through another round of manual stimulation or sexual intercourse.

o Month 4 – Increase the stimulation. Some men find fellatio much more stimulating. Others find using a slippery lubricant more stimulating. This is not the month to add intravaginal stimulation. But try the next step in stimulation that he finds more sexual. Also increase the “stopping” of stimulation to two times.

o Month 5 – Intravaginal Containment. After one “stopping” point, and he resumes his erection, depending which is the lessor stimulant, he should thrust all the way inside her and stay still or she should envelope him from above and stay still. Talking to each other, good eye contact, expressions of love, can enhance this moment. Then the couple should disconnect for a period of time while his arousal reduces. They may then resume sexual intercourse, both climaxing anyway they prefer.

o Month 6 – Vaginal Thrusting. While treatment is often near the finish, some couples really struggle with this stage. Staying at month 4 for two months might be necessary. Most of my client say female on top is the position that is easier to maintain erections without climaxing because it limits the male ability to thrust which is often a significant way his arousal increases.

Premature ejaculation occurs in up to 40% of the male population and is the most common male sexual dysfunction. It is also one of the most treatable sexual problems responding in less than 6 months to a focused treatment protocol.

References

Corty, E. W., & Guardiani, J. M. (2008). Canadian and American Sex Therapists’ Perceptions of Normal and Abnormal Ejaculatory Latencies: How Long Should Intercourse Last? The Journal of Sexual Medicine, 5(5), 1251–1256. https://doi.org/https://doi.org/10.1111/j.1743-6109.2008.00797.x

McMahon C. G. (2007). Premature ejaculation. Indian journal of urology : IJU : Journal of the Urological Society of India, 23(2), 97–108. https://doi.org/10.4103/0970-1591.3205

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