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Key points
- The exact cause of premature ejaculation isn't known, but is thought to be a combination of psychological and biological factors.
- Psychological causes of premature ejaculation include anxiety and relationship issues.
- Biological causes of premature ejaculation include abnormal hormone levels and certain thyroid problems.
As a Couples & Sex therapist in Private Practice, many men and couples come to see me trying to fix premature ejaculation. Many men suffer from shame and embarrassment about feeling that they ejaculate too quickly, leading them to have anxiety about sex and their performance during intimate encounters.
According to The Mayo Clinic, the exact cause of premature ejaculation isn't known. While it was once thought to be only psychological, doctors now know premature ejaculation is more complicated and involves a complex interaction of psychological and biological factors.
Psychological causes
Some doctors believe that early sexual experiences may establish a pattern that can be difficult to change later in life, such as situations in which you may have hurried to reach climax in order to avoid being discovered, and guilty feelings that increase your tendency to rush through sexual encounters.
Other factors that can play a role in causing premature ejaculation include:
Erectile dysfunction. Men who are anxious about obtaining or maintaining an erection during sexual intercourse may form a pattern of rushing to ejaculate.
Anxiety. Many men with premature ejaculation also have problems with anxiety—either specifically about sexual performance or about other issues.
Relationship problems. If you have had satisfying sexual relationships with other partners in which premature ejaculation happened infrequently or not at all, it's possible that interpersonal issues between you and your current partner could be contributing to the problem.
Biological causes
- Abnormal hormone levels
- Abnormal levels of brain chemicals called neurotransmitters
- Abnormal reflex activity of the ejaculatory system
- Certain thyroid problems
- Inflammation and infection of the prostate or urethra
- Inherited traits
- Nerve damage from surgery or trauma (rare)
USA News.com reported that the average length of a sex act is 7.3 minutes but 43 percent of men finish in under two minutes.
Treatments for Premature Ejaculation Include:
1. Trying to build control over your ejaculatory reflex. Begin by masturbating regularly (three to five times per week) to become accustomed to the level of sensitivity and stimulation. Try masturbating with both a wet hand and a dry hand to get used to varying sensations. Try building control by masturbating right up until you feel yourself about to release, then stop masturbating, let your erection die down a bit, maybe five minutes or so, and then start masturbating again. Do this exercise three or four times before you finally allow yourself to “finish” and masturbate to orgasm.
Practicing this idea will help you to know where your “point of no return” is so that during partner sex when you feel this sensation happening, you can back off either by “pulling out” to change sexual positions thus dulling your sensation for a moment or you can change your stroke (instead of thrusting in and out during sex you can leave your penis inside your partner and go in circles, which can be a bit less stimulating). Knowing what your “point of no return” feels like is crucial for gaining control over ejaculation.
2. Practice Kegels to attempt to delay orgasm. Kegels are useful when the ejaculation is near and can help to stave the ejaculation off. Just Google “Kegel Exercises” to see what they are. They help to build up the muscles in your pelvic floor to help you have better control.
In a controlled study in 2012 on premature ejaculation, men who couldn’t last for one minute before ejaculation completed a 12-week course of pelvic floor exercises and were found to increase their ejaculation response time from 31.7 seconds to 146.2 seconds.
3. Using condoms also helps to delay ejaculation. They work by reducing sensitivity during intercourse so they can be helpful for a premature ejaculation problem. Use a thick brand condom: Trojan Enz will work if you can use latex.
4. Try making use of the “refractory period” after ejaculation. How soon can you achieve an erection after ejaculation? How long can you stimulate the second erection before ejaculation? Many men experience less sensitivity during the second erection and often a good treatment for premature ejaculation is to have the man ejaculate once (maybe during intercourse) then move on to please his partner until his erection returns, then use that second erection to have a longer intercourse session. Although some couples initially complain about this idea, it has worked very well for lots of couples.
5. Another tip to try mindfulness to help decrease your anxiety. Using apps such as Calm may help you to learn guided techniques to feel tranquil and more relaxed going into an intimate encounter.
6. If you haven't orgasmed within 24 hours of being sexual with your partner, you will ejaculate more quickly. Men who masturbate in the mornings and then have relations with their partners in the evening tend to be able to last longer because they have had an orgasm within the same day. You can also masturbate at night and have sex in the morning with the same effect.
7. How much foreplay are you engaging in? Try more or less, or different types of foreplay. Try more or less focus on the penis to control the level of stimulation. If you are achieving an 8.5 level of stimulation before attempting to penetrate, where a 9 is the point of ejaculatory inevitability, penetrate when you are a 6 or 7. Never carry a lit match into a dynamite factory. Sometimes more foreplay helps with premature ejaculation because it allows the man to gain control over his anxiety and to be relaxed instead of hurrying through, which could “amp up” his anxiety and lead to premature ejaculation.
8. Many SSRI medications work magically to help dull orgasmic sensations. This side effect can be very frustrating to men who don’t have a premature ejaculation problem but for a man who ejaculates prematurely, it can work amazingly. Talk to your doctor about the benefits of taking an SSRI antidepressant for premature ejaculation.
9. Using the “Squeeze Technique." This technique is where the man is having intercourse and then when he feels like he is close to release, pulls out and squeezes the head of his penis where it joins the shaft thus producing a “stop sensation,” helping him to be able to dull the sensation of wanting to orgasm. When he feels like that “point of no return sensation” has dulled he would then re-insert and begin again having intercourse. He could use the “squeeze technique” as many times as he wanted before finally allowing himself to orgasm.
10. Finally, examine the relationship to deal with sexual dysfunction. Look at how we are communicating regarding sex and what our hopes and goals are for our sexual relationship. Talking to a qualified sex therapist can also work wonders. Find a good one on the Psychology Today therapy directory.
