His and Her Health

Premature or Rapid Ejaculation: What to Do When He Comes Faster Than He Wants To

It’s the most common sexual concern for men – coming too soon. Some survey research indicates that over 50% of men would like to be able to last longer. But that doesn’t actually mean that all of these men would be diagnosable as having premature ejaculation (PE).

True PE is defined as orgasming within one minute of vaginal entry, and under this definition, only about 1-3% of men struggle with it. Most men actually last about 5½ minutes during intercourse. Some people think this is long enough, others think it’s too long, and some folks think 5½ minutes just isn’t enough. For example, of those women who do orgasm during sex, many need 15 minutes or more of penile vaginal contact to reach a climax. Needless to say, PE can lead to sexual problems for a couple, and/ or for a man’s partner.

It’s not entirely clear what causes PE, and it is likely that each man may have different issues to blame. Recent research suggests that some men with PE have genetic and neurobiological variations that lead to PE.

Other men may be impacted by psychological issues – for example, a man may be anxious during sex, worried about pleasing his partner, or concerned about getting an erection. This is called performance anxiety, and it can cause a man to ejaculate rapidly. Other men are out of touch with their bodies and physical sensation. These men may become quickly turned on because they have a hard time monitoring and tempering their level of arousal. Finally, if a man is angry at his wife, he may be unconsciously motivated to withhold from her, and PE may be a form of passive aggression.
So what’s a man to do if he wants to last longer? Well, urologists may suggest medication. The most recent approach to “treating” PE is with SSRI’s – antidepressants called serotonin reuptake inhibitors.

I put the word treating in quotes because medications typically don’t cure PE, but they help manage it. Sometimes local anesthetics that help numb the penis are used. Psychologists, on the other hand, help men to become more aware of the stages of sexual arousal. In this way, a man may slow down his rate of thrusting, or even stop moving for a while, in order to better control his level of excitement.

Therapists also help men decrease performance anxiety – perhaps through learning the skills of meditation which give a man better control of his thoughts, or by teaching a couple to slow down and enjoy the process of making love. Eastern sexual practices, also called tantra, help teach a man to move sexual energy up his body rather than out his penis. In this way, he spreads his sexual excitement throughout his body and decreases his need to orgasm.

A man’s partner can be a help or a hindrance in his efforts to overcome PE. If she is critical or cold to him, he will likely have more difficulty than if she is loving and tender. Talking about the issue in a non-judgmental way is step one. Make the conversation about what each of you can do to improve your sex life so that he doesn’t feel like the focus is only on him. After all, everyone can learn to give and receive love better. Why not start now?