Rapid ejaculation (PE) is one of the most common sexual problems affecting an estimated 30% of men across all age groups and as with all of the ejaculatory disorders, leaves men with feelings of embarrassment and inadequacy.
If you are worried that you have this complaint, consider first that the average lovemaking experience lasts 20 to 45 minutes with a latency time, that’s the duration of penetrative sex, from 2 to 9 minutes. Clinical PE is ejaculation within approximately 1 minute after vaginal entry and the inability to delay ejaculation for penetrative intercourse, occurring at least half of the time and causing negative personal consequences, such as anxiety, frustration, avoidance of sexual intercourse and relationship distress. Most men with PE have always had difficulty with this and in this instance, it’s called primary rapid ejaculation.
The key cause is sensory deficit - A LACK OF SEXUAL SENSORY AWARENESS - in the same way that children who suffer from bed wetting have not yet learned awareness of what it feels like to have a full bladder. Men who ejaculate rapidly are simply too excited to register. Some of the reasons for not developing sensory awareness are:
- Early sexual experiences that took place in a tense situation, such as hurried sex in the back of a parked car or secret masturbation in a bedroom shared with a brother.
- Too concerned about sexual performance instead of enjoying their sexuality (too much pressure to please).
- Negative views or guilt about masturbation or sexual intercourse or sexual fantasies.
Rapid ejaculation is the repeat behaviour of initial experiences when full awareness of the erotic feeling was thwarted, before sticking with the habit.
In some cases, later occurring rapid ejaculation, can be a sign there is an underlying physical problem, such as a urological disorder, prostatitis or diabetes, otherwise the cause is mostly psychological.
Rapid ejaculation can lead to further sexual dissatisfaction. A man who is too preoccupied with his ejaculation may become a spectator rather than a participant in lovemaking, leading to reduced sexual desire and difficulty in getting erections. Trying to think about something else does not work because it tunes you out of your erotic sensations, creating detachment and distance from the sexual moment. Nor does going straight into intercourse as quickly as possible, as “you only have so much time before you ejaculate” because your partner will not be sufficiently aroused. This only compounds the problem for both participants.
Psychosexual therapy is a recognised treatment strategy for PE. It involves undertaking a thorough psychosexual and relationship history before devising a tailored treatment plan. The early part of therapy involves helping you to understand the condition and share how you feel about it. A psychosexual therapist will also help you to find ways to improve your intimate relationship during the treatment.
You may be taught initially how to practice pelvic floor exercises (Kegels) to help tone your muscles. You will then learn how to identify and monitor your levels of pre-orgasmic sexual excitement. The two most common exercises used for ejaculatory control are the Stop-Start and Squeeze techniques - both designed to stop stimulation just before you reach orgasm.
Learning ejaculatory control involves the opposite of trying not to think about how excited you are. It begins with raising sexual awareness, learning how your body is responding, focussing on the pleasurable sensations emanating from the sexual organs and paying close attention to what you think and feel as you approach your orgasm.
A sex therapist can address any deeper causes that may emerge over time in therapy and walk you through a set of exercises that you can carry out by yourself or with a partner. Try not to rush through the process and exercises as quickly as you can in your eagerness to break from a lifetime habit but go at a pace that is right for you. It may take you a short time to master ejaculatory control and it may take a number of weeks to practice but keep in mind that PE is eminently treatable!
Some very helpful literature has been written on this subject and two of the best books are “A New Male Sexuality” by Bernie Zilbergeld and “How to Overcome Premature Ejaculation” by Helen Singer Kaplan. If you believe however that sex therapy is an option for you, make sure that your therapist is an accredited member of COSRT (College of Sexual and Relationship Therapists). This will ensure that your therapist has the appropriate training, qualifications and skill set to hold space while you learn and practice your new skills.