PREMATURE EJACULATION
Premature ejaculation is the occurrence of the male orgasm before the woman is ready. There is no time limit. For some couples, the male orgasm will be considered premature if it happens in less than 30 minutes after the initiation of lovemaking. If the man comes in 30 seconds, it might be O.K. if the women comes in 30 seconds or less. This would also be a very economical use of their time. Busy people might strive for this type of efficiency.
As with all couple problems, communication is the key. Once the couple have decided that they want to delay the male orgasm, they can do it.
What doesn't work, and should never be tried, is for the man to think of something else (like baseball or pizza or whatever). This may delay the orgasm slightly, but wouldn't be much fun for either partner. Frequent use of this technique will lead to impotence.
For the man to delay his ejaculation he must anticipate the sensation of an impending orgasm. This is when the man knows he will have an orgasm very soon. This can be anticipated by all men. At that point the stimulation must stop immediately. The woman needs to know when this point has been reached and cooperate. After a minute or two the man's erection will soften slightly and stimulation can be resumed. This can be done over and over again in a session of love making. This has the obvious benefit for the woman of giving her plenty of time to achieve her own satisfaction. The man gets two big benefits. First, he participates in his partners greater satisfaction. Second, his orgasm, when it occurs, will be more intense than usual.
In general, women have their most intense orgasm after one to four prior ones. Men have the most intense sensation after the longest period of lovemaking and the maximum number of approaches to orgasm that stop just in time.
Technical Definition
Ejaculation that occurs prior to when a man wishes it or too quickly during intercourse to satisfy the partner.
Causes and risks
Premature ejaculation is a common complaint. It is only very rarely caused by a physical or structural problem, and would also be associated with other symptoms (i.e. pain).
Common premature ejaculation is most often a function of anxiety and overstimulation. Other psychological factors (i.e. guilt) may also be relevant if the prematurity develops later in a relationship as opposed to earlier, though this is not a hard and fast rule. With time, it should disappear on its own.
Prevention
There is no prevention for this disorder, though clearly relaxation may decrease its incidence.
Symptoms
Ejaculation happens before the individual or couple would like. (This may range from before penetration to a point too soon after penetration for the couple to feel fully satisfied.)
Signs and tests
A physical examination is usually normal and abnormal findings are unlikely to be associated with the condition. Useful information is more likely to be obtained from interviewing the person or the couple.
Treatment
In general, practice and relaxation is all that is necessary to deal with the problem.
Such techniques may include:
The "stop and start" method:
This involves sexual stimulation until the man recognizes that he is about to ejaculate; the stimulation is then removed for about thirty seconds and then may be resumed. The sequence is repeated until ejaculation is desired, the final time allowing the stimulation to continue until ejaculation occurs. The "squeeze" method
This involves sexual stimulation until the man recognizes that he is about to ejaculate; at that point, the man or his partner gently squeezes the end of the penis (where the glans meets the shaft) for several seconds, withholding further sexual stimulation for about 30 seconds, and then resuming stimulation. The sequence may be repeated by the person or couple until ejaculation is desired, the final time allowing the stimulation to continue until ejaculation occurs. Medications may also be helpful; a common side effect of certain antidepressants is delayed ejaculation, which may help.
Prognosis
In most cases, the man is able to learn ejaculatory control through education and practice of the simple techniques outlined. Chronic premature ejaculation may be a sign of anxiety or depression, both which could be benefited by psychiatric intervention.
Complications
Very early ejaculation, occurring prior to entry into the vagina, may prohibit a desired pregnancy. A continued lack of ejaculatory control may lead to sexual dissatisfaction on the part of either or both members of the couple and be a factor in sexual tension or discord in the relationship in general.