. 

Content Treatment Methods Researched Definitions Causes, Incidence and Risk Factors Symptoms

. Signs And Tests Expectations (Prognosis) Complications Prevention

Treatment Methods Researched

• Stop and Start Method - Identification and control of sensations through sexual stimulation until the onset of ejaculation.
• Tarutao Cure - A natural cure for premature ejaculation without medication.
• Squeeze Method - Just prior to ejaculation, the man gently squeezes the tip or base of the penis.
• Biofeedback Therapy - A rectal plug helps to relax of the muscles that control ejaculation.
• Drug Therapy - Ejaculation may be prolonged with the use of antidepressants such as Anafronil, Prozac, and Zoloft.
• Desensitizing Creams - The penis head is numbed with creams that reduce sensation.
• Different Sexual Positions - Ejaculation can be controlled with different sexual positions.
• Non-FDA-approved medications - Homeopathic dosages of vitamins, caffeine or herbal substances.
• Counseling - Discussion with licensed sex therapists and/or marriage counselors.

Stop and Start Method

Here's another method that doesn't involve a partner: In her book, PE: How to Overcome Premature Ejaculation, Dr. Helen Singer Kaplan describes a start-stop method that will teach you the sensations of orgasm and what it feels like just before you come. When you masturbate, "stop stimulating yourself when you reach a high level of arousal, near orgasm. Stop for a few seconds -- not long enough to lose your erection but long enough for your excitement to go down a little. Then start the rhythmic stroking of the shaft and tip of your penis again. Interrupt three times. Let yourself come on the fourth time as fast and as freely as you can. During this whole experience, try to concentrate on your pleasurable penile sensations. Do not try to hold back." The method involves moving onto a wet masturbatory technique (using petroleum jelly or soapsuds) to simulate the vagina. You focus on your own sensations, learn to stop and then to let go. p>

Tarutao Cure

This ancient Thai technique has been researched and published by  Dr. Mark Sullivan and his team of specialists. Clinical tests have proved success rates above 95 percent. More information is available at Dr. Sullivan's website at http://tarutao.com/.

Squeeze Method

Sex researchers Masters and Johnson found it's possible to recondition sexual responses. They developed the squeeze technique, by which a man -- working closely with his partner -- can learn to exercise control over his ejaculation. Simply put, when the woman feels that her partner is becoming aroused, she puts her first and second fingers just above and below the coronal ridge (imagine holding a cigar) and her thumb on the underside of the penis. She applies pressure for about four seconds front to back, never side to side. The mistake most novices make is to wait until the man is experiencing ejaculatory inevitability (pulling his hair out, bouncing like the springs of a flat-bed truck, shadow-boxing with the big one). Rather, you use the squeeze throughout the foreplay -- before insertion. Once you've mastered this, you can switch to a basilar squeeze technique, in which either the man or the woman slows his excitement by squeezing the base of his penis (again, front to back) for about four seconds.

Biofeedback Therapy

In Biofeedback Therapy a man is encouraged to become aware of the muscles that control ejaculation and relax them in order to control his body functions. A rectal plug is required to stimulate these muscles.

Drug Therapy

Some studies have revealed that low doses of antidepressants such as Anafronil, Prozac, and Zoloft have been effective in prolonging ejaculation by up to 5 - 10 minutes. There are, however, a few side effects. 
It is important to note that this therapy is NOT approved by the FDA.

Desensitizing Creams

The application of desensitizing creams serves to lessen the sensations felt by men during intercourse. The underlying basis of this treatment is that men can maintain an erection for a longer period of time. However, many men have found intercourse to be less pleasurable due to decreased stimulation.

Different Sexual Positions

A man's ability to control his ejaculation can be affected by the sexual positions a couple engages in. Engaging in coitus while on his back gives the partner control and allows the man to feel more relaxed and allows him to guide his partner. Controlling ejaculation while on top of your partner (the missionary position) is much more difficult.

Non-FDA-approved medications

There are other creams, suppositories, sprays, drops and other non-FDA-approved medications that are available on the market. Although these products do not cure premature ejaculation, patients may feel enhanced self-esteem due to their homeopathic effects.

Counseling

Sessions with licensed sex therapists and/or marriage counselors may address and identify marital and relationship issues that can often be underlying cause of premature ejaculation.

---

Definitions

Premature ejaculation is the inability to delay ejaculation during intercourse to the point that it is when a man desires it or it is mutually satisfying for the couple.

---

Causes, Incidence and Risk Factors

Premature ejaculation is one of the most common complaints of men and couples. Adolescents, young adults and other sexually naive males are more likely to experience this condition than other age groups and sexually mature males. Such factors as lack of sexual experience, lack of knowledge regarding normal male and female sexual responses, and the association of psychological factors (fear, guilt, and anxiety, for example) with sexual activity, all increase risk.

The main cause of premature ejaculation is biological. Upon sexual stimulation and arousal, the normal physical responses for a man and a woman are similar. A man will achieve a climax and then ejaculate about two to three minutes after penetrating the vagina. Women will reach orgasm about 12 to 14 minutes after intercourse occurs. Many women do not achieve orgasm especially if only penetration of the vagina by the penis occurs during sexual activity. Many women achieve orgasm through other methods of sexual stimulation although for some, orgasm is not achieved under any circumstances nor with any type of stimulation. Roughly 10% of women fall into this category. Other causes of premature ejaculation include psychological factors such as marital and relationship issues; performance anxiety (with partners new to each other and especially in the inexperienced partner); fear (associated with concerns regarding getting caught or discovered, sexually transmitted diseases or potential pregnancy ); and guilt (believing the activity is sinful e.g., premarital or extramarital sex).

---

Symptoms

Ejaculation occurs either before the individual or couple desires. The point where satisfaction occurs is entirely subjective but may range from before penetration to a point too soon after penetration.

---

Signs And Tests

An examination usually reveals that nothing is physically wrong. Anything abnormal that is found is usually not associated with the condition. A follow-up interview of the person or couple reveals more useful information.

---

Expectations (Prognosis)

With education and practice of techniques a man is able to learn to control his ejaculations in about 95% of all cases.

---

Complications

• A desired pregnancy may be prevented due to the occurrence of ejaculation prior to entry into the vagina.
• The consequence of prolonged premature ejaculation can cause sexual dissatisfaction on the part of either or both partners and may lead to sexual tension or unhappiness in the relationship.

---

Prevention

The knowledge of normal male and female sexual responses prior to engaging in sexual activity may be helpful in preventing premature ejaculation.
The emergence of sexual tension and relationship difficulties are greatly reduced if sexual activity occurs under these circumstances: only after the partners know each other well and are comfortable with one another. Both partners consent to sexual intimacy without feeling pressured. Sexual activity should occur in a private and relaxed setting. In addition, contraception issues should be discussed, decided and acted upon by the couple.

To make this easier, Kaplan suggests learning to rate your sexual arousal: "Rate the degree of your sexual excitement (not your erection) on a subjective scale that runs from zero to ten. Zero is when you are feeling absolutely no excitement at all and ten is when you reach orgasm. You should have been stopping penile stimulation when you were at about eight and a half. If you tried to go until nine and a half, you went a bit too far, and if you stopped at four or five, you ended the stimulation a bit too soon. Remember, the aim of this program is not tokeep your excitement down until you want to come. That is no fun at all, and besides, that doesn't work. The objective is for you to learn not to ejaculate while staying at the intensely pleasurable sexual plateau stage that precedes orgasm and to be able to relish the delicious sensations of being highly aroused instead of trying to hold back. During intercourse, most men stay somewhere between five and seven, except for brief peaks of eight or so, until they are ready to go all the way." The scale is useful for gauging your behavior during intercourse. For example, if you reach an eight and a half during foreplay, don't try to penetrate. Let yourself cool down (refrain from rubbing or thrusting against your partner's body). The pace you adopt to keep yourself at six may be just the kind of luxurious lovemaking your partner desires most.

And here's more: In an article in "Medical Aspects of Human Sexuality," Daniel Weiss and Dr. David Marcotte suggest that by learning to relax the pubococcygeus muscle (the muscle used to control urination), a man can avoid premature ejaculation. The authors believe that the method is superior to the squeeze technique invented by Masters and Johnson, because it does not require partner cooperation or interruption of the lovemaking. We don't know of any gyms devoted to the relaxation response, but two experiments by Raymond Rosen suggest the shape of things to come. Rosen hooked up 40 male students to a red light and had them listen to a recording of pornography. The light would go on whenever the student got an erection and go off whenever he quelled the erection. Students soon learned to go from full erection to half-mast at will and were better at doing so than those who had not been hooked up to the light. In a related experiment, Rosen told students to try to increase the size of their erections -- an orange light would change intensity according to size. By the end of the study, students who were guided by the light were able to turn on at will. Rig up something yourself and work out.