This page outlines the guidelines generally applied by therapists for learning ejaculatory control nowadays.
As you are probably already aware, premature ejaculation is by far the most common male sexual dysfunction.
The vast majority of adolescent boys and young adults will experience rapid ejaculation in their first sexual experiences. However, a large proportion of adult men – anywhere between 30 and 75%, according to the definition you apply – will also experience premature or rapid ejaculation. (If you’re interested, it’s worth remembering that women can also ejaculate. See this for more.)
It’s important to note that quick ejaculation during sexual intercourse is not necessarily a problem: if a couple have integrated other sexual practices into their sexual relationship, they may be happy with short-lived intercourse, and there may be no reason for them to seek treatment.
Unfortunately, however, such couples may well be a minority, although figures do not exist demonstrate whether this is so or not. What is certain is that for couples where either the man or his partner are dissatisfied with the duration of intercourse, early ejaculation can be a painful problem. For men whose problem centers on making a woman come, this is helpful information about taking a woman to orgasm.
The consequences can range from lowered sexual self-esteem to self denigration, expressing anger towards the self or towards the partner, or avoiding sex altogether. For men who do not have a regular partner, rapid ejaculation can be very emotionally distressing since it may lead to them avoiding sexual relationships or not even dating.
So what can be done about it?
In the past, the recommended and most common treatment technique has been the “squeeze technique”.
This is a treatment based on the observation that firm pressure applied between the frenulum and the opposite side of the coronal rim of the glans penis prior to ejaculation can both soften a man’s erection and reduce his desire to ejaculate.
This effect seems to be modulated through a reduction in sexual arousal. Reports have often suggested that the squeeze technique is ineffective in acting as a long-term treatment for PE, and it is true that new methods of treatment seem to be more effective.
We should not forget, however, that radically different approaches to therapy may also be helpful. For example, yoga has been considered as a tool for the control of premature ejaculation. You can read more about this here.
These techniques rely on teaching a man arousal management (which basically means increasing his ability to control the rate at which his sexual arousal increases) as well as offering techniques which can be used in combination to address different areas of the problem.
But treatment methods also depend to some degree on the type of premature ejaculation a man is experiencing. What used to be known as “organic” or “physiological” causation and is now called biological causation will include such predisposing factors as prostate infection, spinal cord or nerve damage, withdrawal from drugs, or, more questionably, a neurological disposition to quick ejaculation.
It’s fair to say that the last of these is rather controversial: while it’s certainly true that some individuals have a nervous system with a lower threshold for arousal than others, it’s not entirely clear that this is a causative factor in a lack of ejaculatory control. For the moment, despite much research which claims to demonstrate either penile hypersensitivity or exaggerated nervous system sensitivity is a causative factor, the matter remains unresolved.
Psychological causes of premature ejaculation include stress, over arousal, relationship conflicts, or a deficiency of psychosexual skills, whether this be as simple as a lack of ability to communicate about sex or a more fundamental lack of knowledge around sexual intimacy, sexual techniques and even ways to pleasure the partner.
In any case, the consequences of premature ejaculation are legion: it interferes with the couple’s sex life and their interaction outside the bedroom too. That’s why men may find this approach helpful to making women come faster and enjoy orgasms.
Yoga and premature ejaculation
For women, common effects are resentment and anger, combined with sexual frustration if she’s not experiencing orgasm, and possibly sadness at the fact that she’s not in a fully sexual relationship, one that is empowering her to achieve her full sexual potential. It’s common to hear women speak of feeling emotionally abandoned when a man stops making love because he has ejaculated too soon, or because he is not addressing the problem.
In this context, of course, “too soon” is an entirely subjective expression, which may incorporate misunderstandings about the possibility of female orgasm during intercourse when a couple are not particularly well-informed on the mechanics of orgasm for women.
For men, the consequences of premature ejaculation include feeling ashamed of sexual failure, or a belief that it’s impossible for the man concerned to please a woman (which again demonstrates a fundamental misunderstanding of what women want from romantic intimate connections with men).
And seeking help may perversely increase a man’s sense of failure, since asking for professional help can add to the shame and prove his sexual inadequacy – at least in his own eyes.
And so, with these antecedents, it’s hardly surprising that men may do nothing about PE – even for years after the problem has become apparent. These problems can of course be accentuated by other sexual concerns like having a small penis….. if that applies to you, see small dick pictures here (you never know, it might reassure you)!
In fact it’s been stated that the average time for a man to seek professional help is around six years, a time period in which the woman can easily come to believe that the man doesn’t care about her feelings (although in the majority of cases therapists report that nothing could be further from the truth).
One of the difficulties about treating premature ejaculation is that the self-help techniques which have been promoted in books and on the Internet for many years simply do not reduce arousal or prevent a man ejaculating quickly: these techniques include distraction (biting one’s lip, focusing on non-arousing thoughts such as taxes, baseball games or road kill), and using multiple condoms or desensitization creams.
Indeed, such distraction techniques actually make things worse because they reduce a man’s pleasure, and take him away from real connection and interaction with his partner. This may make her feel even more abandoned, and can lead to erectile dysfunction in extreme cases, because the man has successfully reduced his arousal to a very low level.
It’s therefore unsurprising that dealing with premature ejaculation usually requires a combination of techniques, all to be applied and used with considerable dedication.
At the moment an effective treatment modality appears to be (1) emphasizing the need for attention to what is going on in the man’s mind & body during sex – in particular, investigating whether or not he’s relying on fantasy or distraction – and then ensuring he is expressing his feelings, and (2) helping him learn to reduce anxiety through relaxation techniques, and (3) equipping him with a set of behaviors which allow him to pace his arrival at the “point of no return”.
As you may expect, it can be quite challenging for a man to effectively regulate all these three aspects of sexual response during a time when he’s probably highly sexually aroused anyway.
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To summarize, effective PREMATURE EJACULATION treatment requires attention to 3 areas:
1) Becoming aware of the level of sensual and sexual arousal that one is experiencing whilst also maintaining relaxation of the body and mind.
The fundamental basis of this technique is allowing sexual arousal to stem from one’s own physical and mental arousal rather than from involvement with one’s partner (e.g. the sight of her body, or the scent of her arousal) or from internal fantasy.
This, of course, is a fundamental shift of awareness from “other” to “self” during sexual activity; it recognizes the principle that sexual pleasure and satisfaction come from one’s own arousal and not from one’s partner’s pleasure or arousal. And that, for many men with PE, is a radically new way of thinking.
2) Better ejaculatory control through learning various “new” or at least different ways of thinking and behaving during sex: these are explained in a moment.
3) Being more relaxed with one’s lover, and co-operating with her in a way that is agreeable to her as well as pleasurable and satisfying to both partners, and learning techniques that can please her more satisfactorily.
The essence of sexual pleasure and good sexual functioning is physiological relaxation.
This fact can be counter-intuitive: most men assume that sexual arousal is simply dependent upon anxiety or excitement, induced perhaps by the sight of the partner naked and the anticipation of sexual intercourse.
Yet, the truth is that for the body to engage in a natural sequence of sexual responses it needs to be physiologically relaxed. In other words, the natural, uninhibited and effective progression of sexual reflexes to the point of ejaculation can only take place when the interplay of the autonomic and sympathetic nervous system’s reflexes is occurring in a physiologically relaxed body.
This means that any good therapy for PE will require a man to learn specific relaxation techniques, both as a foundation for ejaculatory control and as a part of other treatment methods.
The term given to the state in which this is possible is called “self-entrancement” arousal.
“Self-entrancement arousal” means, in practical terms, that a man will be focusing on the sensations and experiences occurring in his own body so that he becomes more familiar with his responses to sexual stimuli. Most men with premature ejaculation automatically focus on their partner, or indeed upon erotic material outside of the relationship – e.g. using fantasy to increase arousal.
Most men with premature ejaculation (check this site out if you wish to cure it) have learned this way of becoming aroused, but while it is enjoyable it does not provide a man with the means to control his own level of arousal.
This is more or less what would you would expect if the source of arousal is “outside” of yourself and yet you are constantly in contact with it, as a man is with his partner during sex.
The most dramatic example of how “partner involvement” or “out of body focus on sexual arousal” plays out in PE is summed up in the fact that so many men with PE say they are surprised when they ejaculate.
This is usually because they are not focusing on their own body or its sensations. They simply do not know when they are going to come.
So the first step in teaching ejaculatory control is to allow the man to adopt another arousal style which has been termed “sensual self entrancement arousal.”
As you may expect, this takes the focus away from one’s partner to one’s own physical sensations, one’s own bodily sensations. When a man has learned to become aroused by his own sensations he has laid the foundation for greater control of his sexual arousal. Another approach is described here.
By focusing upon his own physical sensations – call this “arousal awareness” – and then how to manage his arousal cognitive and behaviorally – call this “arousal management” – he can both facilitate bodily relaxation, overcome disassociation from his own body, and give up using distraction techniques.
A practical example of this would be giving the man techniques to help him focus upon the pleasurable sensations that he receives from his penis rather than focusing on his partner’s breasts, on sexual fantasy, or on the distractions with which he tries to delay his ejaculation.