is
ejaculation that happens before a man
wants to ejaculate. That may be out
of want to extend his pleasure or
to extend the pleasure of his partner. Clients
that have sought help for not being able
to "last long enough" have complained
of ejaculating anywhere between before entry
to not being able to last for more than twenty
minutes. Sources estimate the average male
ejaculates anywhere from one minute to seven
minutes with adequate stimulation to the
penis. There is a lot of
discussion about the causes of PE. There is
also a lot of discussion about whether PE should
be thought of as a dysfunction. Robert W.
Birch, Ph.D., states in his book,
Male Sexual Endurance: A Man's Book About Ejaculatory Control
, "I believe it to be a normal
variation that can be managed, but what must be
learned is an approach that requires close
attention until age slows the man down...if it
ever does." Regardless of the discussions and
speculations, the one thing that we know for sure
is that lasting longer serves no reproductive
function. I agree with Dr. Birch in
that lasting longer can be thought of as
a learned behavior that can result in
extended and intensified pleasure for a man.
This learned behavior can also extend and
intensify the sexual pleasure for women through
the extended thrusting of the penis which results
in the movement of the labia which in turn
stimulates the clitoris.
Premature
ejaculation can also caused by
psychological factors such as guilt, fear, and
performance anxiety. The possible sources of
these psychological factors are many and can vary
with each individual. When these barriers
are present, they can often be best addressed by
working with a certified sex therapist.
It
is essential for males learning to extend
their sexual endurance to adopt the belief
that good sex is unhurried sex meant to be
enjoyed by him and his mate. The
longer he spends in foreplay prior to his first
orgasm, the stronger and more enjoyable the
orgasm. The extra flow of blood to
the sex organs builds slowly, swelling the tissues
and sensitizing the millions of nerve endings in
and around the genitals.
The
Orgasm,
which is
commonly thought of as a single event, consists
of two stages. One begins with the prostate gland,
which encircles the urethra like a tiny inner
tube above the base of the penis, contracts
and releases its fluids, along with the contents
of the seminal vesicle, into the urethra.
Stage two is marked by the pelvic muscle
contracting strongly forcing the fluid out through
the urethra.. Many men, and women, mistakenly
believe that it is not possible to ejaculate
without having an erection. Sometimes
the ejaculate goes into the bladder instead out of
the urethra.
At this point many
men may be wondering about multiple orgasms.
In the words of Dr. Robert Birch, let us concentrate on
getting it right the first time.
The traditional
treatment of premature ejaculation involves
becoming very familiar with the feelings
and sensations leading up to the "point
of no return" and ejaculation. By learning to
become very familiar with these sensations, men
can slowly learn how to predict when the upcoming
ejaculation will occur and gain more control over
their ejaculations. The treatment of PE is
very male focused and it is not uncommon for the
man's sex partner to feel left out. Males
learning to extend the time it takes them to
ejaculate are usually instructed to not
engage in intercourse during the first
few stages of treatment.
Sex therapy for
premature ejaculation usually starts out with
masturbation exercises, done at home, focused
on identifying the "point of no return"
(ejaculatory inevitability). The male is
instructed to masturbate, without the aid of
pictures, videos, etc. and to concentrate
only on the sensations and feelings in their penis
and the muscles surrounding the penis and rectum.
There is a point at which they will not be
able to control their ejaculation anymore. At
that point, as hard as they try, they
cannot stop themselves from ejaculating. Ejaculation
is can not be stopped because it is a
reflex: caused by the brain sending messages
through the spinal cord to the sex
organs with orders to ejaculation.
Once the individual
identifies their point, the following exercises
involve masturbating until they reach a level of
arousal just before that point and which
they are still in control. They then stop
until the arousal level decreases to a point
where there is no chance of ejaculation, but not
so long that they lose all of their erection.
Some therapist instruct their clients to stop
until they lose their erection. This cycle
is repeated three times and on the fourth cycle ejaculation,
as normal, is allowed. Once the male has
satisfactory control of his ejaculations during
the masturbation exercises, the next step will be
to include his sex partner. The partner will
manually stimulate him in the same manner.
It is important that there be no intercourse until
satisfactory control is achieved during these
exercises
The method just
described is called "stop and start". Another standard
method that is used is called the
"squeeze" method. The squeeze
method, which may be more effective for some,
is more awkward. So I prefer to start with
the "start/stop" exercises.
The squeeze method requires the male, or his
partner, to stop and then squeeze the penis
just behind the crown until he in control of
his arousal level.
Variation in the
next phase of treatment can include masturbating
with the penis close to the vagina, inserting the
penis in the vagina with no movements for short
periods of time, etc. Then transitioning to
intercourse with the female in the on top position
and facing each other. The male uses his
hand on his partner's hips to guide her motions in
the same start and stop pattern used in the
masturbation exercises.
These exercises
continue when the position changes to the man on
top. Then the "stop and
start" method calls for the male to stop
all movements and press the pubic bone against his
mate's pubic bone, just before he reaches the
"point of no return". If
the mate's vagina will not accommodate the full
length of the penis then stopping all movement can
be used. Neither the male or his mate moves
until the urgency to ejaculate decreases to a
controllable level. Then start thrusting
again. This cycle is repeated three
times in a row. The squeeze method calls for
stopping all thrusting and squeezing the
penis in the same manner as it was squeezed during
the masturbation and manual stimulation
exercises.
Sometimes therapist
also teach the male to flex and relax the
muscle that controls the flow of urine. This
muscle can be identified by focusing on the
muscles contracted when urinating that stop
the flow of urine. The muscle is known as the PC
muscle. Some experts recommend that this
exercise be repeated several times every day
to assist in gaining more control of the
ejaculation process.
