Premature ejaculation can be very frustrating for men or couples who are experiencing it. To treat premature ejaculation, the first thing we need to do is identify the causes and examine the treatments that are appropriate for each patient. Premature ejaculation has many factors. Incidentally, there are many aspects of our lives that are likely to contribute to premature ejaculation without us even realizing it.
It is important to understand that humans, being mammals, are not designed for prolonged coitus. The act of reproduction is a very vulnerable position and activity for mammals. In nature (and from an evolutionary point of view) it is important that men deposit sperm on women as quickly as possible so that they do not become prey. Since humans associate reproductive activity with emotional connection, it is our desire to last the sexual experience for as long as we wish. It is important to remember that we are engaging in behavior that is inconsistent with normal mammalian activity.
Two types of premature ejaculation
The medical community divides premature ejaculation (PE) into two types. For some men, exercise has been a lifelong problem. It’s just how they’re wired. This is known as primary premature ejaculation. Just as some men are short or tall, brown or red hair, quick reflexes or clumsy, genetics can play an important role in our sexual function. And while the awkward guy can practice and become less awkward, he will never be as coordinated as some men. The same is true for primary premature ejaculation. We can optimize how long this man can survive, but it is unrealistic to expect that the man with primary premature ejaculation will learn to last 30 minutes without significant medical intervention.
Other men develop premature ejaculation for several reasons. This is known as secondary premature ejaculation. For these men, they went through most of their lives without ever paying attention to how long they took because they always felt in control of climaxing and it was never a problem. But often there are changes (whether or not the man realizes it) that can cause difficulty in controlling ejaculation. These changes can be gradual or sudden.
It is very common for sex therapists or health professionals to accuse men of having premature ejaculation due to poor masturbation habits. I’m not sure why our culture likes to shame masturbation, but when professionals talk like this, they are displaying their own prejudice and discomfort with normal sexual activity. While masturbation activities can be counterproductive, they are rarely the cause of premature ejaculation.
Treatment of PE
Part of what we do in the clinic is to find out and become good detectives, to find out what changes have occurred that triggered PE. Once we understand possible changes, we can try to address or deal with them. Treatments may include medication, as well as sex therapy and education. We’ll cover these treatments in another blog. The two-pronged approach we take in dealing with premature ejaculation is medical intervention to improve ejaculation control. At the same time, we want to practice sex education so that the patient’s sexual activities support the couple’s goals and desires. For example, we encourage couples to change the sequence of events that are part of their sexual routine. I could encourage a couple to have an expanded sexual experience with lots of erotic play and massage and exploration while realizing that intercourse will climax quickly.
Another example of sex education is recognizing the false belief that a climax signals the end of sexual activity. This is a habit that is supported in the porn industry. Every sex scene with a man ends in ejaculation! In real life, this doesn’t have to be the case. Just because there is ejaculation doesn’t mean that sexual activity will stop. It can mean that intercourse can stop, but that doesn’t mean sex has to stop.
If you or your partner are struggling with climax sooner than desired, or if avoiding climax has become a focus during sex, it is time to seek help. Be sure to find a sexual medicine specialist who is knowledgeable about premature ejaculation. You don’t have to suffer when help is available!
For more information about treatment or questions about your sexual health, contact us at Maze for a free phone consultation.