Peter’s couple therapy blog

Rapid or premature ejaculation

She was in the kitchen preparing to boil eggs for breakfast. He walked in; She turned and said, “You”ve got to make love to me this very moment.” His eyes lit up and he thought, “This is my lucky day.” Not wanting to lose the moment, he embraced her and then gave it his all; right there on the kitchen table. Afterwards she said, “Thanks,” and returned to the stove. More than a little puzzled, he asked, “What was that all about?” She explained, “The egg timer’s broken.”

Rapid ejaculation is likely the most common problem in men’s physical and emotional relationship with their penis. At one time or another 30% of men report it. Defined as “ejaculation that occurs sooner than desired, either before or shortly after penetration, causing distress to either one or both partners.”

Lasting longer in bed has many personal, physical, relationship, social and cultural factors acting within the body in a self-reinforcing way. The quality of person’s relationship with their penis, for example, points to the monologue a person has about their sexuality and genitals, or not. It’s the story we tell ourselves about who we are. One part of that self-talk may be about performance, about the penis owner feeling the pressure of initiating and orchestrating a sexual encounter, and the resultant performance anxiety or stage fright. Changing the tone and content of negative self-talk to positive is the beginning of a better relationship. The biggest sex organ in the body is the brain and it will work in the direction of our self-talk.

Here are seven things men wished you knew about their penis in this Women’s Health article covers this and more.

Performance anxiety is a build up of a fearful relationship with ejaculatory orgasm, built up from past experiences. It predicts that it’s going to happen again. That very thought bubble is a major part of the problem and of the cure. Those thoughts are anxiety producing and remove the person from being in the present. The sense of failure sits there the next time, blaming oneself for not having mastery of one’s own body – that’s the story. Our story determines how we feel. How we habitually think will determine how we habitually feel.

One client was so ashamed of this eminently treatable problem, that he chose to develop (unilaterally) a sexless marriage rather than risk the humiliation of failure. That was a risky fix, which created an even bigger problem in the relationship. His partner felt rejected, angry and impotent to do anything about it. If she tried to approach the problem he would shut down and withdraw from any intimate connection. She came to a realisation that there was a choice in here, he was not a victim of a medical problem, the problem was between his ears not between his legs. In addition he was making a choice to not seek help, even when she laid out the risk to their relationship of not doing so. The thought of seeking help for penis failure brought up more shame. It became a self-esteem issue, where none existed before. Ten years into this problem they finally came for help, and by then there was extensive collateral damage.

Differences in sex drives are common in couples and may vary considerably over the years of a committed relationship. Ageing may be a factor. Poor conflict resolution and/or conflict avoidance, as well as other intimacy issues in the relationship may be pre-existing. The difference from loving your partner and being in love with your partner often comes up. These all need to be acknowledged and managed gracefully. Incompatibility is not the big problem it’s made out to be. Well managing the inevitable incompatibilities brought about by change is the key to a long and happy relationship.

In many case I will recommend somatic, erotic education. This is provided by referral to a local practitioner of sexological massage. She will show him how to relax and enjoy intense sexual feeling in his body without orgasm, of climaxing without ejaculation and of soft cock climax. These experiences are life changing for many men and couples. See more of this below.

In moving from a sprinter to a marathon runner, you may find some of the following ideas will help. I have copied them, with minor edits, from this Psychology Today article. There is also more information in this Psychology Today article.

1. Build control over your ejaculatory reflex. Begin by self-pleasuring regularly (three to five times per week) to become accustomed to the level of sensitivity and stimulation. Try masturbating with both a wet hand and a dry hand to get use to varying sensations. Try building control by masturbating right up until you feel yourself about to release, then stop masturbating, let your erection die down a little bit, maybe five minutes or so, and then start masturbating again. Do this exercise three or four times before you finally allow yourself to “finish” and masturbate to orgasm.

Practicing this idea will help you to know where your “point of no return” is so that during partner sex when you feel this sensation happening, you can back off either by “pulling out” to change sexual positions thus dulling your sensation for a moment or you can change your stroke (instead of thrusting in and out during sex you can leave your penis inside your partner and go in circles, which can be a bit less stimulating). Knowing what your “point of no return” feels like is crucial for gaining control over ejaculation.

2. KEGELS are vitally important pelvic floor exercises for this issue. Practice Kegels daily to build the ability to delay orgasm. Kegels are also useful in the moment when the ejaculation is near. They can help to stave off the ejaculation. They help to build up the muscles in your pelvic floor to help you have better control.

In a controlled study in 2012 on premature ejaculation, men who couldn’t last for even one minute before ejaculating completed a 12 week course of pelvic floor exercises and were found to increase their ejaculation response time from 31.7 seconds to 146.2 seconds.

3. Using condoms also helps to delay ejaculation. They work by reducing sensitivity during intercourse so they can be helpful for a premature ejaculation problem. Use a thick brand condom: Trojan Enz will work if you can use latex.

4. Make use of the “refractory period” after ejaculation. How soon can you achieve an erection after ejaculation? How long can you stimulate the second erection before ejaculation? Many men experience less sensitivity during the second erection and often a good treatment for premature ejaculation is to have the man ejaculate once (maybe during intercourse) then move on to please his partner until his erection returns, then use that second erection to have a longer intercourse session. Although some couples initially complain about this idea, it has worked very well for lots of couples.

5. Use more lubricant. Reducing the friction may help you last longer.

6. If you haven’t orgasmed within 24 hours of being sexual with your partner, you will ejactulate quicker. Men who masterbate in the mornings and then have relations with their partners in the evening tend to be able to last longer because they have had an orgasm within the same day. You can also masterbate at night and have sex in the morning with the same effect.

7. How much foreplay are you engaging in? Try more or less, or different types of foreplay. Try more or less focus on the penis to control the level of stimulation. If you are achieving an 8.5 level of stimulation before attempting to penetrate, where a nine is the point of ejaculatory inevitability, penetrate when you are a six or seven. Never carry a lit match into a dynamite factory. Sometimes more foreplay helps with premature ejaculation because it allows the man to gain control over his anxiety and to be relaxed instead of hurrying through, which could “amp up” his anxiety and lead to premature ejaculation.

8. Using the “Squeeze Technique.” This technique is where the man is having intercourse and then when he feels like he is close to release, pulls out and squeezes the head of his penis where it joins the shaft thus producing a “stop sensation,” helping him to be able to dull the sensation of wanting to orgasm. When he feels like that “point of no return sensation” has dulled he would then re-insert and begin again having intercourse. He could use the “squeeze technique” as many times as he wanted before finally allowing himself to orgasm.

9. Explore issues in the relationship, outside of this problem in order to deal with the sexual dysfunction indirectly. Look at how you are connecting and communicating around intimacy and sex, what are your hopes and goals for the sexual relationship.

More ideas

Managing performance anxiety especially this Esther Perel video
masturbating an hour or two before you have sex
using a thick condom to help decrease sensation
taking a deep breath in order to briefly shut down the ejaculatory reflex (an automatic reflex of the body during which ejaculation occurs)
holding breath and pushing as if to do a poo may delay ejaculation
having sex with your partner on top, as you may find this position less arousing
distracting yourself – take a break and think of something other than sex

Develop relationship with yourself
Introvert or Extravert?
Make time for personal reflection and self-development
Am I an authority in my own life?
Loss of direction: who am I, how did I get here, what are my wants and core needs, and where am I going?
Adjust work life balance
Anxiety and stress management techniques

Couple Therapy

All over this site

Sexological body work

A combination of practising Kegels, Body work and Couple’s therapy are in my experience the best of all the ideas on this page. I recommend Tamar and I for Couples therapy, and Eve Marie in Byron shire for sexological body work: Eve Marie 0425 347 477 and eveglimma@gmail.com

https://www.trustedbodywork.com/profiles/tantra-byron-bay

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