Even though its often the butt of many jokes, premature ejaculation (PE) is no laughing matter. Its the most common type of sexual dysfunction a man can have, with many experts estimating that up to 30 percent of men have PE. In my new book Overcoming Premature Ejaculation, I use the latest research to distinguish myth from reality and offer a new approach for managing a condition that has left many men, myself included, feeling like a sexual cripple.
Theres been a lot of disagreement and discussion in the medical community about how we should define PE. But the latest, most widely accepted definitionfrom the International Society for Sexual Medicine (ISSM) says that PE is a male sexual dysfunction characterized by:
* ejaculation that always or nearly always occurs prior to or within about one minute of vaginal penetration;
* inability to delay ejaculation on all or nearly all vaginal penetrations;
* and negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy.
To say that its tough to talk about PE is an understatement. Most guys dont want to admit that theyve got any kind of sexual problem, especially one as sensitive as ejaculating too soon. It doesnt help that stereotypes about PE tend to label it as a problem limited to teenagers (just take a look at movies like "American Pie" or "Fast Times at Ridgemont High") or selfish jerks (Lorena Bobbitt famously claimed, after cutting off her husbands penis, He always has an orgasm and doesnt wait for me).
The truth is that PE can happen to anyone. It doesnt matter how old you are, how much experience you have, or how much you know about sex. What was once believed to be an anxiety disorder is now thought to include not just psychological factors but biological origins as well. Most guys with PE have chronic PEtheyve never known any other way.
Do you suffer from chronic PE?
1. Are you unable to control how long you last during sex?
2. Do you climax within a minute or less of starting intercourse?
3. Have you tried various methods to deal with PE, only to have your hopes dashed?
4. Are you dissatisfied with your sex life?
5. Do you often worry about pleasing your partner?
6. Does even foreplay often lead to end of play?
7. Do you avoid intimate situations because they could lead to premature ejaculationso why even bother?
8. Has PE damaged your relationships with women?
If you answered yes to most of these questions, you could have chronic PE. And youre not alone.
Although the stereotype of PE tends to be a teenager who cant control himself, nothing could be further from the truth. Because lifelong PE is chronic, its a problem in young and old men alike. Its true that your ejaculatory control does get a little better with age, but thats because your body is getting older, not because your PE is improving. In fact many older men with PE face the double whammy of erectile dysfunction.
Researchers now believe there well may be a genetic basis for chronic PE, not unlike congenital heart problems and other conditions present at birth. Studies of twins show an increased risk of PE in families, and one Dutch study found that men with PE were likely to have at least one first-degree relative (such as a father or brother) with PE, too. This tells us its possible that PE is has a genetic basis and that your risk for it may be inherited, just as your risk for heart disease and some types of cancer.
In my book Overcoming Premature Ejaculation the program I recommend is biopsychosocial, or combination therapy, which combines behavioral, medical, and interpersonal approaches. That means there are:
1. Behavioral techniques - things you can do during sex. For years sex therapists have been advising men that PE can be cured with two techniques that focus on arousal-awareness and postponing climax. But in fact, those techniques have limited efficacy. If anything, they often interrupt sex. Instead, I suggest a unique series of sexual positions that allow men to maintain sexual interaction without the interruption of more commonly recommended techniques.
2. Medical therapies - medications such as SSRIs that help to delay ejaculation and other medical approaches that are on the near horizon. While pharmaceutical solutions shouldn't be relied upon on their own, they can help guys to get a jump-start on managing PE and developing sexual self-esteem.
3. Interpersonal methods - changes to the way you relate during and around sex. For example, many women don't understand PE and often think that men with the condition are sexually selfish. In fact, this couldn't be further from the truth. Men with PE care greatly about their partners' sexual satisfaction, and need to be able explain the issue without shame and develop alternative paths to pleasure with their partners.
For best results, you need a combination of all three. While we cant cure PE because there frankly is no cure we can learn to manage and ultimately overcome it.