Many men complain of premature ejaculation. The good news is that this problem tends to respond to sex therapy. Clearly, if you are reading this tip, you may be thinking about this issue, but not ready to go to a sex therapist for information and help. If that is the case, then you have come to the right location. The next series of tips are devoted to what steps you will take for yourself so that you too can learn how to maintain an erection and look at some proven ejaculation dysfunction solutions.

    In case you are wondering what exactly is a premature ejaculator, it is a person who on a regular basis ejaculates before he and his partner are satisfied. In other words, lovemaking (penal-vaginal or anal intercourse) is disappointing. According to Helen Kaplan, "the essence of prematurely is lack of adequate voluntary control over the ejaculatory reflex". These men experience ejaculation continence. Thus, it follows that men who prematurely ejaculate have not learned to recognize the pre-cursor sensations to ejaculation. This can be seen as similar to a young child learning to control her/his bladder. In the beginning children do not recognize the signal(s) that their body is giving them about the degree to which their bladder is full until it is too late. As a child ages, she/he develops an awareness of when she/he needs to urinate, control of bladder muscles and an understanding that the more liquid consumed, the greater the need to urinate.

A typical adult male not only has relative control over the timing of when he lets himself urinate, but when he lets himself ejaculate. Yet, as a human, there are times when even the man with the best control finds himself in a long car ride with a desperate need to urinate and is forced to pull over to the side of the road to relieve himself, or extremely sexually turned on and ejaculates before he ideally would like to. It happens. This only becomes problematic when the loss of control happens frequently enough to impair your day-to-day life. Recognizing the sensation(s) of the pre-cursory signs for the need to urinate or ejaculate are critical to the treatment process.

    There are two primary treatments for premature ejaculation: the Stop & Start Method & the Squeeze Technique. Personally I prefer the stop & start technique. I believe that it is easier to learn and has fewer ways to go wrong. I will focus on two ways that the stop & start technique is taught. For the sake of explaining both techniques, I will explain it to you as if you are in a heterosexual relationship. Clearly some of you are in a homosexual relationship, single, or just plain curious. If this is the case, then even if the wording feels awkward to you, the information will be useful for you.

Word of Caution: Both techniques are male in focus. The exercises centers around pleasuring the male. Many women will get a lot of pleasure also because in the long run they will be able to start to be better satisfied because their partner's erection will be maintained. Second he will feel better about himself in bed, and thus she will derive pleasure from his positive energy. Do note, that because the exercises are male focused, that at times the female will need her time for direct sexual pleasuring. This may mean giving her manual, oral, vaginal & anal stimulation prior to beginning each exercise or doing it afterwards, or alternating days. In the beginning the two of you may be so excited to begin that this feels like a non-issue. But, for most couples whom I have worked with this issue does surface. Therefore, the two of you should take some time now to discuss how the helping partner (the female) will have her needs sexually satisfied (i.e. oral sex, masturbation...)throughout the formal set of exercises that you are both about to embark upon.

First, the husband and wife should begin lovemaking. As soon as the husband's penis becomes erect, they need to stop. Then he lays down on his back and the wife proceeds to masturbate him. During this time, the husband must focus on the sexual sensations that he feels. As soon as he begins to feel like he is going to orgasm, he must tell his wife to stop. This procedure should be repeated 5 times in a row. After the fifth time, he should offer to pleasure his wife (oral/manual stimulation). This is important because she has just spent a considerable amount of time pleasuring her man and may want some sexual attention also. Before moving on to the next exercise, make sure the two of you feel comfortable with this exercise. Successful completion means, that for three nights in a row, you will be able to tell your wife to stop prior to orgasm, enabling your need to orgasm to abate. You will have achieved the beginning stage of control.

The second stage is to engage in the same foreplay, your partner masturbating you, but this time with the help of some lubrication. I recommend Astroglide. In my opinion, this is the best stuff on the market. However, I am sure that some of you will disagree and prefer KY Gelly. Repeat the above procedure; the sensations may be stronger because she is not only touching you with her hands, but there is lubrication. If per chance, you ejaculate before you are mentally prepared, your partner will admonish you for not taking better care to feel your sexual sensations. She will redirect your attention to focus more selfishly on your own bodily feelings.

The third stage consists of the man and woman engaging in coitus (sex). The woman should be in the top position and the man on bottom. He then guides her thrusting movements with his hands. When he comes close to having an orgasm, he stops her. Together they wait until his intense sensations abate. After his sensations have substantially decreased, he again guides her thrusting movements. This process should be repeated five times for four days in a row.

For most couples to accomplish the above tasks will take 2-6 weeks. Congratulate yourselves for your hard work. To truly achieve delayed ejaculations may take several additional months of practice, but you will be well on your way to having learned successful control. With this new found control you will be in a much more superior position to pleasure both yourself and your wife.

For those of you who do not quite feel comfortable with the first form of the Stop & Start Technique there is a second version, which still depends upon the same set of assumptions. People who suffer from premature ejaculation do not recognize the erotic sensations that they feel as they approach the point of no return, which is the point just prior to orgasm. To learn control, you must slow down the process. The overall, theme to the second approach is identifying the sensations based on a numbers approach. The numbers may vary a bit depending on what you consider to be sexually exciting. I have merely suggested a few which others have thought helpful. What the male will need to do is to take the next week or more, both by himself, and with his partner to name exactly what sensations each different numbers represent. Zero being the least sensations, and one hundred being the most.

Zero = a flaccid penis with no sexual thoughts or energy Five = an erect penis with minimal sexual thoughts and/or energy Ten = ears being nibbled Fifteen = reading sexy stories together Twenty = breast stimulation Forty = slow penal stimulation Fifty = slow oral stimulation of your penis Eighty = medium paced penal-vaginal intercourse Ninety-nine = point of no return One Hundred = orgasm

Now that you have a number system this will be your primary way of communicating with your partner (and yourself) what sensation you are feeling at any given point in time. If she is stimulating you to orgasm from manual stimulation you should be able to tell her at every different junction what number you are feeling. It may only be a matter of five seconds before you orgasm, but within those five seconds you should be able to say 2,5, 38, 69, 88, 99, 100. If the numbers are rising very rapidly you are exactly where you want to be. If you are able to take longer approaching each number, then you are slightly ahead of the game. Do not think for a moment that you are in any position to skip any of the below steps. It just means that you might have an easier time achieving each step. Developing control over your premature ejaculation will take time. It does not happen overnight.

Now, like in the first way of treating a premature ejaculation, after the man has become sexually aroused and has an orgasm, he should lie down on his back and the woman should begin to masturbate him with her hands. This time do not allow him to achieve higher than a 20 from the scale of 1-100 which measures his level of excitement. After he has achieved the 20, she must stop and wait until his penis returns to its flaccid state.

     After he is flaccid this process begins again. This cycle repeats for 5 days. On the fifth day, the wife should stimulate him until he reaches a 25. When he reaches level 25, she must stop and wait for him to return to his flaccid state. This cycle of reaching a 25 and then stopping repeats until he is able to master this process for three days in a row. After the husband is able to reach a level 50, the woman must stop what she is doing until his feelings of excitement return to level 25 (the degree of sensations on a scale of 1-100). This process repeats all the way up until he can tell his wife that he is not only at level 98, and she is able to successfully stop while his sensations abate to the mid-twenties, but he is able to tell the difference between level 97 and 98. Expect that this exercise will take 1-3 months to achieve.

Having achieved success, the two of you are now ready to begin the next phase. This assignment is progressively harder, but operates with the same principals. Instead of simply using manual stimulation, the wife should combine lubrication and manual stimulation. After the two of you are able to complete this process, try using fellatio (which is a blow-job/giving head). However, in these two phases, you can spend one day on achieving each number at five point increments. If you find yourself having difficulty maintaining control, then feel free to take slightly longer at each stage and try moving by one-point increments. The purpose of using a one hundred point scale is not to bore/tire you to death, or make this process take any longer than necessary. Rather the purpose is to help the two of you to slow down enough so that you the man can really feel and recognize each stage and be extremely aware of all the different sexual sensations that he is experiencing. This is critical to his developing control of his ejaculations.

     Now the two of you are ready for penal-vaginal intercourse. By now I am sure the two of you can expect that the one hundred-point scale will be used to help the two of you out again. As in the first stop & start technique, the woman is in the top position and the man is on the bottom. He again helps to control her hip movements. When he reaches the sensation of a 20, he must tell her to stop and wait until his penis returns to a flaccid state. After he has become flaccid, the two of you will begin again to pleasure each other (while the man's penis is inside the woman). This may mean mouth-to-mouth stimulation (i.e. kissing), ear nibbling, breast-fondling/caressing, dirty talk . . . . Once the man's penis is erect begin again with the thrusting of the hips. After reaching a level of 20 stop. Each day, increase the degree of sensation by five points. If any point seems to cause you difficulty, break the steps down into the actual five incremental steps (31,32,33,34,45). There is no need to rush each other. The two of you are not going anywhere. Besides, good sex requires lots and lots of practice. Good sex is not something that is learned overnight. Ok, once the man has reached a level 40, his goal is to let his sexual sensations abate until his level of sexual excitement is at a 20. This continues until the man has achieved a level of 98.

    By the time the man has reached a level of 98 sexual excitement and been able to tell his partner to stop during manual, oral and penal-vaginal intercourse the problem of premature ejaculation has become a problem of the past. There is almost no need to orgasm any longer - unless you want to. Smile - Congratulations!

    If, after practicing the above technique, you are still having difficulty 'lasting long enough' then you may want to consider seeking the help of a trained professional. To contact a urologist.

written by Alex Caroline Robboy, CAS, MSW, LCSW

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