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    How to stop premature ejaculation: treatments and techniques

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      Primary Premature Ejaculation (PE) describes a man who ejaculates in less than a minute of penetrative sex around 75% of the time. For some men and their partners, ejaculating quickly may not be a problem. However, if it does cause distress, you may wish to address the difficulty.

      PE can have physical and/or psychological causes and can be helped with medication and/or behavioural techniques. Although PE is a very common sexual problem, there are also several treatments available.

      Below we discuss some of the causes of PE and identify treatment options, exercises and techniques.

      Premature ejaculation causes

      Physical causes
      PE may occur due to medical conditions affecting the nervous system and urinary and reproductive areas of the body. A man’s ability to control his ejaculatory reflex can also be affected by alcohol, drugs and medication, as well as low testosterone or an over-sensitive penis. Visit your GP or our PE clinic for more information. .

      Psychological causes
      Some common causes of PE stem from having limited sexual experience, infrequent sex, or a rushed masturbation style where you may have trained yourself to ejaculate quickly. Other influences can be worrying about losing your erection, experiencing anxiety over ejaculating too quickly, relationship difficulties and feeling shame and guilt associated with sex. Also, having a partner with a sexual problem, such as low desire or discomfort during intercourse, may cause eagerness to get sex over with quickly.

      Premature ejaculation treatments

      Medical treatments

      There are several medical treatments available to help alleviate PE in the short term, such as topical numbing cream that can be applied to the penis. A condom would need to be worn during sex with a partner, to prevent the cream affecting them. As with all medication, there may be side effects and it may take a few attempts to notice the benefits. There is also an oral treatment available, which is a low-dose anti-depressant that has been developed especially for PE. Find out more about EMLA cream and Priligy tablets

      Exercises for premature ejaculation

      There are exercises that you can practice until you have gained more control over your ejaculation:

      Pelvic floor exercises
      Situated between your legs is a layer of supportive muscles, known as the pelvic floor or PC muscles. Strengthening them can enable you to have more control over your ejaculation.

      Directions: 

      1. Three times a day (perhaps at meal times), squeeze and lift the muscles in that area, then relax them fully. 
      2. Hold the squeeze for ten seconds, then rest for four seconds; do this ten times. 
      3. Then do ten quick flicks. 

      This should only take a few minutes and you can do it whilst sitting or standing. When you squeeze the PC muscles, it should feel as though you are holding in wind or urine. Make sure you are not holding your breath and don’t squeeze your buttocks, thighs or tummy muscles.

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      The stop-start technique
      The stop-start technique is a widely used exercise that can help to control sexual excitement in men. When practiced this exercise can help you hold off from ejaculating for longer periods of time during sex.

      Directions: 

      1. Three times a week, stimulate your penis and notice your arousal increasing.
      2. Imagine a scale marking your sexual excitement as it builds from one to ten.
      3. Imagine a scale marking your sexual excitement as it builds from one to ten (ten would be orgasm and ejaculation).

      If number eight on the scale is the point of ‘ejaculatory inevitability’ (the part when you can’t stop yourself from coming), then you need to learn to recognise all the points on that scale from one to seven and let your arousal travel up and down a few times before you ejaculate. It may take many attempts, so don’t give up. When you are happy with the time it takes you to ejaculate during this exercise, make it more challenging by adding in lubrication to stimulate yourself with, and then ask your partner to take part in the exercise.

      You may find that your partner’s involvement makes you come more quickly, but with patience and perseverance from both of you, it may improve with practice. Doing this exercise regularly can help you to become an expert in recognising the stages of your arousal process and to know which point to stop stimulation for a while to slow things down.

      De-sensitisation exercises
      Some men have a highly sensitive ‘Glans Penis’ (the head of the penis), which can cause PE. Practicing a de-sensitising exercise regularly can be helpful.

      Directions: Ten minutes twice a day, pull back your foreskin (if you have one), apply some lubrication, then walk around so that your underpants are touching the sensitive area of your penis to get used to this sensation.

      Practice being present
      When you worry about PE occurring, you can often become pre-occupied with this worry during sex, so you aren’t really present, enjoying what is happening. You might find yourself trying to think about unsexy things to slow your arousal, but then sex becomes about performance, rather than about your pleasure.

      Directions: To become more present and less preoccupied, focus on the physical sensations you are experiencing in your entire body when you and your partner touch each other.
      Ask yourself, what temperature, textures and pressures can you notice?
      Explore what you can smell, taste, see and hear. Stay with the physical sensations when your mind starts to wander. When your arousal builds, place your hand over your partner’s hand and move it to somewhere you are curious about being touched, away from areas like your genitals that might be highly sensitive.
      Focus on touching and stimulating your partner, asking them what they enjoy and allowing them to guide your hand around their body.

      The squeeze technique
      If you have not benefited from the other exercises, you might like to try the squeeze technique.

      Directions: Indicate to your partner when your arousal is high, then your partner should apply a very firm squeeze to the head of the penis for 15-20 seconds.

      The thumb should be placed under the ‘Frenulum’ and the two forefingers need to wrap around the penis under the ‘Glans’ (the head) where it meets the shaft.

      This will inhibit the ejaculatory reflex and you may lose your erection somewhat for a little while. You can repeat this every time your arousal builds, until you wish to ejaculate.

      Having co-operation and support from your partner will go a long way in helping you to overcome PE. If your partner resents and blames you for it, this can deepen your feelings of shame and increase conflict within the relationship, which is likely to make it worse.

      If you find that you still need further help with PE or any other sexual difficulties, you may wish to seek specialist help from a qualified, accredited Psychosexual Therapist.

      Charlotte Simpson is an Accredited Psychosexual Therapist and Relationship Counsellor in Private Practice in North West London.

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