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Sex
& Ayurveda
Rapid Ejaculation
A lot of men and/or
their partners wish they were able to prolong their sexual
encounters. Lack of ejaculatory control might, in fact, be the
number one sexual complaint among men under the age of 50. The
details of the complaint vary greatly though. Concerns range from
the man who will ejaculate within seconds, at the first touch or
just prior to penetration, to the man who is able to receive oral
and manual stimulation without ejaculating, but with intercourse
will orgasm within a minute. There are men who report being quick to
ejaculate from their very first sexual encounter and remain so.
There are men who report having been quick during early sexual
encounters but somehow gained control until suddenly losing control
again. Then there are men who seem never ever to have been bothered
by an untimely ejaculation. Obviously there is not just one type of
ejaculatory concern.
"Premature"
or "rapid" ejaculation is also relative to the man and/or
his partner's expectations. There are men who are able to thrust for
5 minutes before ejaculating and complain because they had hoped to
last another 25 minutes. There are men who last 20 minutes but their
partners complain that they did not wait for her -- or worse yet,
draw comparisons with her last lover who had set a record for
marathon thrusting. Consider another couple who plays for an hour
after a very romantic evening. In the course of love play the man
manually and then orally stimulates his partner who, in response,
has three orgasms. He then mounts, thrusting hard and deep, and
ejaculates in about 45 seconds. This couple then holds each other in
the afterglow of their intimate exchange, telling each other how
wonderful the lovemaking had been. Does this man have a problem? Not
if both are happy with the encounter. What if he moves on to another
relationship and the next woman is not comfortable receiving oral
stimulation to orgasm and expects 10 minutes of coital thrusting!
These examples make it clear that a man's expectations and/or the
expectations of his partner (s) have something to do with his
labeling himself as having a problem.
In the past,
premature ejaculation was defined by the percent of times the man
ejaculates during intercourse before his partner does. There is,
however, a major problem with defining a man's ejaculatory control
in terms of his partner's orgasmic frequency during intercourse. It
has been clearly demonstrated that the majority of women (perhaps
around 65%) are unable to orgasm with the stimulation of intercourse
alone... never could and probably never will. For most women the
vagina is significantly less sensitive than the clitoris, which is
not always stimulated in most coital positions. A fair number of the
roughly 35% of women who can make it during intercourse do so by
combining clitoral stimulation with what they are experiencing
vaginally. It is fortunate that some positions that work best for
the woman are the same in which a man might exercise better control
of his ejaculatory process.
You might now ask,
"What is normal or typical?" Let's first, however,
consider the question, "What is natural?" In nature the
purpose of sex is procreation, and this process is accomplished by
the deposit of sperm deep in the vagina, independent of the time it
takes to do so (or, for that matter, the partner's satisfaction).
Our primate cousins, the apes, chimps and monkey, ejaculated in
seconds.
As human beings,
however, sex is more often for recreation, typically with great
pains being taken to prevent pregnancy. Sex for humans is an
expression of love, a sharing of intimacy, a form of communication,
and often we feel it is an expression of our manhood or womanhood.
We have a certain investment in being good at it! However, it
appears natural for a man to move toward vaginal intercourse, thrust
upon penetration, and ejaculate quickly.
This brings us to
the question, then, about normalcy. It is my position that it is
normal for men to sense an urge to ejaculate quickly and feel the
need to exercise some control. We'll finally look at the question
now of "What is typical?" Although averages stated vary a
bit from study to study, it would appear safe to say that the
average healthy male under 30, with steady vaginal thrusting, will
ejaculate in 1 to 3 minutes, not 15 minutes as most men would wish.
There are factors
that influence how quickly a man will ejaculate. The younger the
man, the more likely it is that he will ejaculate quicker. The more
excited the man, the quicker he is likely to be, and related to
this, the more novel and exciting the partner, the greater the
tendency to orgasm rapidly. Also, the longer the time since his last
ejaculation, the greater the loss of control. Furthermore, the more
active and rapid the thrusting, the sooner he is likely to reach the
point of ejaculatory inevitability - that point of no return. It
also seems clear that the more worried or anxious the man, the
shorter his fuse will be. In summary, the man at greatest risk of
ejaculating quickly is the young man who is with a new partner after
a long dry spell and is very excited, but very nervous, as he
penetrates and thrusts steadily and rapidly.
Men have tried many
things to slow themselves down. Makers of the desensitizing creams
have made fortunes because men believe that if they numb the end of
their penis they will last longer. However, most men are
disappointed with these over-priced creams, as the ejaculatory
reflex is much more complicated than just superficial nerve endings.
Someone once said that our largest sex organ is not between our
legs, but rather between our ears. There is a lot of complicated
neurology between the end of a penis and the top of the man's brain!
More recently, physicians have been prescribing medications that
have been found to have ejaculatory retardation as a side effect,
but as a behavioral therapist I have a problem with this. Even if
such medication does work (and it often does not), it will
"cure" nothing. The man can't take it for a lifetime, and
in relying on the magic pill will never learn how to manage his
ejaculatory process in a way to prolong the pleasure both he and his
partner experience. Condoms might help (and should always be worn in
the practice of safer sex), but in a long-term committed
relationship, condoms may be a nuisance unless being worn for
contraceptive purposes.
Unfortunately, much
effort by well-intended sex therapists has been wasted, for many of
my colleagues have not understood the dynamics of the natural
ejaculatory response nor the important learning components of
gaining better management of the process. In part, the difficulty
has been with them viewing rapid ejaculation (a term I prefer over
premature ejaculation) as a pathological condition rather than a
natural one. Rapid ejaculation has been grouped with the sexual
dysfunctions, even though it is quite common and the majority of
young excited males will ejaculate rapidly at least in the early
encounters with a responsive and novel partner. Calling it a
dysfunction is essentially turning a natural process into an
illness. In the medical model of thinking, if there is an illness,
there is hopefully a cure. Thus we find many self-help books
promising a cure in from 4 to 8 weeks! If it is a natural and fairly
typical response, what is there to cure? I am not surprised to learn
that a three-year follow-up study has shown that a significant
number of the men thought to be "cured," end up right back
where they started from before beginning treatment. Something is
missing in the routine prescription of behavioral homework given
with the promise that faithful compliance will effect a lasting
life-long remedy. Just doing the prescribed exercises will not
change anything over the long run if the man does not learn
something new.
It may well be that
some men are just more sensitive than others. There is no cure for
what is just one more of the multitude of individual differences we
find among people. However, I had mentioned earlier two very common
features of men who consistently ejaculate rapidly: High sexual
excitement and high psychological anxiety. If a man is to learn an
effective strategy for managing his ejaculatory response, he must
not allow himself to become overly excited. Yes, ejaculatory control
will cost a man something, for he cannot get caught up in crazy-wild
passion without dashing uncontrollably toward that point of
ejaculatory inevitability. Increasing the frequency of ejaculation,
either with a partner or through self-stimulation can help. Also
staying relaxed both in mind and body is very important.
There is a series
of step by step exercises "prescribed" by sex therapists
called the start-stop method, but it is not simply starting and
stopping that helps a man gain control. The man must focus in on his
steady progression toward the inevitable, that point of no return.
He must identify all the internal indicators that he is approaching
that threshold where his body will automatically take over and
propel him to orgasm. This requires relaxation and concentration. He
cannot be thinking of his partner's response nor even looking at her
body. He must stay within himself and feel his process unfolding.
Then he must stop before reaching the point of ejaculatory
inevitability. Typically the instructions are to start and stop four
or five times before "letting go" and ejaculating. I
always remind men to identify what that psychological / physical
"letting go" really involves. The start-stop procedure
works best with a committed and giving partner whom is willing to
take the time to help. Typically the "homework" starts
with manual stimulation with a dry hand.
After a few such
encounters, a lubricant is introduced, but the stimulation is still
manual. If all is going well, after several such episodes oral
stimulation is suggested if the woman is comfortable performing
fellatio. Remember, with each of these steps, the stimulation is
started and, as the point of no return is approached, the
stimulation is stopped. The man must not allow his partner to begin
again until he is absolutely sure he is back under control, even if
this means he is beginning to lose some of his firmness.
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