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Premature
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.
Herbs
which is useful :
Asparagus (Safed Musli):
The dried root s of asparagus are used in ayurveda as an
aphrodisiac. They are available in the market as Safed Musli.
Fifteen grams of roots boiled in one cup of milk should be
taken twice daily. The regular use of this remedy is
valuable in impotency and premature ejaculation.
Garlic:
Garlic is
one of the most remarkable home remedies found beneficial in
the treatment of Premature Ejaculation .It is a natural and
harmless aphrodisiac. According to an eminent sexologist of
USA , garlic has a pronounced aphrodisiac effect. It is a
tonic for loss of sexual power due to any cause.
Drumstick:
A soup made with about 15 gms of drumstick boiled in 250ml
milk is very useful as a sexual tonic in the treatment of
sexual debility. It is also useful in the functional
sterility in both males and females. The powder of the dry
bark is also valuable in impotency, premature ejaculation,
and thinness of semen. About 120 gms of powder of the dry
bark should be boiled in half a liter of water of about half
an hour. Thirty grams of powder, mixed with tablespoon of
honey, should be taken three times daily for the month.
Diet :
Diet is an
important factors, to begin with the patient should adopt an
exclusive fresh fruit diet. Take fresh fruits and fresh
fruit juice twice daily. Concentrate on food like
nut, cereals , vegetables, fruits, milk, honey etc. Avoid
smoking, alcohol, tea, coffee all processed canned refined
and denatured foods especially white sugar and white flour
and products made from them.
Life
Style :
Other
regimens:
All medicines, which produce active sperms of better
quality, are usually aphrodisiac, i.e. they are sex
stimulants. The individual should, however take care not to
indulge in sex too frequently. Restraint in sex is always
good for this condition.
Ayurvedic Supplements :
Ayurvedic Application (for Massage) :
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