Premature ejaculation

the premature ejaculation is an ejaculation which occurs in less than 3 minutes after the beginning of sexual stimulation. The person really suffering from premature ejaculation is that which ejaculates systematically in less one or two minutes. After, from three or four minutes, they are only men who let themselves go to their pleasure. Although the women do not ejaculate systematically, they can also suffer because of having too quickly their orgasm. The true problem of the premature ejaculation is for those which set up the vicious circle of the failure and which are systematically let surprise by their ejaculation.

One speaks about primary premature ejaculation when the man always ejaculated in an uncontrolled way, since his first sexual relation, in spite of an long experience and sexual relations repeated, with stable partners. One speaks about secondary premature ejaculation when a man who did not have a problem of control of his ejaculation finds suddenly there confronted in a repeated way. Often it is following an emotional shock that the premature ejaculation appears.

Is this current?

Premature ejaculation, still called premature ejaculation, is the male dysfonction most widespread. 75% of the men questioned by the report/ratio Kinsey (1948) say to ejaculate in less than two minutes after the penetration. Approximately a third of the consulting men in sexology complains about this difficulty which would justify 20% of the requests concerning sexuality in general medicine.

For young people

One cannot speak about premature ejaculation when the man is still virgin. The fact of making last the masturbation longer, to avoid practicing it when one is not at ease (fear of being surprised etc) and not to seek the fastest possible ejaculation more is positive and makes it possible to discover the pleasure related to the masturbation in itself and either only that related to ejaculation. In the same way, one should not worry if the first sexual relations are very fast. It is necessary to leave time with the body and the brain to be accustomed to all these new feelings. Especially not to neglect the preliminaries: to shorten will not allow to hold longer and will result in to focus even more the sex act on the penetration and the feelings on the level of the nipple.

A first thing to be tested

A possible use of Lidocaïne in local application with an increase in the frequency of the sexual relations is enough in the minor forms to fast ejaculation.

To look after its premature ejaculation

This section does not give a miraculous formula to the premature ejaculation (there is not). It aims just to convince the ejaculatory early one of the existence of solutions to its problem and to give him an idea of the ways to be explored. In any event, the assistance of a doctor is necessary.

Bases

There exist various serious methods making it possible to improve this problem. However they ask:

a real investment of the man (and his partner),
a real will to leave itself there and a strong motivation (the resolution of such a problem passes perseverance and the fact of not being discouraged at the time of the moments of disappointment which will not fail to mark out the period of rehabilitation)
a mental work to take again self-confidence, helped by its partner. The support of a qualified doctor in this field or a Sexologue is thus to recommend.

It is with also knowing that:

the premature ejaculation is not due to a physical malformation.
the over-sensitiveness of the nipple which the ejaculatory early one feels is completely reversible.
this disorder is not its fault, that it is not a disease, but on the contrary, a proof of a good performance.

The support of the partner

The support of its partner is fundamental. Often the ejaculatory early one is locked up in a vicious circle and is folded up on itself. The dialog, even if it is certainly difficult to engage, is a first step necessary and liberator. If the partner must take the first step, it must find the words which clearly express its frustrations and its waitings but by ensuring his/her companion of all its support and its love. It is not used for nothing to wait: the ostrich policy does not make it possible to hope to find a miracle solution and waiting ends up amplifying frustrations and the resentment which are then likely to fade on the other aspects of the relation of couple.

For the ejaculatory early ones which is not in stable couple, there is a whole work of rehabilitation which they can only make. The need for the assistance of a partner is necessary only for the phase in couple, to learn how to manage the excitation. Nevertheless, this phase can go very quickly, without being very constraining for the woman (with share the prohibition of penetration).

One should not fear the judgment of a new partner. A woman who has feelings will be lenient and attentive, especially if she sees opposite her somebody of volunteer, solid, in her life of the every day and in front of this problem. It is necessary to establish before a a whole emotional relation and of confidence. For the first report/ratio, it is necessary to have confidence, (helped in that by exercises of rehabilitation and the work of autopersuasion). For the least failure, one should not be folded up on oneself, but take again the caresses clitoridiennes until the orgasm of its partner. Then, it is necessary to dialog with her so that she can take share with the exercises (which can also be approached in a ludic way)

Foot-note: What diverts more the women, it is to deal with ejaculatory early which makes the ostrich.

Exercises

The correction of the premature ejaculation can be seen like a rehabilitation by exercises. Their goal is to learn how to control and stabilize its level of excitation: it is indeed not the ejaculatory reflex which escapes control from ejaculatory early, but well the level of excitation which leads to release reflex of ejaculation. It is not possible to act on the ejaculatory reflex but only on the level of excitation starting it. Here exercises to be followed initially:

To avoid contracting the pelvic musculature and the supply mains of the thighs, because that precipitates ejaculation. It is necessary on the contrary to be slackened as at the time of the micturition, and to gradually learn how to anticipate the ejaculatory reflex.
Effectuer daily series of musculation of the zone of the Périnée gradually make it possible to become aware of the existence of these muscles and to discover ways of using them, in particular the effects on the excitation of the contractions or relaxations.
To learn how to locate the feelings which announce the imminence of ejaculation in order to be more let surprise by its ejaculation.
To approach techniques of relieving, like the Sophrology, has all their interest here and can make it possible the man to better live his body and to increase its capacity to locate the ejaculatory threshold.
To carry out meetings of masturbation during which one compels oneself not to ejaculate before a certain time. That makes it possible to learn how to separate excitation and ejaculation.
To approach the masturbation differently: usually, the man seeks in the masturbation the relief by ejaculation, of a certain sexual tension. Unfortunately, it thus acquires a fast automatism of excitation which brings it towards a faster ejaculation. To counter that, it is necessary to learn how to enjoy all the masturbation, to take pleasure with an erection and an excitation which last, with better locating its levels of sexual excitation.

In the second time, there are several exercises to practice according to the programs of rehabilitation considered:

paradoxical injunctions (ejaculate as quickly as possible!),
meetings programmed of mutual massages,
teaching of the stop and go or the squeeze (see low),
training of the perfect stabilization of its excitation in spite of a very strong stimulation.

These techniques can be disappointing when they are proposed as done everything receipts. Their goal is to encourage the patient, with the assistance of its partner, to do a work on oneself, to modulate its level of excitation, to locate the premonitory signs of the ejaculatory reflex and to influence the threshold of it. Whereas he generally lived a anhedonic sexuality, it is invited “to taste” the pleasure which precedes and accompanies the ejaculatory discharge and to share this discovery with its partner.

behavioral technique invented by Seemans and recovery by Masters and Johnson: the squeeze

It consists in asking the partner to strongly tighten the base of the nipple to a signal of the man. This method is effective if the signal of the man is carried out sufficiently early, i.e. before feeling the risk to ejaculate.

In fact, essence is not squeezing as well as its signal; because which says signal says reference mark: the man thus underlines (reference mark) the level of excitation reached. He calibrates his excitation. The purpose of squeezing is only one reinsurance. It is understood that if the signal is carried out too late, at the time when the man feels that it is likely to ejaculate, this squeezing will compress the urethra temporarily preventing with sperm from evacuating itself; with the relaxation, it will run without pressure.

the Stop and Go of Kaplan

It consists in varying and even stopping the movements according to its excitation. One asks the man to concentrate on his feelings; as soon as it perceives the signs heralding occurred its ejaculation, it beckons with its partner to stop any movement " Stop ". Its excitation having decreased, it again makes the signal with its partner take again stimulation " Go ". They are one the simplest methods and most effective, but request a great concentration. In the event of failure, we must locate and to evaluate a nevrotic etiology, the analytical cure will be then to consider. If there exists a conflict of subjacent couple explaining the origin of premature ejaculation, a therapy of couple will be then to consider.

The medicamentous solution

For a few years, doctors have been able to propose an inhibiting antidepressant, the Sertraline (50 mg/j) or the Paroxétine (20 to 40 mg/j), which seem to give the best results. However, these drugs must be prescribed in partnership with the psychodynamic and behavioral approach, and seen like a temporary help. Like any drug, the recourse to antidepressants has more or less awkward side effects and must be done within the framework of a medicalized follow-up.

Remarks

There exists much of means of making love which do not require a penetration and which thus release the partners of the stress not to be able to ensure a penetration which answers their waiting or their idea of the sex act. And for all these alternatives of the sex act, ejaculatory early is not constrained at all by its problem.

Let us not forget that the sex act is before a whole shared moment of intimacy, relieving, tenderness, search of its pleasure and division. No need to return this moment anxiogene while wanting at all costs to conform to a model.

Notes and references of the article

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