PE or premature ejaculation – two letters or two words dreaded by all men out there. And yet, this continues to be the most common ejaculation problem in men. In fact, according to data from the American Urological Association, around 1 in 3 men, aged between 18 and 59 years In the US have experienced trouble with PE. Another source, from Harvard Medical School, says it’s actually 1 in 5 men that experience “uncontrolled or early ejaculation at some point in life”. In any event – that’s a lot of men. It can stem from psychological issues, or it can be caused more by biological factors – it depends on the person, really. So, with these numbers in mind, naturally, the question of how to prevent premature ejaculation becomes very, very important.
And that’s precisely what I want to focus on in this article.
First I’m going to briefly explain what PE is, and then I wanna talk about the reasons behind it. But, the main thing I actually wanna talk about is how to prevent premature ejaculation and gain (back) your self-confidence in the sack.
And yes, premature ejaculation is manageable, treatable, and most importantly – preventable!
What is PE or Premature Ejaculation?
Premature ejaculation is when a man reaches orgasm and the semen is ejaculated sooner than the man would want to during sex all the while causing him distress and frustration and low or no control over it.
So the key aspects of PE are the following:
- Ejaculation happens without much control and with little or limited sexual stimulation.
- Changes in your mood, sexual anxiety, and decreased desire for sex because of little control over your ejaculation.
- Accompanying feelings of frustration, guilt, embarrassment/shame.
There are two main types of premature ejaculation:
- Lifelong or also called primary PE – as you can see from the name, this type of premature ejaculation has likely shown up in the first sexual experience or nearly always in the beginning of your sex life. Lifelong PE sometimes manifests as periods of early ejaculation and periods of normal ejaculatory times.
- Acquired or also called secondary PE – this type of PE shows up once you’ve already had sexual experiences without any problems with ejaculation.
Both of these PE types aren’t scary or dangerous or anything, and can be treated with the stuff I’m gonna talk about further down in this article.
Does PE Happen Only During Sex?
That’s the thing – it doesn’t happen only during sex. Premature ejaculation can also happen during foreplay as well or just before intercourse.
But How Premature is Too Premature?
Yeah, this is a good question. Now, you might think the definition of PE I gave earlier is a pretty vague one. I mean, how soon is too soon, right? And yes, there isn’t only one correct interval of ejaculating. But, there is an agreed-upon “ejaculatory latency time”, which is used to diagnose PE, as it varies somewhere between 1-2 minutes, or less than that.
And, according to another comprehensive study on PE, the median “normal” ejaculatory latency time” during PV (penis-vagina) intercourse was 7.3 min for men who don’t experience PE and 1.8 min for men who do.
Should You Worry if You Experience PE?
No, not really since it’s not a serious medical condition and 1 in 3 men, or 1 in 5 men, will have it at a certain point in their lives, so it’s nothing to worry about much in terms of health consequences or underlying conditions.
In very rare cases, PE can actually be a consequence of a more serious or underlying medical diagnosis, like for example inflammation of the prostate gland or problems with the spinal cord.
However, I understand how frustrating it can be in terms of sexual performance and how it can affect your confidence, your views on how sex should look like, your desire to please your partner/wife, and sometimes even the way in which it can affect the whole relationship. In one word – it can be damn frustrating, especially if it happens often.
How Long Does PE Last?
There’s no specific prognosis time for how much PE lasts. It can be a one-time thing, it can last for weeks and then go away on its own, but it can also be months.
Stress is a significant factor in PE so relieving stress should definitely be on the menu once you start experiencing PE, as well as tackling other psychological issues.
Some men may need therapy, aka professional help in the form of either pills or a psychologist.
And the way men respond to the treatment differs from person to person. Some respond very quickly and some take more time.
But, the main thing is it’s treatable and preventable and I’m gonna show you how!
What Are the Main Causes of Premature Ejaculation?
Nobody can pinpoint an exact cause for PE. Most likely it’s a mixture of psychological and biological factors, which is why therapy (as in counseling) and drugs/creams/other means might work best for treating it.
But here I wanna briefly go through the potential factors that might be behind premature ejaculation. So there are both psychological and physiological (or biological) factors that might be causing it.
Potential Psychological Factors Behind Premature Ejaculation
While these may be why you’re experiencing PE, it doesn’t mean that if you recognize some of these psychological factors in your life that they’re the definitive culprit behind it.
- Low self-confidence and poor body image – how can you expect to enjoy sex and feel fulfilled if you hate your body?
- Experiences of sexual abuse – whether it’s done in childhood or in adulthood, it can leave long-lasting trauma, which can manifest in the sex life of adults in various ways.
- Early sexual experience(s).
- Stress – stress can be the culprit behind almost anything, whether it’s a mental health or a physical condition. And stress can stem from the work/professional environment, from the relationship with your partner, from family obligations, kids, financial troubles, etc. So stress management is vital for any reason, including for struggles with premature ejaculation.
- Depression and anxiety – depression can cause erectile dysfunction, it can decrease your libido and it can definitely be the cause behind premature ejaculation. Similarly, anxiety as a mental health condition can also affect your libido, your erections, and your ejaculatory times.
- Sexual performance anxiety – both men and women can have SPA, and one of the ways it can manifest in men is precisely with premature ejaculation.
- After experiencing PE once or a couple of times, incessant worry that it will happen again can also be a factor.
- Feelings of guilt or fear when you’re having sex that affect your mental health and make you rush through the experience. This can stem from religious or other types of strict/conservative upbringing, or it may also have to do with fear from contracting any STDs, for example.
Other psychological factors that may also play a role in your PE
- Erectile dysfunction (ED) – men who are experiencing ED and have trouble maintaining erections, or even having one, may develop a pattern where they’re in a rush to ejaculate, which may persist once the ED is treated.
- Relationship issues – conflict, dissatisfaction with your sex life, and other relationship issues may all affect your premature ejaculation. This might especially ring a bell if you’ve had a satisfactory sex life with previous partners where you’ve never had an episode of premature ejaculation, or you’ve had it very rarely. Of course, the reason why you’re having it with this particular person might be something else entirely, but it’s definitely worth going over your relationship issues if you think it might have to do something with them.
Potential Biological Factors Behind Premature Ejaculation
Biological factors may also play a role when it comes to PE.
- Infection or inflammation of the urethra (also called urethritis) or the prostate (also called prostatitis). If you notice any signs of a burning sensation while you’re peeing, or an itchy and burning feeling close to the opening of your penis, any kind of weird discharge in the urine or semen, or presence of blood, it might be urethritis, so please have it checked out. The symptoms for prostatitis are similar, with the addition of pain in the abdomen, lower back or groin, frequent urination, and painful ejaculation.
- Off-whack hormone levels – hormones take part in a number of processes in our bodies, and they also have a role in premature ejaculation.
- Genetics and inherited traits – I mean you obviously can’t argue with this but you can definitely treat it.
- Abnormal levels of neurotransmitter brain chemicals like serotonin – I will talk a little bit about this further down, but yeah, among other roles, serotonin takes part in regulating our erections and ejaculations as well.
How to Prevent Premature Ejaculation
Okay, so we’ve come to the main part of this article. Let’s take a look at all the ways you can treat and prevent premature ejaculation.
Now, guys, I have a whole separate, long article on edging which I suggest you check out. But I still want to write a bit about it here, so you can see how helpful it can be for treating your PE.
What is edging for those of you who hear about this just now? Well, edging is a practice where you deliberately delay your orgasms in order to enhance them and gain better control of them in the long run.
There are several ways you can practice edging.
The squeeze method
One type of edging is by squeezing or gripping the end of the penis, where the head (or glans) connects to the shaft.
You can do this on your own (through masturbation), or with a partner (a hand job). The main thing is to stimulate your penis (obviously) and then to do the famous squeeze when you feel you’re close to an orgasm. Hold the end of the penis tightly for a couple of seconds until you feel you’re not close to orgasm anymore.
And don’t worry, you can do this more than once in your masturbatory or handjob sessions. Plus, you get to have a really nice, intense orgasm once you finish, and who doesn’t want that?
Alternatively, you can also do this during intercourse if you’re both comfortable that way.
The stop-start method
Another way to practice edging is to use the stop and start method.
This is done very easily. Again, you can do it on your own or with a partner, whatever feels more comfortable.
So, first, you start stimulating your penis. Use whatever pace or grip or pressure you want as long as it leads you to climax. But, when you do feel you’re about to come, stop. Stop and wait for a brief while (a couple of seconds or a minute or more if you need) to let your body cool off a bit and not come with the next touch of your penis.
And then the key is to start again. Then stop again. And yeah, that’s it. You do this however long you want. I’d recommend a gradual increase from 10 to 30 minutes, or more if you want.
You can also experiment with how close you are to orgasm. You don’t always have to do it right at the brink of one – mix up the sessions. Try doing it in one session when you indeed are on the brink of an orgasm, and then try pulling off when you feel like you will be able to come soon enough although not right away.
The stop and start method will help your body recognize and better prepare for that infamous “point of no return” when you can’t get back from climaxing.
TIP: You can always try masturbating before sex for better endurance results. Of course, try to make it at least 30 minutes before sex so you can actually reap the benefits.
Kegel Exercises for Men (Pelvic Floor Exercises)
I’ve written an extensive article about Kegel exercises as well, and I urge you to read that one too.
But, of course, I’m going to say a few words here as well and give you the gist of what you need to do.
Kegel exercises help strengthen your pelvic floor muscles, a set of muscles that are responsible for controlling the flow of urine and also for controlling your orgasms.
You can start by first identifying your pelvic floor muscles – by starting to urinate and then stopping midway. And that’s about it, that does it for identifying these guys.
The next thing you need to do is Kegel exercises. The great thing is you can do them everywhere.
Just start by tightening the pelvic floor muscles and holding them contract for about 3 to 5 seconds. After that, you relax the muscles for about the same amount of time. And yeah, again this is pretty much it.
Also, it’s recommended that you do this, in the beginning, at least three sets and 10 repetitions a day. But after that, you can also start increasing the amount of time you hold the muscles contracted to about 10 seconds before you start relaxing them.
A word of advice when you’re doing the Kegel exercises is to keep the other muscles around the area relaxed. I’m talking about the muscles in the buttocks, the abdomen, and the leg muscles.
Also, make sure you don’t raise your pelvis. Just put your hand on your stomach and check yourself if you’re contracting the muscles of the abdomen.
Condoms for Controlling Premature Ejaculation
Also called numbing condoms or climax controlling condoms, these condoms come from various well-known and lesser-known brands and are designed specifically for people experiencing PE.
How do they work?
Well, it’s pretty simple – on the inside, they’re coated with a substance that works as a numbing agent or anesthetics by inhibiting the sensitivity of your penis. The goal is to get you there slower than usual and to delay pleasure a little bit, which is a win-win for both you and your lady.
Some of these condoms contain benzocaine and some contain lidocaine. Both of them work on a similar principle – both are local anesthetics and they’re safe to use, so you needn’t worry about that. They’re actually used often as creams or sprays and can be applied topically in the ears, the skin, the mouth, and the throat, etc.
People have reported that they actually work, so if you want immediate results I suggest you try them out.
Numbing Creams and Sprays
You can put numbing creams and sprays directly onto your penis. They usually also contain benzocaine or lidocaine as the main anesthetic substances.
The numbing cream or spray is usually applied on the tip (the glans) of the penis, but also the shaft of the penis and especially the underside.
Now, there are certain things to have in mind when using these sprays and creams.
First of all, you should apply them 20-45 minutes before sex. And it’s good to wash your hands once you apply one, so you don’t make another body part temporarily anesthetized as well.
Another thing is you’d also have to put on a condom once you apply the cream or spray so you don’t anesthetize your partner’s vagina as well. Or you can wait for it to dry up, after 20 minutes or so.
You can apply spray 10-15 minutes before sex. But it will still take about 30 minutes to work properly, so have that in mind as well.
I also wanna show you two studies that show the successful effects of numbing creams and sprays.
Study on prilocaine-lidocaine numbing cream
The first study is from 2002 and it concluded that the numbing cream increased the pre-ejaculation period to 6.71 minutes (with a +/- of 2.54 min) for the first group that applied it 20 minutes before sex. For the second group, which applied it 30 minutes before sex, the pre-ejaculation period increased to up to 8.70 (with +/- 1 min). There was a third group that applied it 45 minutes before sex but all of them experienced a loss of erection because of the numbing cream. Also, six people from the second group experienced the same thing.
Study on prilocaine-lidocaine numbing spray
And the second study, conducted by Queen’s University, Canada in 2003, is about the prilocaine-lidocaine numbing spray. With men applying it to their glans 15 minutes before intercourse, their “intravaginal ejaculation latency time” increased from 1.24 minutes to 11.21 minutes.
This is a pretty significant increase in time and it shows how effective these PE prevention creams and sprays can be. And the moral of the story is – with numbing creams and sprays it’s all about the right timing.
(NOTE: These were studies for creams and sprays based on prilocaine-lidocaine. There are creams and sprays based on similar numbing agents.)
Premature Ejaculation Wipes
Another thing you can use if creams and sprays are too messy for you is PE wipes. They work on a very similar principle, since they contain a numbing agent as well, usually benzocaine.
And they’re very easy to use – you just wipe your penis with them and then you throw them away. You can wipe just the head of your penis, the place that has the most nerve endings, and you can wipe the whole thing for extra effect.
A study from 2017 shows their success rate. In the study, 4% benzocaine wipes were applied to a group of men who had trouble with PE and had an average intravaginal ejaculatory latency time (IELT) equal to or less than 2 minutes.
And after two months, the men who weren’t in the placebo group reported that their IELT had improved for 231.5 (with ± 166.9 seconds). A large part of them also reported that after these two months they could go for it for at least 2 minutes, and they also reported feeling less stressed about experiencing PE and having more control of their ejaculation and more overall satisfaction with their intercourse.
The study doesn’t report any side effects from the wipes.
Using Medicine for Your PE
If none of the techniques, creams, sprays, lubricated condoms or wipes help with your premature ejaculation, then it’s time to turn to medication, right?
Well the thing with medication for PE is that it’s not that reliable. There was no particular pill or magic drug that could target your PE and make it disappear in an instant, up until recently. Now there is something that I guess could work if all else fails.
Let’s take a look at what this drug actually is.
SSRIs or selective serotonin reuptake inhibitors
SSRIs are a class of drugs whose primary function is antidepressant. However, researchers have found that they can also be useful for treating premature ejaculation. Why is this?
Well, it’s because PE has to do with the serotonin in your brain, which is a neurotransmitter responsible for a range of processes from memory to mood and cognition, and, as it turns out, it also has a role in causing or inhibiting erections.
These SSRIs seem to somehow inhibitor ejaculation and/or delay it. Not all SSRIs affect PE equally well. I mean low libido and erectile dysfunction can be common side effects of certain antidepressant and anti-anxiety drugs. But some of these meds, especially in small doses and taken in a limited amount of time can actually have a very beneficial effect on men who experience PE.
There’s one particular type of SSRI that has actually started being used as a primary means to treat and prevent premature ejaculation. It’s the drug ‘Dapoxetine’, also going by the names of ‘Priligy’, ‘Duratia’, and ‘Joypox’. Dapoxetine used to be an antidepressant but scientists found out that it’s works really well as a means to prevent or treat premature ejaculation. The body absorbs it and eliminates it pretty rapidly, which makes it more suitable as a PE drug than as an antidepressant.
Of course, you can’t take this kind of drug on your own (it’s not an over-the-counter drug), so you will need to get a prescription from a medical professional. They’ll also be able to tell you in more detail how and when to take the pill for the best effect.
However, there’s really one big problem here – it’s still not FDA approved in the USA, so you can’t legally obtain it.
There are also other SSRIs that can be used for PE, as they say, ‘off label’. This means that treating PE is not their primary function but they can still be used for other purposes.
A couple of other SSRIs that you can use for treating PE are the drugs paroxetine, sertraline, or fluoxetine.
Again, these are the kinds of drugs that must be prescribed by a doctor or another medical professional equipped to tell you how to take these drugs and for how long.
Drugs that treat ED – erectile dysfunction
Premature ejaculation sometimes shows up as a problem in men who experience erectile dysfunction. So taking erectile dysfunction drugs can sometimes help with premature ejaculation as well.
Yeah, ED along with PE can sound a bit counterintuitive but look at it this way: when you’re about to fall, at least have some pleasure along the way. Your brain and body know that you’re having serious trouble maintaining that erection so why not just have it right away and get on with it.
That’s why drugs like Viagra (sildenafil) or Cialis (tadalafil), which are commonly used to treat impotence and ED, can help out in premature ejaculation as well. They can prolong the erection and help you relax during sex since you won’t be constantly thinking that you’re gonna come in the next 30 seconds or the next minute.
Also, these drugs may work well in combination with some SSRIs, but that should of course be discussed with your doctor in more detail.
Use of analgesics
Some analgesics (drugs used to treat pain) like Tramadol (also called Ultram) can be used to treat PE as well since one of their side effects is actually delaying ejaculation.
When SSRIs don’t work, doctors sometimes prescribe analgesics for men who experience PE. This means that they can’t be used alongside SSRIs.
According to a study done in 2013 at the BRD Medical College in India on the use of Tramadol for premature ejaculation, men reported a greater sexual frequency, bigger intravaginal ejaculatory latency time, and overall bigger satisfaction in the sack.
Other potential drugs for treating PE
Other drugs that have shown potential for relieving or treating problems with premature ejaculation are Modafinil (Provigil) and Silodosin (Rapaflo).
Modafinil is used as a treatment for narcolepsy, the sleeping disorder where you fall asleep suddenly and without control.
And the other, Silodosin, has been used to treat the benign condition of prostate gland enlargement.
Trying Different Behavioral Techniques
Sometimes all it takes to beat premature ejaculation is to change some habits or develop new ones. I mean, sometimes it might be as easy as masturbating 1-2 hours before you plan to have sex (and for the more spontaneous sessions, well, just use the wipes or the spray). Masturbating an hour or two before sex can sometimes help you prevent premature ejaculation.
Another thing you can do is to defocus from the actual intercourse. Put your attention to other types of sex play, instead. You know, like foreplay for example. Try having sex without an orgasm, for a change, to release yourself from the pressure of always having to be the high-achiever in sex.
Counseling and Therapy
If all else fails or you really don’t wanna try out pills, creams, or sprays, you can always turn to a mental health professional.
You can schedule a session with a sex therapist, a marriage counselor, or a couples therapist who knows a thing or two about sex therapy. Sharing your problem with premature ejaculation, and/or any other issue you might be having in the sack, or even in your relationship, may help you deal with the stress and anxiety behind PE in a healthy way that’ll pay off big time in the long run.
Now, you might see even bigger success in treating PE if you combine therapy with the right pills.
Or just visit a plain ol’ doctor and see what they have to say.
Communicate With Your Partner/Wife
I know that premature ejaculation troubles can cause shame and anxiety and that because it’s so hard to meet these negative emotions head-on, it’ll be easier for you to deal with it and them by yourself.
But that’s the harder road, the one I don’t wanna urge you to take. Instead, I suggest you share all of this with your partner – the embarrassment, the fear of not holding up to the expectations you think she might be having, the anxiety that comes out of feeling like you’re not a good lover, and the like. I’m sure you’ll be surprised at how understanding your partner can be, especially if PE has caused a bit of a rift in your relationship, and a dry spell in your sex life.
So yeah, don’t exclude your partner from it. You’re committed, you’re in it for the long haul, and you wanna be open with her for all the intimate troubles you might be having. I mean, I’m sure she’s also upset seeing you like that, as she’s also likely upset because of the ensuing change in your sex routine.
That’s why talking is the best medicine here. Put on a glass of wine, or a hot cup of tea, play some light jazz, dim the lights, and start talking! You’ll see how much better you’ll feel afterward.
If you’re having increasing trouble opening up, however, I suggest you try doing it through couples therapy, with a sex therapist, or some sort of couples counseling.
As you can see, there’s actually nothing to be afraid of. Yes, premature ejaculation can be embarrassing, frustrating, and downright annoying for us guys, I’m not denying that.
But we’re lucky. We live in a time with plenty of options and really, there’s nothing to be afraid of.
You can try different edging techniques to curb your PE. Or, you can try any number of creams, sprays, wipes, and condoms with anesthetics whose effectiveness has also been scientifically proven.
Not satisfied with that? Ok, then try pills. This is a bit more complex solution, though, since you would need to consult with a doctor. And heck, even the FDA hasn’t approved some of the pills out there yet. However, if the problem gets serious and shit hits the fan, you’ll have to talk to your doctor. They may be able to help you out perhaps with some SSRIs or maybe erectile dysfunction drugs.
And then, of course, you have psychological therapy and the good old communication technique of actually sharing stuff with your partner.
Whatever you decide to try guys, I’m sure some of it will work and you’ll be happy, satisfied, and back in the sack in no time!