Men
Premature Ejaculation
Sexual intercourse on average lasts about 5 ½ minutes, with the high side of the range being around 10 minutes. There are many causes that can lead to considerably shorter sexual encounters for some couples. Duration of sex can also be affected by mood and time of the day. That’s normal and nothing to worry about. However, if a man regularly ejaculates within 1-2 minutes against his own will, or finds it difficult to get or maintain an erection, there may be more serious issues at hand that need to be addressed.
Premature ejaculation — defined as an unintentional male orgasm within one to six minutes of vaginal (or anal) intercourse leading to stress in a relationship. It is a problem for up to 30 percent of men. For some it will be a lifelong issue, whereas for others, it may be a transient issue lasting a few weeks or months. Science still hasn’t found a satisfactory explanation for why so many men have involuntary early orgasms. Short-term premature ejaculation appears to be due to psychological issues, such as performance anxiety, and is more common among younger men who are new to sex.
In contrast, chronic, long-term premature ejaculation, which is also called secondary premature ejaculation, has real physical causes. In particular, it seems to be related to low serotonin levels in the body. Serotonin is an important neurotransmitter in the brain and its concentration directly affects your mood and emotional health. Low serotonin levels are associated with depression and other psychological disorders, and they also make it more difficult to control and delay ejaculation in men. Why this happens still isn’t entirely clear.
To be clear, premature ejaculation is not a health problem and it doesn’t affect fertility. There’s more to a fulfilling sex life than intercourse — in fact the intimacy and the foreplay can be much more gratifying than the actual final act. So, if premature ejaculation doesn’t bother you or your partner, there’s no reason to worry about it or seek treatment.
Erectile dysfunction is another common problem impacting men’s sexual performance and preventing them from lasting as long as they’d like to. Either an erection fails to form altogether or it cannot be maintained long enough during sex. Among younger men, erectile dysfunction can occur due to performance anxiety, alcohol consumption, decreased libido because of excessive porn use, intense stress, and several psychological conditions, such as depression. It may be reversible if the underlying causes are addressed, and in most cases does not require medical treatment.
Erectile dysfunction is a greater problem for men aged 40 and above. Some 50 percent of this age group will at some point in their lives experience erection problems, mostly due to physical health issues. Declining testosterone levels, heart problems, obesity, diabetes, poor physical fitness, and side effects of certain medications are the primary causes. As men then notice increasing problems with getting and maintaining firm erections, performance anxiety may worsen the issue by inhibiting their sexual arousal.
If you want to learn more about these two common issues as well as other factors that influence the duration of sexual intercourse, ask your doctor for additional information.
There are several medical options available for treating both premature ejaculation and erectile dysfunction, which are discussed in the next section. But let’s first take a look at what else you can do to last longer in bed.
The first step you’ll have to take is to openly discuss the issue with your partner. Make sure she or he understands your problems and associated psychological pressure. In fact, that pressure often comes from the fear of disappointing your partner with your sexual performance, or from an effort to hide your problem and concerns. Therefore, an honest, open discussion with your partner can take you a long way and may sometimes be all that’s needed to make you more relaxed and last longer during sex.
Try making foreplay rather than intercourse, the most important part of your sex life. This can increase your sexual appetite, give firmer erections, and ease fears of premature ejaculation. Similarly, try to give your partner orgasms through means other than intercourse. Having alternative orgasm options your partner enjoys will take away some pressure and feelings of guilt during intercourse. In fact, sexual encounters can be perfectly enjoyable without having intercourse every time.
To tackle premature ejaculation, there are exercises that can help you improve control over your ejaculation. Sex therapy experts can teach you a whole range of exercises, such as pelvic muscles training. The most popular and often-used exercise is the “squeeze method.” In this exercise, your partner arouses your penis until you are short off ejaculation. She or he then squeezes the penis for a few seconds, thus stopping your erection and desire to ejaculate. Frequent practice will teach you how to delay and time your ejaculation better. Seek advice from a therapist to learn more.
Other popular methods for preventing premature ejaculation are to masturbate shortly before having sex or to wear thick condoms during intercourse, as this lowers the penis’ sensitivity.
For erectile dysfunction, there aren’t any special exercises. However, lifestyle changes that improve underlying physical health can deliver very positive results. Work with your doctor on improving your nutrition, physical exercise regimen, and stress reduction. It will take some time and effort to yield results, but for most men, lifestyle changes are a sure way to a firmer erection.
Given how common sexual performance problems are, pharmaceutical companies over the past decades have invested heavily in R&D of applicable drugs. Below is an overview of the available treatments for premature ejaculation and erectile dysfunction in the U.S. market.
Antidepressants from the SSRI class are a popular choice of doctors to treat premature ejaculation, as many studies have demonstrated their effectiveness.
SSRIs (selective serotonin reuptake inhibitors) raise serotonin levels in the brain and thereby treat depression, anxiety and other psychological disorders. One of their side effects is a reduced libido and penile sensitivity. When taken as needed 4-6 hours before sex, SSRIs will delay ejaculation by an average 5 minutes. Taken daily, the effect can be more pronounced, extending intercourse for 7 - 13 minutes. Different SSRI have varying effects, but doctors typically prescribe sertraline (Zoloft), fluoxetine (Prozac), paroxetine (Paxil), and escitalopram (Lexapro). All of these are available in a generic version.
Another option to treat premature ejaculation are anesthetic creams and sprays that numb your penis and thereby help delaying the orgasm. Combinations of lidocaine and prilocaine are the most widely used treatment and available as prescription creams. Prilocaine on its own can also be bought as an over-the-counter drug.
These topical anesthetics usually are applied on top of the penis 5 to 10 minutes prior to sexual intercourse. Make sure to completely clean them off before you have sex. There are also special condoms that have the anesthetic applied to the inside, which will make the numbing effect last throughout intercourse if needed.
Several drugs have been specifically designed for treating erectile dysfunction, such as sildenafil (Viagra), tadalafil (Cialis) and vardenafil (Levitra, Staxyn). They are taken orally and all are now available as generic drugs.
All of them function in a similar way. They increase the blood flow in the penis and thus make it stiffer. However, due to their differing chemical compositions, they vary in terms of timing (how early you have to take them before sex) and duration. The success rate of these drugs can be up to 80%, but it depends on how severe a man’s erectile dysfunction is. Psychological aspects are important, as these medications only increase the physical firmness of your penis but don’t improve your libido. Without sexual arousal, ED medications may not be useful.
All of the above-mentioned drugs have a long track record and are usually well tolerated by the millions of men who take them. That said, there are several possible side effects to all of them that you’ll need to be aware of. Whether you are looking for a medication for premature ejaculation or erectile dysfunction, you can discuss the best treatment options and possible side effects with your doctor.
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