Reasons for premature ejaculation
The clinical definition of premature ejaculation, as most experts would define it, is an involuntary male orgasm that happens within 60 seconds of vaginal intercourse. The premature ejaculation topic is less researched for anal sex, but it’s safe to assume that the same time definition applies. For reference: studies place the average time of sexual intercourse across the population at slightly above five minutes. The upper range of a “normal” intercourse timing is 10-12 minutes. Forget about the 30+-minute intercourse shown in porn; that’s not the norm and most men and women in real life wouldn’t even find it enjoyable.
Up to 30 percent of men experience early ejaculation against their will at least for a period of their lives, but for many it can be a life-long issue.
So far, there’s no fully satisfying explanation for why so many men can’t help orgasming after 30 seconds into the act. Premature ejaculation appears to correlate with low levels of serotonin in the brain. Some 95 percent of serotonin resides in your gut, where it plays an important role for your digestion, but the remaining 5 percent function as neural messengers in your brain, i.e., they carry information back and forth between brain cells.
Order effective treatment for premature ejaculation discreetly View all treatments
Brain serotonin levels are associated with your mood and general emotional wellbeing. The higher your serotonin levels, the happier and balanced you are. By the same token, people with clinical depression and anxiety disorders often have very low serotonin levels. How and why low serotonin levels make it more difficult for you to control and delay your ejaculation still is subject to ongoing research.
Beside serotonin levels, intense chronic stress can also cause premature ejaculation for as long as the stress persists. Anxiety can also trigger or worsen premature ejaculation, in particular if there are inflated expectations of what the “normal” duration of intercourse is. For example, a young man may wrongly think that five minutes is too short — not knowing that this is the national average — and begins worrying about premature ejaculation. In rare cases this can turn into a downward spiral, where growing performance anxiety reduces his ability to control ejaculation, which in turn worsens the anxiety.
Here’s another way to think about premature ejaculation though: health-wise there’s nothing wrong with it. Of course, in today’s society premature ejaculation puts a lot of psychological pressure on men, who want to enjoy sex longer and better pleasure their partners. But it’s not impacting your physical health, nor does it lower your chances of getting a woman pregnant. Premature ejaculation thus isn’t an illness or deficiency, but perhaps something that nature intended on being this way.
How to stop premature ejaculation?
There are several things you can do to bring your ejaculation successfully under control and enjoy longer intercourse with your partner. Here’s an overview of the most common tools and medications:
Premature ejaculation pills
There aren’t any pills or other oral medications that are specifically designed and approved for treating premature ejaculation in the U.S. market. However, antidepressants of the SSRI class often are prescribed by doctors as remedy against premature ejaculation because many studies have shown them to be very effective at delaying ejaculation. In fact, the American Urological Association recommends their use to treat premature ejaculation.
SSRI stands for “selective serotonin reuptake inhibitor” and as this name already indicates, they manage serotonin levels in the brain. By keeping serotonin levels elevated, SSRI can treat depression, anxiety and other mental disorders. One common side effect of SSRI are reduced sexual appetite and sensitivity. Because of this side effect, SSRI are ideal for delaying ejaculation. Studies show that SSRI can delay ejaculation by 5-6 minutes on average, which brings it into the “normal” range.
For this, you don’t need to take pills every day but only before sex when you think it’s necessary. Serotonin levels take some time to build up, which means the medication typically is taken 4-8 hours before sex. Different SSRI have different effects and some are stronger than others. Popular choices are sertraline (Zoloft), paroxetine (Paxil), fluoxetine (Prozac) and escitalopram (Lexapro). All of them are available as generic versions.
Discuss with your doctor whether you should take sertraline or another SSRI or first try alternative treatments. Your doctor can also inform you about the side effects of SSRI, which can include dizziness, insomnia, diarrhea, and mood swings. It’s important to be aware of these side effects before taking SSRI.
Premature ejaculation cream and spray
Before you consider SSRI, it’s worth exploring other options. One of them are creams and sprays that, when applied to the tip of your penis, have a numbing effect and thereby reduce penile sensitivity, which then helps to delay ejaculation. Wearing a condom has a similar effect but not with the same level of intensity. Lidocaine and prilocaine are the most often used medications for this purpose. Just like with SSRI, treating premature ejaculation isn’t their purpose by design. Lidocaine and prilocaine actually are topical anesthetics.
The most popular choice are creams that combine the two medications and they are available upon prescription. Prilocaine as a stand-alone substance can be found as an over-the-counter drug.
Ask a doctor for instructions on how to use either cream or spray. They normally are applied 5-10 min before sexual intercourse and then carefully washed off after a few minutes. If not properly cleaned off, they’ll may numb your partner’s genitals.
Premature ejaculation exercises
There are several exercises that can teach you how to better control and postpone your ejaculation. A behavior therapy expert specializing in sexual behavior can help you learn more about the different exercises. One often-applied exercise is the so-called “squeezing method.” First, your partner stimulates your penis until you are just about to orgasm. Your partner then squeezes your penis for several seconds, which will weaken your erection and the urge to ejaculate. Timing it right needs some practice, but when frequently exercised, this method will let you understand your climax better and you’ll eventually learn how to delay it yourself.
You can also train your pelvic muscles to become stronger, which will allow for better ejaculation control. Exercises you can do here include tightening your anal muscles as if you want to avoid passing gas and stopping peeing midstream. Try to hold the muscle in the contracted position for several seconds each time. When practiced several times a day over the course of several months this can strengthen pelvic muscles. Talk to a therapist to learn more about this and other exercises.
Masturbating a few hours or shortly before you have sex also is an effective method to delay your ejaculation during sex, as it reduces your libido.
Premature ejaculation therapy
Being open with yourself and your partner about your premature ejaculation and the concerns and worries it may cause you is important. A good psychologist can help with that. Therapy can make you more relaxed and improve your self-confidence. In some cases your partner even can join the therapy, which will make her or him more understanding of your issue.
Supplements for premature ejaculation
There’s a huge market of natural remedies and supplements that promise to delay ejaculation, ranging from Ayurvedic to Chinese herbs. This also includes the use of acupuncture for premature ejaculation. There’s some preliminary evidence that a few herbs may indeed have a delaying effect on ejaculation, but more future research is needed. Acupuncture didn’t show any significant improvements.
Seek advice from an expert on alternative medicine before you start taking natural supplements for premature ejaculation. A serious problem is that side effects of medical herbs often are poorly studied or unknown altogether. Since these are natural products, there also can be dangerous impurities depending on where and how the plants were grown, such as pollution with heavy metals or pesticides.
- Wylie, Kevan. “Recent Advances in the Treatment of Premature Ejaculation.” Drug Design, Development and Therapy, Jan. 2010, p. 1, https://doi.org/10.2147/dddt.s6077. Accessed 20 Dec. 2019.
- Althof, Stanley E., and Chris G. McMahon. “Contemporary Management of Disorders of Male Orgasm and Ejaculation.” Urology, vol. 93, July 2016, pp. 9–21, www.sciencedirect.com/science/article/pii/S0090429516001898, https://doi.org/10.1016/j.urology.2016.02.018. Accessed 20 Dec. 2019.
- Gurkan, Levent, et al. “Premature Ejaculation: Current and Future Treatments.” Asian Journal of Andrology, vol. 10, no. 1, 2008, pp. 102–9, www.ncbi.nlm.nih.gov/pubmed/18087649/, https://doi.org/10.1111/j.1745-7262.2008.00369.x. Accessed 20 Dec. 2019.
- Cooper, Katy, et al. “Complementary and Alternative Medicine for Management of Premature Ejaculation: A Systematic Review.” Sexual Medicine, vol. 5, no. 1, Mar. 2017, pp. e1–e18, www.sciencedirect.com/science/article/pii/S2050116116300721, https://doi.org/10.1016/j.esxm.2016.08.002. Accessed 20 Dec. 2019.
- Lewis, Gemma, et al. “The Clinical Effectiveness of Sertraline in Primary Care and the Role of Depression Severity and Duration (PANDA): A Pragmatic, Double-Blind, Placebo-Controlled Randomised Trial.” The Lancet Psychiatry, vol. 6, no. 11, Nov. 2019, pp. 903–914, www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(19)30366-9/fulltext, https://doi.org/10.1016/s2215-0366(19)30366-9. Accessed 20 Dec. 2019.