Premature ejaculation

Premature ejaculation is male sexual climax (orgasm) prior to or immediatelyfollowing penetration. In spite of the many theories and speculations about this disorder, the simple fact seems to be that sexual control is learned behavior. It can be learned correctly or incorrectly, and it can be relearned correctly. There is no definitive evidence that suggests disease or psychological conditions contribute to premature ejaculation.

In 1966, William H. Masters and Virginia E. Johnson published Human Sexual Response, in which they broke the first ground in approaching this topic from a new perspective. Their method was devised by Dr. JamesSeman and has been modified subsequently by Dr. Helen Singer Kaplan and others.

A competent and orthodox sex therapist will spend much more time focusing onthe personal than the sexual relationship between the two people who come fortreatment. Without emotional intimacy, sexual relations are superficial andsexual problems such as premature ejaculation are rarely overcome.

With that foremost in mind, a careful plan is outlined that requires dedication, patience and commitment by both partners. It necessarily begins by prohibiting intercourse for an extended period of time--at least a week, often a month. This is very important to the man because "performance anxiety" is the greatest enemy of performance. If he knows he cannot have intercourse he is able to relax and focus on the exercises. The first stage is called "sensate focus" and involves his concentration on the process of sexual arousal and climax. He should learn to recognize each step in the process, most particularlythe moment just before the "point of no return." Ideally, this stage of treatment requires the man's partner to be devoted to his sensations. In order toregain equality, he should in turn spend separate time stimulating and pleasing his mate, without intercourse.

At this point the techniques diverge. The original "squeeze technique" requires that the partner become expert at squeezing the head of the penis at intervals to prevent orgasm. The modified procedure, described by Dr. Ruth Westheimer, calls upon the man to instruct the partner when to stop stimulating himto give him a chance to draw back. A series of stages follows, each offeringgreater stimulation as the couple gains greater control over his arousal. This whole process has been called "outercourse." After a period of weeks, theywill have together retrained his response and gained satisfactory control over it. In addition, they will each have learned much about the other's uniquesexuality and ways to increase each other's pleasure.

With either technique, the emphasis is on the mutual goal of satisfactory sexual relations for both partners. Cures for premature ejaculation have had very high success rates. The "squeeze technique" has illicited a 95% success rate, whereby the patient is able to control ejaculation.

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