Premature Ejaculation

...more accurately called Rapid Ejaculation

Definition of Premature Ejaculation:

Distress about ejaculating sooner than desired during a significant percentage of sexual interactions.

Prevalence of PE:

5 million to 25 million
*Estimates on the prevalence of rapid ejaculation vary widely, and are almost completely a function of definition. When evaluating your own situation, remember that unrealistic expectations can shape your perception of the seriousness of your difficulty. If you feel you have a problem, talk with your partner(s). An evaluation by a physician, psychologist, or therapist may also be helpful.

Background of PE:

Our problem starts with a definition: What if someone wants to last for an hour? Some men -- and women -- have unrealistic expectations about their sexual performance. When their bodies behave reasonably, they feel disappointed. And that's where the problem starts: expectations, pressure, and anxiety. Rapid ejaculation is not about excitement, as most people think, but about anxiety. The unwanted orgasm is triggered by anxiety, not by pleasure.

Symptoms and Diagnosis of PE:

Unfortunately, the diagnosis (and occurrence) of this problem is typically intercourse-oriented. This perspective is compounded by the fact that most people seem to feel that sex is over when the man ejaculates. No wonder people are so distressed by a man's speedy orgasm. On the other hand, when male orgasm is seen as one part of a larger sexual interaction, quick ejaculation is not so upsetting. A helpful strategy is to precede intercourse with plenty of other sexual activity, or at least with the kind of sex that usually gives a woman an orgasm. If people feel they have plenty of pleasure before the man ejaculates, they'll be less distressed if he comes quickly.

How fast is too fast? Physicians used to define rapid ejaculation based on a man's inability to give a woman an orgasm at least half the time he had intercourse. We now realize this is not only unrealistic, but beside the point. Nor should "too fast" be measured by the clock. Rather, a lack of control and a sense of powerlessness are more salient.

Most people agree that a man who usually climaxes within seconds of insertion (or at insertion, for that matter) has a problem.

But how many minutes must a man last in order to be problem-free? No one can really say. Some people complain about sex that other people would kill for.

Treatment for Premature Ejaculation:

Rapid ejaculation frequently reflects one or more psychological issues. A good therapist can usually identify which issues are involved, which may be fear of sex or women, self-consciousness or fear of inadequacy, attempting sex under adverse circumstances, or a relationship that doesn't foster relaxation and caring. The therapist will talk these issues over with the patient, helping him resolve any ambivalence or other feelings that interfere with sexual functioning.

If rapid ejaculation involves simple misinformation or naiveté, a good therapist will help the patient focus on his physical experience during sex. Most rapid ejaculators attempt to distract themselves during sex, on the theory that this will reduce the perceived stimulation and delay the orgasm. But a man with this concern needs to learn to focus more on what's actually going on: the sensation in his penis, his breathing, his level of excitement, his connection with his partner, etc.. If he is in a supportive environment, doing so will reduce the anxiety and allow the ejaculation reflex to operate in a more satisfactory way.

Unfortunately, some women contribute to drama around rapid ejaculation. They assume that if they were more attractive or better lovers, their man wouldn't come so quickly. Other women assume that if the man cared for them more, he'd somehow find a way to last longer. Generally, these beliefs are inaccurate, and frequently make things worse. All a woman can do is let a man know that she's still interested in being sexual with him, and encourage the two of them to talk about ways of enjoying sex that make sense in the circumstances. A little encouragement to see a sex therapist can be helpful, too -- as long as a man feels loved regardless of the outcome.

Marty Klein has been a licensed Marriage and Family Therapist and sex therapist for over 20 years. His entire career has been aimed at a single set of goals: telling the truth about sexuality, helping people feel sexually normal and powerful, and supporting the healthy sexual expression and exploration of women and men.