Myths and Truths About Premature Ejaculation

Many popular beliefs about premature ejaculation are mistaken.

Posted Oct 31, 2015

Across the lifespan, premature ejaculation (PE, coming too soon) is men’s number one sex problem. In every adult age group, about 30 percent of men complain of poor ejaculatory control. Among older men, erectile dysfunction becomes more common—and gets all the headlines—but across the lifespan, from 18 on, PE affects more men.

As a result, PE has spawned a conventional wisdom, for example, that the men who lack ejaculatorty control suffer serious anxiety problems. But researchers at the University of Liege, Belgium, surveyed 492 men, age 18 to 74, and 80 of their women partners and found that many prevalent beliefs about PE are mistaken:

• Myth: PE sufferers are plagued by anxiety. Truth: Men with PE have anxiety levels in the normal range.

• Myth: If you have PE, you have it all the time. Truth: it’s often situational—PE with one lover and not another. Or PE or not with the same lover depending on the circumstances.

• Myth: PE decreases with age. Truth: PE prevalence remains remarkably steady from the teen years to age 50, and then it spikes upward before settling down again.

• Myth: Men with PE consider it very distressing for their lovers. Truth: Compared with men, women feel considerably less stressed about lovers’ PE, and when women express distress, it’s almost always a reaction to the suffering PE causes men than to their own dissatisfaction with how long sex lasts.

• Myth: Men have PE if they ejaculate within two minutes of insertion. Truth: Many survey respondents lasted longer than two minutes but insisted they had PE. Fixation on the duration of intercourse misses the point. The issue is not duration but lack of control over ejaculatory timing, no matter how long things last.

• Myth: PE treatment has become “medicalized,” and the treatment of choice is low-dose antidepressants. Truth: Only 12 percent of respondents had tried any drug treatment.

PE Sufferers Are Not Anxiety-Ridden

Anxiety makes the nervous system more excitable. When the nervous systems of sexually aroused men become overly excited, they often ejaculate before they want to. So on first impression, it sounds reasonable to blame PE on anxiety and to postulate that men with the condition are anxiety-ridden. But the Belgian survey shows that PE sufferers are not particularly anxious.

Anxiety plays a role in PE, but men who come too soon aren’t plagued by it. They feel sex-specific stress. PE is common in young, sexually inexperienced men who feel performance anxiety. (Will she let me? How do I do this?) If they come quickly during their first attempts at intercourse, they may develop a habit of rapid, involuntary ejaculation.

Overcoming PE does not require a personality transformation. Mostlty, men need to slow the pace of lovemaking with the help of deep breathing, playfulness, laughter, check-ins (Is this okay?), and mutual whole-body massage includes the genitals but does not fixate on then, massage that spreads arousal around the entire skin surface and takes pressure off the penis. The woman-on-top position also helps. Compared to the missionary position in which men must work to support themselves atop women, the woman-on-top position allows men to lie supine and relax—and last longer.

PE is Often Situational

Some men have PE every time, but the Belgian survey shows that it often depends on the situation. Basede on my years as a sex counselor, I totally agree. I’ve heard dozens of men explain that they have decent control with their wives or girlfriends, but lose control if they have flings with other women.

This is another reflection of sex-specific anxiety. Men feel relaxed with their regular lovers, but more excited—and nervous, guilty, and stressed— with other women. Or men have reasonable control with their wives or girlfriends and then get hit by some major stressor—job loss, money woes, family issues—and the added stress makes them come quickly.

PE Can Develop At Any Age

The stereotype is that PE is a young man’s sex problem, that it subsides with age. PE may well subside as young men become more sexually experienced and learn to relax with steady lovers. But the Belgian survey shows that prevalence holds pretty steady at 25 to 30 percent of men from the teen years to around 50, and then spikes upward before settling back down in the later 50s.

Here again, sex-specific stress is the culprit. Around age 50, erections become iffy and ED starts to become a significant issue. Middle-aged men suddenly worried about balky or lost erections may subconsciously decide to use it or lose it. Rather than risk wilting, when they raise erections, they come quickly. Hence the spike. But as time passes, most men adjust to life without firm erections, and the rate of PE declines.

Men Project PE Distress on Women

PE can drive men crazy. Men often assume that the women in their livers feel equally distressed about it. But the Belgian survey shows that few women care much about it. In my counseling, I’ve heard many women say, “I really don’t care how long he lasts, as long when he's done, he makes me come by hand, mouth, or sex toy.”

Men project PE distress on women in part because they believe they should bring women to orgasm during intercourse. If they can’t last long enough to do this, then they see themselves as failures and assume that their lady loves consider them lousy in bed. Of course, this just adds to men’s stress load and cements the habit of coming quickly.

In fact, a great deal of research shows that only 25 percent of women are reliably orgasmic during intercourse. The old in-out can feel very stimulating for a man’s penis, but it usually doesn’t stimulate the clitoris enough to bring her to orgasm. The clitoris sits outside the vagina, a few inches above it, beneath the top junction of the vaginal lips. No matter how long men last during intercourse, to enjoy orgasm, three-quarters of women need direct clitoral stimulation by hand, mouth, or sex toy.

Toss the Stopwatch

Many sexologists consider men to have PE if they ejaculate within two minutes of insertion. But the Belgian survey shows that many men lasted longer than that but still insisted they had PE.

The issue is not how long men last in seconds or minutes or even hours. It’s the feeling of being out of control, of ejaculating involuntarily. Men want to control how long they last whether it’s 90 seconds or 90 minutes.

Drugs Are Rarely Necessary

For the past twenty years, doctors have treated PE with low-dose antidepressants. Not that PE sufferers are depressed, but one side effect of the most widely prescribed class of antidepressants, the selective serotonin reuptake inhibitors (SSRIs), is delayed ejaculation. Some doctors tout these drugs as “the cure,” but antidepressants don’t teach men ejaculatory control. They simply extend the time to ejaculation—and often by not very much. Men recognize this, which is why, in the Belgian survey, only 12 percent of men had tried drugs.

Fortunately, sex therapists have developed a simple program that can teach an estimated 90 percent of PE sufferers to last as long as they’d like in a few months. I’ve summarized this program in an e-booklet, The Cure for Premature Ejaculation, that’s the top-selling item on my website, GreatSexGuidance.com

You can be single or coupled. The program involves no drugs. And it gives men the tools they need to overcome future sexual stressors (new relationship, aging, etc.) and re-establish ejaculatory control.

It’s a real shame that across the lifespan, PE is men’s number one sex problem. If you suffer PE, you CAN learn to last as long as you’d like. Check out The Cure for Premature Ejaculation.

References:

Kempeneers, P et al. “Functional and Psychological Characteristics 0of Belbian Men with Premature Ejaculation and Their Partners,” Archives of Sexual Behavior (2013) 42:51.

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