The commonly accepted belief is that premature ejaculation is the result of anxiety. It is said that anxiety to please, and a fear of being unable to do so, is the root cause of it. This is a gross oversimplification.
These concerns may be factors, but they are only some of the many that lie behind the most common cause of male sexual dysfunction. A great deal of nonsense is talked about premature ejaculation. The over-enthusiasm of rampant, virile young men is as likely to result in this problem as over-anxiety. About 30 years ago I was consulted by a footballer who was having this trouble. Either our discussion, that included some practical suggestions, or the pills prescribed improved his performance. Within days many of his team-mates came round for a similar talk and request for the same treatment.
Chatting to this hyper-fit athletic group of young men confirmed that the almost universal assumption that the usual cause for premature ejaculation was the result of fear felt by some young, inexperienced men that their performance might disappoint — even displease — their partners was unlikely. Men who have played before a Wembley crowd, and are not usually sexually inexperienced, are not going to be such shrinking violets that they would allow a little bedroom angst to put them off their stroke. Rather, they were just too eager and too randy.
Your question also shows that someone must have been talking to you about another age-old myth but, unfortunately, either you or your informant have misunderstood the concept. The Victorian idea was that the foreskin in uncircumcised men so protected the glans beneath it that it became hypersensitive. The suggestion was that if the patient was circumcised the constant friction of pants and trousers on the glans toughened its skin so that its sensitivity was lost and the man didn’t ejaculate so quickly. Your boyfriend would, if this theory truly accounted for most cases of premature ejaculation, have ejaculated even more quickly if his foreskin had not been removed in childhood. The concept of variable levels of hypersensitivity of penile skin has been supported by recent research. This has shown that some men who are premature ejaculators do have unusually sensitive penile skin. As men grow older, so their penile skin becomes less sensitive as a previously abundant nerve supply begins to deteriorate.
This accounts for the popular belief that older men are able to sustain intercourse longer, and have greater control of the timing of their orgasm. Men who ejaculate too soon are recommended to increase the length of foreplay and tactile, but non-genital, contact so that some of their sexual enthusiasm is dissipated. This also allows their partner greater time to become aroused. Men who want to prolong sex should initially adopt positions that they find less stimulating and spend longer times while having sex remaining relatively still. Some men like to postpone ejaculation by training themselves while making love to think of something other than sexually exciting thoughts, but that seems to defeat the object of the exercise. Masters and Johnson developed a technique of gradually desensitising a man to intercourse by training his wife to inhibit his orgasm just before it occurred.
There are various medical ways of delaying ejaculation. The application of anaesthetic creams have been recommended for 50 years, but these must be removed before intercourse. The first drug that was specifically prescribed to delay orgasm was clomipramine (Anafranil). Now, one of the SSRI antidepressant group is usually prescribed but only in such small doses that it doesn’t have any other side-effects. Many of the drugs in this group affect sexual performance and some may, occasionally, even prevent ejaculation entirely.
Sometimes it’s easier to accept things if they can be explained away as illness or injury, but premature ejaculation is rarely a result of either. Occasionally it can be caused by urinary tract or prostate infections, or sometimes it can reflect more serious underlying health problems such as arteriosclerosis or neurological disorders.
In most cases, premature ejaculation is related to psycho-social issues. Some experts believe that boys who rush masturbation because they are afraid of being discovered begin a pattern of rapid ejaculation that they can never subsequently break. In later life it can be triggered or aggravated by occupational stress, financial difficulties, family problems, guilt, sexual confusion or a lack of sexual and interpersonal skills. A ccording to the Sexual Dysfunction Association (SDA), a charitable organisation that was set up to raise awareness, men who suffer from premature ejaculation tend to have more problematic relationships. A man may be with a partner who has unrealistic expectations or who is too sexually demanding, or feels dissatisfied with aspects of the relationship yet unable to communicate her concerns. An unsympathetic response intensifies anxiety which can lead to further failure.
The SDA runs a helpline (0870 7743571) from Monday to Friday, 9am to 5pm. If your partner calls, they will help him to find a specialist in his area who will decide what treatment is appropriate. He may be advised to do both cognitive and behavioural therapy, a dual approach that tackles psychological concerns and teaches “delay techniques” at the same time.
Delay techniques, such as the “stop-start” or “squeeze-release” masturbation methods, can help men to build up ejaculatory control, but in men who suffer from severe premature ejaculation these techniques don’t translate into successful penetration. For details, visit www.sda.uk.net or http://www.bbc.co.uk/relationships/sex_and_sexual_health/. Your boyfriend may also be advised to try an anaesthetic cream or a delay spray. These products are constantly being improved and clinical trials of a spray which experts have high hopes for are currently under way in the UK. But unfortunately, because they work by decreasing sensation, they are not always popular. Prolong — a penile ring device which reduces sensitivity to delay ejaculation — works on the same basis.
The number of treatment options for grows annually but, statistically, your boyfriend is unlikely to try any of them without your support. A survey by the Impotence Association has revealed that nine out of ten men suffering from sexual dysfunction never tell their GPs, even though 21 per cent of them blame it for the breakdown of their relationship and 62 per cent admit that it has had a negative effect on their self-esteem.
Since you don’t have the glue of marriage or children to bind you together, your boyfriend’s premature ejaculation may feel too big a compromise for you to deal with. But before you allow your frustrations to destroy this relationship, remember that no one is perfect. The next guy you get might be a god in the bedroom and a useless good-for-nothing elsewhere. If your boyfriend is a great partner in every “other” way, maybe you should concentrate on “other ” approaches to sex. There’s a smorgasbord of delights that don’t include penetration. But if you want that, too, then show him how to use a vibrator or get him to pump your G spot (two fingers curled about two inches in behind your pubic bone, press behind your tummy button, as if to say “come here”).
Direct your sex life differently and you will alleviate the performance pressure on him and hugely increase your sexual satisfaction at the same time. In other words, if you help him to help himself, you will be duly rewarded.
OVER TO YOU Do you have a sexual dilemma for Suzi Godson and Dr Thomas Stuttaford? Send your e-mails to body&soul@thetimes.co.uk
or write to
Body&Soul, The Times, 1 Pennington Street, London E98 1TT. The authors regret that, although your letters are much appreciated, they cannot respond personally.
