I recently saw a question about premature ejaculation over on Quora. All of the answers, including two by self-proclaimed sexperts, were wrong. This reminded me it’s been a good while since I posted on this here.
A big part of the confusion is the failure to properly define PE. Many see it more or less like the definition below:
“Premature ejaculation is when a man ejaculates sooner during sexual intercourse than he or his partner would like.”
Now I ask you, how useless is that? Let’s say Bob lasts 5 minutes, climaxing after his wife does so. Joe lasts 10 minutes, which is rarely long enough for his wife to climax. So based on that definition, Joe suffers from PE even though he lasts twice as long as Bob. And what about poor Sam who can go half an hour or more, but his wife wants him to last longer, or is unable to climax from intercourse alone, something many women can’t do?
The International Society for Sexual Medicine has written a definition for premature ejaculation. This comes from an international panel of 21 premature ejaculation experts:
“Premature ejaculation is a male sexual dysfunction characterized by ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration; and, inability to delay ejaculation on all or nearly all vaginal penetrations; and, negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy.“
The vast majority of PE is actually a genetic disorder. A mutation causes serotonin to be less active between the nerves in the part of the brain that controls ejaculation. This means the men come much faster. This is why SSRIs can help, as they increase the amount of serotonin in the brain.
Since a man has no way to control the amount of serotonin in his brain, or how responsive his ejaculation centre is to serotonin, he can’t “fix” this by force of will or some exercise. It’s possible to gain a minute or two with delay sprays or pelvic floor exercises, but aside from medical intervention most of these men will never last three minutes. And even with medical intervention the gains are minor and may come with side effects.
If you have PE it probably seems rather unfair. It’s a genetic roll of the dice and if you have it you’re stuck. My suggestion is to accept it and do what you can to keep it from being a problem. A delay spray such as Promescent will give you a bit more time. Unlike earlier numbing products, modern ones don’t leave you so numb you can’t feel anything. I’ve also seen some evidence that doing Kegels can add about two minutes. Doing Kegels is good for other reasons, so go for it.
Beyond trying to last longer, learn to give your wife pleasure despite the PE. If you stay erect for a while after you come, keep going. If you don’t stay firm enough for long enough, try putting a vibe between your bodies so she can keep going even if you get soft. Alternatively, use your hands, mouth, or a toy to give her an orgasm before or after intercourse… or both!
We’ve talked to couples where the guy has never lasted a full minute and yet the wife is very happy with their sex life. PE will only destroy your sex life if you get hung up on it!
Image Credit: Photo by Veri Ivanova on Unsplash
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Ha! Not many comments, embarrassing to talk about it! When we first got married, calling me a “minute man” would be generous, but I always made sure my wife had fun too.
@Ron – Yeah, not a big locker room conversations!
I have been fortunate to have honest conversations with a few men who struggle with it.
Thanks for covering this topic and bringing up the genetic factor. But I did some research and cannot find the “vast majority” evidence. I saw a particular study of twins saying genetics for lifelong PE accounts for 30%, but I’m wondering if you’d share your source information.
@J. Parker – I’ve simplified this to the point it’s inaccurate. Thanks for keeping me honest!
The issue here is there are now four subtypes of PE; lifelong, acquired, natural variable, and subjective.
First a definition – IELT = Intravaginal ejaculation latency time, the time between penetration and ejaculation.
Lifelong: Always happens. IELT is under a minute, and usually under 30 seconds. Research shows this to be strongly genetic. This is the only one of the four where genetics is a significant factor. It’s also the only one that responds well to SSRIs.
Acquired: Did not happen from a man’s start of being sexual. It’s caused by medical or psychological events. IELT is usually 1 to 2 minutes. In some men this is situational, in others, it’s always there once it starts. Causes suggested but not all proven are performance anxiety, ED (speed up to climax before lost of erection), drugs (prescription or recreational), various medical issues, and relationship issues.
Natural Variable: The man sometimes climaxes very quickly, but other times has good control. This is often situational, such as a man being with a new partner.
Subjective: This is not really PE except that the man thinks it is. The IELT varies from 5 to 20 minutes. Sounds to me like men seeing too much porn.
How common each of these types is has not been well determined. A Turkish study found 2.3% of men had lifelong, 3.9% had acquired, 8.5% natural variability, and 5.1% subjective. That only makes 20%, which is lower than the usual numbers given. A Chinese study found 3.2% lifelong, 4.9% acquired, 11.4% variable, and 6.4% subjective for a total of 25.80%. In several other countries lifelong was double the rate of acquired.
All in all, it’s a mess with more questions than answers. Men’s unwillingness to talk about PE is a major block to good science here. I pulled most of this comment from one source (below). I could use others that would give different numbers. For example, various studies have placed the prevalence of PE from 4% to 39% of the male population. Some of the difference is based on how a study defines PE, but much of it is because it’s very difficult to get a large random sample of men to answer questions on PE. I expect we will get better data in the future, but it may be slow going.
While the definition of PE I gave makes this post just about lifelong PE, I failed to say that. I need to do some more study and rewrite this.
Referances:
Toward Evidence-Based Genetic Research on Lifelong Premature Ejaculation: A Critical Evaluation of Methodology | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3037500/
Also see The pathophysiology of acquired premature ejaculation | http://tau.amegroups.com/article/view/11133/11766