Premature ejaculation is the most common ejaculatory problem, found in 1/3 of American men. This can be very embarrassing and be devastating to relationships. The good news is that there are effective treatments. Other forms of ejaculatory dysfunction are anejaculation and/or the inability to climax.
Treatment options for premature ejaculation include behavioral techniques, medications and psychotherapy. For many men, a combination of these treatments works best. Anejaculation can be caused by some medications, aging, and sometimes low testosterone. Careful evaluation by your physician will be helpful to find out whether this problem will be able to be corrected.
In some cases, sexual therapy may involve simple steps, such as masturbating an hour or two before intercourse so that you're able to delay ejaculation during sex. Your doctor may also recommend desensitizing measures, such as the “squeeze technique” to help control premature ejaculation.
The squeeze technique
Your doctor may instruct you and your partner in the use of a method called the squeeze technique. This method works as follows:
- Step 1. Begin sexual activity as usual, including stimulation of the penis, until you feel almost ready to ejaculate.
- Step 2. Have your partner squeeze the end of your penis, at the point where the head (glans) joins the shaft, and maintain the squeeze for several seconds, until the urge to ejaculate passes.
- Step 3. After the squeeze is released, wait for about 30 seconds, then go back to foreplay. You may notice that squeezing the penis causes it to become less erect, but when sexual stimulation is resumed, it soon regains full erection.
- Step 4. If you again feel you're about to ejaculate, have your partner repeat the squeeze process.
By repeating this as many times as necessary, you can reach the point of entering your partner without ejaculating. After a few practice sessions, the feeling of knowing how to delay ejaculation may become a habit that no longer requires the squeeze technique.
Certain antidepressants (SSRI’s) and topical anesthetic creams are used to treat premature ejaculation. Although none of these drugs is specifically approved by the Food and Drug Administration to treat premature ejaculation, some are used for this purpose. You may need to try different medications or doses before you and your doctor find a treatment that works for you.
Sex Therapy (Psychotherapy)
This approach, also known as counseling or talk therapy, involves talking with a mental health provider about your relationships and experiences. These talk sessions can help you reduce performance anxiety or find effective ways of coping with stress and solving problems. Counseling is most likely to help when it's used in combination with drug therapy.