Premature Ejaculation- Final Word

Premature ejaculation is one of the most common sexual problems in men. The condition is most often described as being an inability to delay ejaculation to a point when it is mutually desirable for both partners. The definition of when ejaculation is premature is subjective. While some men have difficulty controlling their orgasm before entry, females think 5-10 minutes of copulation is too little time. How long a man is able to last is not the important factor in treating premature ejaculation. The crucial issue is if both partners are satisfied with the length of coitus. If both of you are satisfied-move on with your life.

My partner has premature ejaculation. What do you think I should do to help him?

In some cases, premature ejaculation may be caused by poor communication between partners and unrealistic expectations. Many men and women have little knowledge of their partner’s sexual needs and what satisfies them. Women typically require more foreplay and prolonged stimulation than men do to reach orgasm, and this lack of understanding causes tension and undue stress. For many men, feeling anxiety and the pressure to perform frequently leads to premature ejaculation. Drug treatment is not always the answer. Best advice is to relax, understand your partner’s wants and take some time understanding each others sexual organs and erotic zones.

Are there any nutrition supplements that can treat premature ejaculation?

Everyday on the internet and glossy magazines, there are ads about nutrition supplements to treat premature ejaculation. The majority of these supplements are based on the science of quackery and do not work. If one is interested in getting adequately treated, the best advice is to avoid this hodgepodge of non-tested chemicals and see a physician. Not only are these supplements expensive but a large percentage of them are fake pills. Like most things in America- buyer beware.

I have read that prostate massage may help with premature ejaculation. Any thoughts?

Based on the technique of squeezing the tip of the penis prior to ejaculation, some experts even recommend squeezing the prostate or pulling the testis downwards. The testis and prostate gland do play a very important role in sexual arousal. The glands do get engorged and become sensitive during intercourse. The advocates of prostate squeezing claim that the prostate should be massaged just prior to ejaculation. 


Squeezing of the prostate is done to decrease  pleasurable sensations and prevent ejaculation. This completely idiotic stupid idea should not be propagated. Prostate squeezing and testicle pulling is not safe and can cause serious injuries to internal organs and be very painful. The advocates of this technique, have obviously, never had their prostate/testes squeezed.

My therapist suggests that hypnosis may help my premature ejaculation. What do you think?

Hypnosis is Bullshit. It does not work for anything or anyone (unless you a gullible fool and retarded). Secondly, you do not want to go to sleep while having sex, do you? And third, are you going to have the hypnotist in another room or the same room as your partner, before attempting sex?


Some individuals indicate that hypnosis has been helpful in the treatment of premature ejaculation. However all these data are anecdotal and have no scientific basis. As to how hypnosis prevents premature ejaculation remains a mystery. Most men claim that in the lethargic or sedated state they are no longer able to have an erection nor have any sexual desire. This is not a recommended therapy today.

I have heard that certain sexual positions may prevent premature ejaculation. Is this true?

Some sexologists maintain that the entire problem can be solved by changing the position for sexual intercourse. It is said that the "missionary" position (man on top of the female) is not the best position while attempting to control ejaculation. One should reverse the position by letting the female be on top. Everyone agrees that ejaculation is delayed in this position, but females claim that they have difficulty reaching orgasm in this position. So alternating the position and squeezing the tip of the penis may be part of the answer.

Are condoms of any help for premature ejaculation?

Wearing ultra thick condoms has also been suggested as a remedy for premature ejaculation. The condom reduces sensitivity of the penis and prevents rapid arousal. Some claim that wearing two condoms may be required at times to decrease the penile sensitivity. Condom use also protects against STDs. However, many individuals claim that they frequently ejaculate while trying to get the condom on.

I have heard that latex sheath may help premature ejaculation. Is this true?

Today, various types of external latex rigid sheaths are available. Basically these devices are worn over the penis and fastened around the pelvis with a belt. The penis is placed inside a plastic dildo and it is the actual sheath which is placed inside the vagina. The sheath prevents the penis from getting stimulated from the vagina walls and helps regain control of their ejaculation. This technique has not been useful as many women claim that they would rather use a “dildo” instead- and many do behind your back.

My fiancée says I should try psychotherapy for my premature ejaculation. Do you think it can help?

Psychotherapy or counseling, with the partner is an essential component of treatment.  With understanding and emotional support, you are more likely to obtain the level of relaxation required for sexual satisfaction. Both your partner and you are encouraged to communicate freely and with sensitivity. While your premature ejaculation is being treated, you may want to satisfy the partner orally, or if the partner wants, anally.

By increasing knowledge of sex organs, sexual responses and responsibilities, the sexual tension can greatly be reduced. All sexual activity should be done without any pressure or tension and performed in a private relaxed environment.

Are there any Topical creams for treatment of premature ejaculation?

Various topical anesthetic creams are available that may help improve premature ejaculation. The local anesthetic work by decreasing sensation in the penis. One usually applies the local anesthetic 30-45 minutes before sex. One has to wipe the anesthetic off before intercourse. Using the anesthetic cream as a lubricant will also cause numbness of the female’s vagina and cervix. This is a poor man’s version of drug treatment. The effect of the local anesthetic is very short lived and it often fails to work. Most women hate these creams because it numbs their genitalia. Best to leave these topical anesthetic creams to numb the painful hemorrhoids.

Are there Medications to treat premature ejaculation?

Numerous antidepressants drugs have been shown to delay ejaculation in men. However, individuals who take anti depressants complain that these drugs not only cure premature ejaculation but also take away the ability to have an erection. The SSRIs  are considered the most effective medications for premature ejaculation. The drugs include paroxetine, fluoxetine and sertraline. One should start at the lowest dose because the drugs do have side effects. Recently a new SSRI (dapoxetine) has been recommended for premature ejaculation but no one knows for sure if  it works.


Other substances known to delay ejaculation are opioids, cocaine, and marijuana. However, this may not be appropriate as the drugs are addictive and have legal implications.

The majority of medications do not have to be taken on a daily basis to prevent premature ejaculation. One takes the medication an hour before planning to have sexual intercourse. For those who initially do not respond initially, the dose may need to be adjusted or another medication can be tried.

My doctor recommends the squeezing technique to help my premature ejaculation. Does this help?

Various squeezing techniques have been developed to prevent premature ejaculation and some methods do help. It is recommended that your partner squeeze the end of the penis just before you are about  to ejaculate. Your  partner has to maintain the squeeze for a few seconds until the urge to ejaculate diminishes. After the urge is over, the individual can resume the sexual activity and repeat the process. The theory is that by repeating this maneuver numerous times, the male will finally be able to have sexual intercourse without ejaculation. This technique is believed to train the penis to delay ejaculation.

However, follow-up of patients who have used this technique claim that is a poor method to manage premature ejaculation. In short, it sucks and makes a real mess of your partner’s hand.

Can Sex therapy help my premature ejaculation problem?

Some sexologists recommend that individuals masturbate an hour or two before sexual intercourse. This enables one to delay the ejaculation during sex. Other sexual activities such as foreplay are encouraged to relieve the anxiety of the actual process of sexual intercourse. Masturbation is in fact, used by men to prolong their sexual activity. It is believed that masturbation before sexual activity decreases the amount of desire/intensity the individual feels, thereby giving him more control over the penis. However, the results in men with premature ejaculation are variable. Some claim that there is no benefit and others claim that after masturbation, they lose the desire to have sex.

How is premature ejaculation generally treated?

There are varied treatments for this condition and like everything in medicine- one treatment may not be helpful for all individuals. Occasionally a combination of treatments is used. The essence of all treatments is to combine sexual therapy, medications and psychotherapy for the best results.

IS premature ejaculation dangerous?

Premature ejaculation is not a life threatening disorder. Physically the worst that can happen is that you will soil your bed sheets, underpants or mess up your partner’s thigh/genitals. Emotionally, the disorder can have severe repercussions in your personal life and relationship. Sometimes, premature ejaculation can make conceiving difficult if one continues to spurt the sperm on the bed or the floor instead of the vagina.

How does the doctor make a diagnosis of premature ejaculation?

The diagnosis of premature ejaculation is based on the individual’s history. The history and the initial interview are the most difficult part of the entire process as intimate sexual details are revealed. However, frank details about the problem can lead to the most effective treatment. In order to diagnose the cause, sexually intimate questions may involve your:

• religious upbringing
• early sexual experiences
• past and present sexual relationships
• when premature ejaculation started
• conflicts or concerns within your current relationship
• feelings of guilt, anxiety as related to performance
• use of medications
• illicit drug use

Can hypersensitive genitalia be a cause of premature ejaculation?

Sure. There are some experts who claim that perhaps the genitalia of some men are ultra sensitive to the touch of female genitalia or her hands. Perhaps some men may have altered levels of sex hormones which make them come prematurely. However, there are no scientific data supports such theories. Finally, some individuals may be taking certain medications (anti psychotics) which may cause premature ejaculation.

What is the cause of premature ejaculation?

The majority of cases of premature ejaculation are thought to be psychological. Early sexual experiences, family upbringing, rigid family social life an upbringing where sex is always thought of as dirty, taboo or evil, leads to guilty feelings which eventually may express as premature ejaculation.

Premature ejaculation can be caused by temporary depression, financial stress, unrealistic performance anxiety, history of sexual repression and an overall lack of confidence. Conflicts in interpersonal relationship, emotional torment, unresolved conflicts and dynamics strongly contribute to sexual dysfunction such as premature ejaculation. 

Even during foreplay, I tend to have premature ejaculation. Is that also considered a disorder?

There are no set guidelines to determine what early ejaculation is. The question remains, “Are you having an orgasm at the regular time or is the female taking too long to have an orgasm?” The primary sign of the disorder is that ejaculation occurs before either the male or the female can reach orgasm, causing anxiety/distress in one or both the partners. Premature ejaculation is not always a problem associated with sexual intercourse, but may also occur during foreplay, masturbation and even simply fondling or cuddling and may not even involve a partner.

I have premature ejaculation and am only 22. Should I see a doctor?

One episode of premature ejaculation is never a problem, however, if it occurs on a very regularly basis than one wishes (usually before intercourse or orgasm), then one has a disorder known as premature ejaculation. The major cause of premature ejaculation is believed to be psychological, but occasionally some organic causes are also responsible. In a number of cases, premature ejaculation is secondary –mainly due to anxiety, mental stress, preoccupation with satisfying a female and fears about maintaining an erection during sex. 

So if you have only one or two episodes, you will overcome the problem with time. Over the years numerous treatments have been postulated to help treat this condition. Some of these are outright based on quack medicine whereas others may help to some extent.

Can you please tell me how common is premature ejaculation? I am only 22 and have this darn problem

The majority of men experience premature ejaculation at least once in their lives. Frequently, adolescent teenagers and young men experience "premature" ejaculation during their initial sexual encounters. The vast majority learn how to control the problem and a few use a variety of home based therapies. Premature ejaculation is the most common male sexual disorder. In the United States, premature ejaculation affects nearly 20% of males between the ages of 18-60.

Is there an age limit on who can use Viagra?

Definitely not. Elderly people can also buy Viagra. Most people seem to think that Viagra is only meant for young members of society. This is utterly false. In fact, erectile failure is much more common in seniors than in younger individuals. Elderly people tend to have numerous medical disorders like diabetes, hypertension, and atherosclerosis that also affect the ability to have an erection. Many doctors often tell elderly patients to buy Viagra to treat their erectile failure. However, before elderly individuals buy Viagra, it is important to speak to make sure that your doctor has said it is ok. For seniors, the 25 mg dose usually works quite well.

Can testosterone help people who have erectile failure?

The sex hormone, testosterone, is sometimes used in some men who are known to have low testosterone or deficiency of this hormone at birth. Testosterone does work in these people, but it has many side effects and there is a small chance of developing liver cancer. When testosterone is used in healthy males to boost erection, it often does not work. There are countless cases of bodybuilders who have used testosterone and now have inability to have an erection and also have small size kahounas. Thus, testosterone is not recommended for healthy males. In addition, the hormone is hard to come by and whatever is available on cyberspace is either fake or contaminated with a bunch of bad chemicals.

Is alprostadil useful for erectile dysfunction?

Other options for men who have erectile failure include use of alprostadil. Before Viagra was available, alprostadil was frequently used as an injection or a suppository to enhance erections. This medication only works in a few men. It is primarily used in individuals who have had a stroke or are paralyzed. The side effects of alprostadil include pain from injection, prolonged and painful erections, and small bumps formed at the site of injection. Alprostadil is not only expensive, but has to be injected and only works in a few people – most of whom are paralyzed. For healthy young me, this is not a great drug of choice. If you do not believe me, stick a needle in your penis and see what is feels like- definitely not erotic!

Do I need to see a doctor before I buy Viagra?

No, if you are young and healthy, there is no need to see any doctor. However, men who take nitrate pills for angina, or are on medications to treat prostate hypertrophy, have heart disease, or have had a stroke or uncontrolled diabetes need to see their doctor. In fact, if you have any major health problem you should first speak to your doctor before taking these erectile failure pills.

Are there any other pills besides Viagra that may help my erectile dysfunction?

Individuals who do not respond to Viagra have other options including cialis or levitra. Both cialis and levitra appear to work much better in men who do not respond to Viagra. All three medications work in the same way. These pills enhance the effects of nitric oxide and relax muscles in the penis. This results in increased blood flow, which causes an erection when the penis is stimulated.

The dose and the duration of action of these medications vary.  Unlike Viagra, erections with levitra are said to last more than 8-12 hours- of course you need some type of sexual stimulation for this. Spontaneous erections do not occur with any of these medications.