Overcoming Premature Ejaculation: Solutions for a Healthier Relationship

I'm feeling very troubled?

I remember that when I was a teenager, I would ejaculate in about a minute during masturbation.
Now, when I have intercourse with my girlfriend, I either ejaculate as soon as I try to insert or right after insertion.
This issue has made me hesitant to get married.
Dr.
Liu, could you please advise me on how to resolve this problem? Thank you.

Xiákè, 30~39 year old female. Ask Date: 2002/03/30

Dr. Liu Jianting reply Urology

It's really frustrating! Actually, you can train yourself in a self-defense manner.
When it comes to the issue of "premature ejaculation," it's important to stay relaxed; the more you worry, the worse it gets.
I suggest you read a book called "About Sex," published by Tianxia.

Reply Date: 2002/03/30

More Info

Premature ejaculation (PE) is a common sexual dysfunction that affects many men at various stages of their lives. It can lead to significant distress and impact intimate relationships. Your experience of ejaculating quickly during sexual intercourse, especially upon penetration, is not uncommon, and there are several strategies and treatments available to help manage this condition.

Understanding Premature Ejaculation
Premature ejaculation is typically defined as ejaculation that occurs with minimal sexual stimulation, often within one minute of penetration. This can be classified into two types: lifelong (primary) and acquired (secondary). Lifelong PE occurs from the first sexual experiences, while acquired PE develops later in life, often due to psychological factors, relationship issues, or medical conditions.

Psychological Factors
Anxiety, stress, and performance pressure can significantly contribute to premature ejaculation. Many men find that the fear of not being able to satisfy their partner leads to a cycle of anxiety that exacerbates the problem. Addressing these psychological factors through counseling or therapy can be beneficial. Cognitive-behavioral therapy (CBT) is particularly effective in helping individuals manage anxiety and improve sexual performance.

Behavioral Techniques
Several behavioral techniques can help you gain better control over ejaculation:
1. Start-Stop Technique: This involves stimulating the penis until you feel close to ejaculation, then stopping until the urge decreases. Repeating this process can help you learn to control your ejaculation better.

2. Squeeze Technique: Similar to the start-stop method, this technique involves squeezing the base of the penis when you feel close to ejaculating. This can help delay ejaculation and increase control over time.

3. Pelvic Floor Exercises: Strengthening the pelvic floor muscles through Kegel exercises can enhance control over ejaculation. These exercises involve repeatedly contracting and relaxing the muscles used to stop urination.

Medical Treatments
If behavioral techniques do not yield satisfactory results, several medical treatments are available:
1. Topical Anesthetics: Creams or sprays containing numbing agents (like lidocaine) can be applied to the penis to reduce sensitivity and delay ejaculation.

2. Oral Medications: Certain antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), have been found to delay ejaculation as a side effect. Medications like paroxetine, sertraline, and fluoxetine may be prescribed by your healthcare provider.

3. Hormonal Treatments: In some cases, hormonal imbalances may contribute to PE. Consulting with a healthcare provider can help determine if this is a factor for you.

Communication with Your Partner
Open communication with your partner about your concerns and experiences can foster understanding and support. Discussing your feelings and exploring alternative forms of intimacy can help alleviate pressure and enhance your relationship.

Seeking Professional Help
If you find that your situation does not improve with self-help strategies, or if it continues to cause distress, it may be beneficial to consult a healthcare professional or a sex therapist. They can provide tailored advice and treatment options based on your specific circumstances.

Conclusion
Overcoming premature ejaculation is possible with the right combination of techniques, treatments, and support. It is essential to approach this issue with patience and an open mind, as improvement may take time. Remember, you are not alone in this experience, and many men face similar challenges. Seeking help is a positive step towards a healthier and more fulfilling sexual relationship.

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