Exploring Solutions for Premature Ejaculation

<em>For several years now, I have felt like I have a problem with premature ejaculation. While I recognize that the mythic &quot;porn star endurance&quot; is often a fallacy, I feel that I may still be under-performing. My girlfriend and I have worked on the problem, and I am usually able to bring her to climax. However, this seems to happen only when she is predominantly on top. In other positions, I climax much too early. By &quot;too early,&quot; I mean within a minute or two of penetration. I also even run into this problem when masturbating. Oftentimes, it seems as if there is little middle ground in between slightly stimulated and that &quot;point of no return.&quot; I feel like this could mostly be a mind thing. I also probably do not help my cause by worrying about prematurely ejaculating every time I masturbate or have sex. </em><em><br /><br />I would love to be able to increase my endurance in order to help spice up my sex life and be able to handle more intense sexual positions. Instead of focusing on prematurely climaxing, I'd love to focus much more on the moment. I have seen all sorts of pills and potions that are supposed to help, but most seem like snake oil. However, I have read some positive things about DuraMale. Do you have any suggestions or advice? Is there any non-sketchy solution or potential source of help out there? Is this something I can talk to my doctor about, despite it being a potentially uncommon and embarrassing topic to bring up?</em><br /><br />You end your question by saying that premature ejaculation (PE) is “potentially uncommon,” but, in fact, many men deal with this issue at some point in their lives<a href="http://www.psychologytoday.com/blog/all-about-sex/201005/premature-ejaculation-the-two-causes-mens-1-sex-problem" target="_blank">up to 30%</a>, according to research conducted at the University of Chicago. You are definitely not alone. However, there's not really a “quick fix” to solve this problem.<br /><br />I wrote about some of the most commonly suggested solutions <a href="/article-6631-speed-racer.html" target="_blank">in a previous column</a>. I still recommend trying physical exercises, such as the stop-start method or the squeeze technique (described in detail in the book <a href="http://www.toolshedtoys.com/details.php?prodId=984" target="_blank">Coping With Premature Ejaculation</a>), before others. These exercises can be done alone during masturbation or with a partner. Their main function is to help you recognize when that “point of no return” is approaching before it actually happens. Some men will try using a Fleshlight or other sleeve during masturbation to help simulate the feeling of sex with a partner and practice ejaculatory control in “real-life conditions,” as it were. Fleshlight actually makes a specific product called the <a href="http://www.toolshedtoys.com/details.php?prodId=789" target="_blank">Stamina Training Unit (STU)</a>&nbsp; for this purpose.<br /><br />You mention that you think the issue might be “<a href="/article-12867-can-sexual-problems-be-lsall-in-your-headrs-.html%20" target="_blank">a mind thing</a>” and that worrying about the problem seems to make it worse. For some folks, counseling or cognitive-behavioral therapy can help with premature ejaculation. <a href="http://www.aasect.org/directory.asp" target="_blank">The American Association of Sexuality Educators, Counselors and Therapists (AASECT)</a> maintains a directory of mental health professionals who have experience working with this type of issue.<br /><br />I agree with your hunch that most pills and potions that are marketed to men to help with premature ejaculation are worthless. They are not regulated by any reputable agency, and thus the ingredients in them and the claims that they make are not objectively evaluated. Don't waste your time and money. Some people recommend numbing sprays that contain lidocaine; I wrote a whole<a href="/article-8530-numb-nuts-why-i-dont-recommend-desensitizers-other-lsenhancersrs.html" target="_blank"> column </a>about why I think they're a bad idea.<br /><br />I do absolutely recommend talking to your doctor or other health care provider. This is a common problem that health care providers are frequently asked about, and your clinician knows your body and medical history and can thus help you work out some individualized solutions. There are some prescription medications that are sometimes used to treat premature ejaculation, especially specific types of anti-depressants, which have the side effect of delaying orgasm. One of these anti-depressants has been re-packaged and labeled specifically to treat premature ejaculation under the brand name Priligy; however, it is not yet approved for use in the United States. We have a tendency in this nation to try to treat every problem in our lives with a pill; as I said before, I think that trying physical exercises and/or seeing a counselor are much better long-term solutions that will get at the root of the problem and do not have the cost and side effects associated with drugs.<br /><br />It sounds like you and your girlfriend are already communicating about this issue and have experimented with different positions. This is great. Keep her in the loop as you explore other options. Physical exercises like the ones described above are often designed as exercises that couples do together. Remember, too, that it's not all about the penis, as <a href="/article-18429-dont-be-embarrassed-about-ed.html" target="_blank">last week's column</a>&nbsp; makes clearthere are plenty of erotic things that you can do that don't involve penetration or even an erection. Taking the pressure off your penis might paradoxically make it easier to control ejaculation.<em><br /><br />Want Laura to answer your questions in SEXpress? Send them to <a href="mailto:laura@shepex.com">laura@shepex.com</a>. Not all questions received will be answered in the column, and Laura cannot provide personal answers to questions that do not appear here. Questions sent to this address may be reproduced in this column, both in print and online, and may be edited for clarity and content.</em><em><br /><br />Laura Anne Stuart has a master's degree in public health and has worked as a sexuality educator for more than a decade. She owns the<a href="http://www.toolshedtoys.com/"> Tool Shed</a>, an erotic boutique on Milwaukee's East Side.</em>