What is PE (Premature Ejaculation)?
Premature Ejaculation is when a man (or penis-owning person) ejaculates semen sooner than desired during sexual intercourse. According to the Mayo Clinic, it can be normal for a person to experience PE every now and then, however, if an individual ejaculates within 1 to 3 minutes of penetration all or most of the time, or feels frustrated and avoids sex because of the PE, it can be cause for concern. Luckily, there are solutions, both medical and otherwise, that can successfully reduce the occurrence of, or completely get rid of, premature ejaculation.
According to a study completed by Gillman and Gillman (2019), 20-30% of men will experience premature ejaculation at some point in their lives regardless of age or ethnicity. Despite the frequency of PE, it is an area of male sexual health that is regularly overlooked. Gillman and Gillman state there is an "unmet therapeutic need" and "this is likely due to a combination of many factors, including poor rates of seeking treatment as a result of embarrassment or shame, as well as confusion on the part of the clinician surrounding clinical management of the dysfunction" (2019). PE can have various negative impacts on an individual's quality of life, including on self-esteem and partner relationships. It is important that we start to discuss PE candidly in society and the medical community, so penis-owning individuals can know that (a) it is common and (b) begin to explore medical and alternative treatments.
Keep in mind there are two distinct classifications of PE- Lifelong PE and Acquired PE. As the names suggest, Lifelong PE means that an individual has experienced premature ejaculation since becoming sexually active, whereas Acquired PE means there was a time in the individual's sexual life when PE was a non-issue.
Do I have PE?
The only way to get an official diagnosis for PE is to speak with a medical professional about your symptoms. However, it is generally accepted that an individual suffers from PE if ejaculation consistently occurs less than 3 minutes into penetration and this fact causes distress or has a negative impact on the person's life, self esteem, or relationships.
While it is normal to feel shame or frustration around PE, it is important to remember that one in three men will experience premature ejaculation at some point in their lives. Other struggles, such as pain and difficulty orgasming plague vulva-owners with just as much, if not more prevalence. In fact, according to Rosen (2000) "Sexual dysfunctions are highly prevalent, affecting about 43% of women and 31% of men." Sexual dysfunctions are as much a part of being human as asthma, acne, and IBS. This doesn't make living with PE any more pleasant, but it can hopefully help to remove some of the taboo around it, and other, sexual dysfunctions. We are all in this together and solutions do abound.
Treatments for PE:
There are a variety of treatments, lifestyle changes, and alternative options available for individuals wishing to find a solution to PE. It is worthwhile to seek both medical and psychological treatment for PE, as the same solutions do not work for everyone and will vary depending on the underlying cause of the PE.
Please keep in mind that the following treatment ideas are compiled from peer-reviewed articles accessed by Honey Dew staff and not directly from a medical professional. These ideas should not be taken as medical advice and the guidance of a professional is recommended.
- Behavioral Therapy: there are two behavioral interventions that have proven generally successful in slowing down ejaculation.
- Squeeze Technique: this technique essentially involves the penis being stimulated to the point of extreme arousal, verging on ejaculation. Stimulation is then stopped and the penis should be squeezed firmly at the tip for up to 10 seconds with one finger firmly over the frenulum until the urge to ejaculate decreases. This process is repeated several times and over time, can increase control over when ejaculation occurs. It can be practiced alone or with a partner.
- How-to resources:
- Proactive Men's Medical Center: how-to squeeze technique
- National Library of Medicine: list of PE prevention techniques
- Healthline: how-to squeeze technique alone or with a partner
- Start-Stop Technique: also known as edging, this process involves reaching the precipice of orgasm and then stopping until the urge to ejaculate passes, before beginning again. This can be more pleasurable than the squeeze technique and the practice of edging (regardless of PE) can result in more intense orgasms for both men and women.
- Pelvic Floor Exercises: a weak, tight, or damaged pelvic floor can make it more difficult to control ejaculation. There are several exercises that can be used to either relax or strengthen pelvic floor muscles. Kegels and pelvic floor work aren't just for vulva owners after all. The pelvic floor is a critical part of male anatomy, it is the sling of muscles that holds up the bladder, bowel, and sexual organs. These muscles can have a profound impact on sexual function.
- A trial study presented to the European Congress in 2014 found that pelvic floor exercises improved ejaculation time by over 4 times. Kegel and relaxation techniques can be practiced at home, while seeing a pelvic floor PT can also be helpful to learn individualized exercises and access additional interventions such as electro-stimulation and biofeedback.
- SSRI's: otherwise known as Selective Serotonin Reuptake Inhibitors, SSRI's increase the serotonin levels in the brain. SSRI's are most often used for the treatment of depression and anxiety. Serotonin is a neurotransmitter that helps to regulate mood (the Cleveland Clinic refers to it as your "feel good" chemical). It also impacts digestion, sleep, bodily health, and, you guessed it, sexual health.
- Fast-acting SSRI's have been shown to be helpful in treating premature ejaculation, according to several studies as serotonin is known to be the main neurotransmitter involved in the mental control of ejaculation (Gillman & Gillman, 2019).
- If you think SSRI's might be beneficial to you, talk to your healthcare provider. SSRI's are only available through prescription at this time and the use of SSRI's to treat PE is still evolving.
Alternatives to try for PE:
Some penis-owning individuals have found it helpful to introduce a mindfulness practice to their lives while others have found that using a cock ring helps them to last longer. Masturbating before partnered sex is also shown to be helpful to some, as is wearing thick condoms during penetration. The most important thing is to have fun while experimenting and to keep in mind that pleasuring your partner doesn't have to end when you ejaculate.
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Cock Rings: cock rings are a great accessory to add to any playtime, regardless of their potential use in helping PE. Cock rings are usually made of silicone, although they sometimes come in metal or body-safe plastics. Cock rings work by restricting blood flow by gripping the base of the penis and come in a wide range of varieties, including vibrating versions that are fun for partners as well as wearers. Check out Honey Dew's selection of cock rings here.
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Masturbate first: yes, we know it's obvious, but sometimes the simplest solution is a winner. Consider turning it into foreplay, some people enjoy watching their partners masturbate- it can be a fun form of voyeurism to experiment with. Alternatively, take a shower and use the time to freshen up as well as prime your penis to last a little longer. Using a stroker can help increase sensation and build up a tolerance to stimulation. Honey Dew carries the b-swish stroker, which has a silky textured interior and is easy to clean with soap and water.
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Develop a mindfulness practice: a mind is a powerful tool and it can be exercised just like a body can be. Learning to recognize when pleasure is about to peak and how to back it off is a skill that you can teach yourself with practice. Remember about edging and Cognitive Behavioral Therapy from above? It's really just an applied mindfulness practice. Alternatively, a general mindfulness practice may help improve mental control in all aspects of one's life, including ejaculation, so this can be a great place to start if focusing on edging specifically feels overwhelming. Just 10 minutes a day has been proven to make a difference. For guided mindfulness exercises, try YouTube or one of the meditation apps such as Headspace or Calm.
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Finally, there's always the option to stop worrying about ejaculation and find other ways to please your partner. Penetration with the penis is only one way to be intimate sexually and there are many ways to find satisfaction, both for yourself and your partner. If continued penetration is desired after ejaculation occurs, consider introducing a dildo or g-spot or anal vibrator. There are more toys available today than anyone could possibly imagine, so have some fun and experiment. Communication is king here, as always, so talk with your partner about what you both like, and don't be afraid to get creative. It's high time the stigma against sex toys became a thing of the past and pleasure became the priority. Check out Honey Dew's selection of Dildo's here, Vibrators here, and hands-free options here.
Final Thoughts:
Overall, PE is common. One in three men will experience it in their life time. Women have other sexual dysfunctions that are just as prevalent. While unfortunate, there is no need for shame or stigma around sexual dysfunction. It is part of the human condition and luckily, there are many solutions. For PE, there is no one size fits all solution, but rather a variety of techniques and approaches that have been found to be helpful. Try to keep an open mind and approach the issue with curiosity instead of judgment, experiment and find what works for you and your partner(s).
Citations:
Gillman N, Gillman M. Premature Ejaculation: Aetiology and Treatment Strategies. Med Sci (Basel). 2019 Oct 25;7(11):102. doi: 10.3390/medsci7110102x. PMID: 31731516; PMCID: PMC6915345. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6915345/
(2021) An update on the treatment of premature ejaculation: A systematic review, Arab Journal of Urology, 19:3, 281-302, DOI: 10.1080/2090598X.2021.1943273
Rosen RC. Prevalence and risk factors of sexual dysfunction in men and women. Curr Psychiatry Rep. 2000 Jun;2(3):189-95. doi: 10.1007/s11920-996-0006-2. PMID: 11122954.
