PE by the Numbers

American Pie. Fast Times at Ridgemont High. In pop culture, climaxing too soon is usually the punch line to a bad joke. But there's nothing funny about premature ejaculation (PE), especially if you have it. Most guys occasionally ejaculate sooner than we--and our partners--would like. As frustrating as it is, coming too quickly every now and then isn't usually a cause for concern. But for an estimated 30 percent of men, PE--consistently ejaculating too soon--is a real problem.

Think that number sounds high? I believe it may be even higher. In fact, PE is the most common sexual issue a guy can have. It doesn't matter how old you are, how much experience you have, or how much you know about sex. It can happen to anyone.

The Short Comings of PE

Despite what you've seen in movies or heard in the locker room, most guys can actually only have intercourse for an average of about two to five minutes before ejaculating. For men with PE, though, that's an eternity--the majority can only last about a minute or less before they come. Most studies show that men with PE typically last somewhere between 15 and 60 seconds.

From my experience as a sex therapist, I can tell you that many guys with PE don't even make it to penetration. They orgasm with any direct stimulation. And there's nothing worse than having your partner ask you to "wait"--and then coming anyway. If you have PE, you know all to well that the old "think about baseball" trick doesn't work. You can't control or delay ejaculation at, or shortly after, penetration--whether you want to or not.

A New Way of Thinking

Over the years, a number of different causes of PE have been suggested, including psychological problems like anxiety and guilt, bad masturbation habits, greater penile sensitivity, and lack of sexual experience. While there may be some truth to some of these theories, none of them appear to be the only reason a man develops PE.

Instead, exciting new research suggests that PE is like certain birth defects--it's a problem you're born with. Researchers have also uncovered links between PE and changes in the way our nervous system works. Specifically, changes in levels of two neurotransmitters (the chemical messengers your nervous system relies on to regulate various bodily functions) may be at least partly responsible for PE.

That may explain why one promising line of treatments may work. Selective serotonin reuptake inhibitor (SSRI) antidepressants help boost levels of the neurotransmitter serotonin, which can help delay ejaculation. Right now, you can ask your doctor for prescription of a low-dose SSRI like Paxil to help manage PE. A new SSRI called dapoxetine is currently being marketed for PE specifically. Unlike regular SSRIs, dapoxetine is short-acting, so you only take it "on demand" an hour or so before sex, similarly to Viagra. Recent studies suggest that men with PE who take dapoxetine last up to 4 times longer than those who don't. Although the drug isn't yet available in the U.S., results like these may help dapoxetine get another chance here soon.

Researchers have also developed an anesthetic spray that may have real benefits for PE. The spray, called PSD502 or TEMPE (Topical Eutectic Mixture for Premature Ejaculation), contains an aerosol version of lidocaine and prilocaine, two numbing compounds. When sprayed on the penis before intercourse, these compounds appear to increase the amount of time men with PE last from average of about 15 seconds to about 3 minutes. Like dapoxetine, TEMPE spray is currently not available in the United States, although its manufacturer plans to submit it for FDA approval soon.

Putting It All Together

Pharmaceutical approaches like these can help, but they won't cure PE. Just as there's no one treatment for PE, there are also no quick fixes. Instead, medication can slightly increase how long you last and boost your confidence so that you can focus on learning new skills to bring your partner to orgasm--and that's the real goal, after all.

Many of these skills involve giving her oral sex. (For details, see my book She Comes First.) I also recommend experimenting with "perpendicular sex positions" that emphasize the top of your penis rather than the sensitive underside. Combined with an SSRI, good communication with your partner, a positive attitude, and patience, these techniques can help you manage PE--and that's no joke.

If you want to learn more about my approach to sex as a PEer, as well as other insights into the condition, visit my website at and check out my new ebook, the Good in Bed Guide to Overcoming Premature Ejaculation.

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