Trigger unhappy: the truth about PE

By Ian Kerner, Ph.D., LMFT

If you've read my best-selling book, She Comes First, you'll know that I'm passionate about the topic of PE (premature ejaculation).

That's because PE is the most common type of sexual dysfunction a man can have, with many experts estimating that up to 30 percent of all men suffer from it.

But to say that it's tough to talk about PE is an understatement. Most guys don't want to admit they've got any kind of sexual problem, especially one as sensitive as PE. It doesn't help that stereotypes about PE tend to label it as a problem limited to overly excited teenagers or selfish jerks.

The truth is that PE can happen to anyone. It doesn't matter how old you are, how much experience you have or how much you know about sex. Trust me when I say I know this all too well: I've grappled with PE myself.

Do you suffer from PE?

1. Are you unable to control how long you last during sex?

2. Do you peak within a minute or less of starting or even during foreplay?

3. Have you tried various methods to help with your PE, only to have your hopes dashed?

4. Do you avoid intimate situations because of PE and think, "Why even bother?

5. Do the words "stop-start" and "squeeze" make you want to scream?

6. Do you need help with your PE?

If you answered "yes" to these questions, you could have chronic PE, and you're not alone.

But most men with PE are living lives of quiet desperation, and have been told by experts over and over again they could solve their problem with two simple techniques: "stop-start" and "squeeze." But this couldn't be further from the truth. Most of these "experts" haven't lived through the agony of PE, and if they have, then they know they're lying when they recommend just a few simple steps to cure PE. 

I've dedicated my life to better understanding PE and helping guys deal with it, and here are five things about PE I know to be true:

1. The vast majority of men who suffer from PE suffer from it chronically. They've never known any other way, and it doesn't get better with age. In fact, it often gets worse. It's not uncommon for an older guy to grapple with PE and erectile disorder (ED).

2. Poor masturbation habits have nothing to do with PE. I used to buy into that line of thought, too, the idea that guys with PE masturbated too quickly and trained their bodies to ejaculate easily, but studies show that guys with PE don't do anything differently than guys without PE when it comes to masturbation, and their penile sensitivity is about the same.

3. Not only do techniques like "stop/start" not help, they often make things worse. Think about it: As a guy with PE, what do you mainly want to accomplish? To last longer? Sure. But why? To pleasure a woman and help her achieve orgasm. For a woman to have an orgasm, she needs to be able to relax and disconnect and let go. Studies have shown that parts of the female brain associated with stress and anxiety actually need to deactivate during sex. If she's worried that you're going to say "stop" in 15 seconds, there's no way she's going to have an orgasm.

4. PE is not curable, it's manageable. Men with PE have a brain chemistry that predisposes them to PE. In that sense, PE is a genetic condition. Just like there are genetic birth defects, PE may be a genetic sex defect. I personally found that taking a low dosage of an SSRI antidepressant such as Paxil helped significantly, because SSRIs have the side effect of delaying ejaculation. They also have other side effects, but in my case the benefit of being able to last longer far outweighed any negatives. I didn't stay on the meds forever, and while I did find that when I went off them it was harder to last longer, my time on an SSRI did give me the chance to develop some confidence and learn some new sex skills.

5. These sex skills largely focus on oral sex, as discussed in my book "She Comes First," and what I call "perpendicular sex positions," which involve making love with an emphasis on the top side of the penis as opposed to the sensitive underside.

If you want to learn more about my approach to sex for guys with PE, as well as other insights into the condition check out my e-book, the Good in Bed Guide to Overcoming Premature Ejaculation.

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