How can we make sex last longer?

By Ian Kerner, Ph.D., LMFT

Question: My boyfriend always comes so fast. How can I make sex last longer?

P.E. (premature ejaculation) is a topic I'm passionate about. No only is it the most common type of sexual problem a man can have, (with many experts estimating that up to 30% of all men suffer from it), it's also one I've struggled with personally. In fact, my struggles with PE led me to write my bestselling book "She Comes First."

Most guys can actually only maintain intercourse for an average of about two to five minutes before ejaculating, but for men with PE, 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 as a guy, there's nothing worse than having your partner ask you to wait, and then come anyway. 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).

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, new research suggests that PE is like certain birth defects: it's a problem you're born with.

Researchers have also uncovered links between P.E. 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 certain medications can help. Selective serotonin reuptake inhibitor (SSRI) antidepressants help boost levels of the neurotransmitter serotonin, which can help delay ejaculation. So your boyfriend could ask his doctor for a prescription of a low-dose SSRI like Paxil to help manage PE.

But while pharmaceutical approaches like these can help, they won't cure PE. Just as there's no one treatment for it, there are also no quick fixes. What medication can do is slightly increase how long your guy lasts and help him boost his confidence so that he can focus on learning new skills to bring you to orgasm, which is the real goal, after all.

Many women don't understand PE and often think that men with the condition are sexually selfish. In fact, this couldn't be further from the truth. Men with PE care greatly about their partners' sexual satisfaction; they need to be able explain the issue without shame and develop alternative paths to pleasure with their partners. They're not trigger-happy, they're trigger-unhappy.

My number one suggestion: Use pathways to pleasure outside of intercourse. Help take the pressure off of his penis, and encourage him to use oral sex to provide you with lots of direct clitoral stimulation. Most women don't orgasm consistently from intercourse alone anyway, so focusing on "outercourse" and extending foreplay into a complete act of love-making is the best way for you both to enjoy sex.

That's not to say you can't enjoy intercourse. Let your guy know when you're close to the point of coming, and then transition into a position like "woman on top" where you can still maintain a lot of direct clitoral stimulation. Even if he ejaculates prior to your orgasm, it will still take a couple of minutes for him to fully lose his erection and, in that window, you have a high likelihood of being able to reach orgasm.

Also, in my book, "Overcoming Premature Ejaculation," I outline a series of "perpendicular sex positions" that emphasize the top-side of the penis, rather than the sensitive underside.

While PE is not curable, it is manageable. And with an attentive partner, your sex life can be very enjoyable!

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