Category Archives: delayed ejaculation

delayed ejaculation

How To Delay Ejaculation

How To Define “Premature”?

Several large scale studies have suggested that the most common male sexual dysfunction is premature ejaculation (otherwise known as PE). Unfortunately there is no consistent definition of the word “premature”, nor indeed is there any definiton of delayed ejaculation. (If you are seeking to recover the ability to ejaculate in a timely way during sex this book might help.)

And there’s another point here – we tend to think of a man who ejaculates quickly as being a poor lover… but what if quick ejaculation was normal in the human male? How would that affect our thinking? It would mean that to last longer in bed, to delay their climax, men must learn how to control their natural responses during sex.

Previous attempts to define just what is “premature” when it comes to the male orgasm have been based on the number of pelvic thrusts before ejaculation, or the time before ejaculation, or the level of satisfaction with sex of both the man and his partner. Not very helpful. Men want to know how long they “should” last during intercourse. Just what is the normal delay before male orgasm? How would anyone know? 

Video – Laci Green On 2 Minute Sex

We Don’t Know How Delayed Ejaculation Stacks Up

Startlingly, it has been shown that up to half of all men come too quickly for their liking, and this includes even those men in couples who are happily married or in long term relationships. But what may be even more astonishing to you is that up to 25% of young men’s first attempts at sexual intercourse result in ejaculation outside the vagina, before they’ve even penetrated their partner…..!

So let’s look at some expert opinions of what a good definition of premature might be. By doing so, we might be able to say what men need to do to fall into the category of average delay before ejaculation.

The fourth version of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-IV) defines premature ejaculation as a condition in which a man regularly experiences climax (i.e. orgasm and emission of semen) with only a little stimulation, before he wishes it to happen, which may be at the point of vaginal penetration or very shortly afterwards.

But this is meaningless if a man is with a new sexual partner or is sexually inexperienced: a rapid climax with ejaculation is the norm in such circumstances. It’s also meaningless if a man is on medication which is prompting him to come quickly.

Is Not Knowing How To Delay Climax Really A Problem?

Well, probably only when it’s causing a man or his partner lots of emotional stress or interpersonal difficulty, so their lives are adversely affected. And that’s more common than you might think – for although not knowing how to delay enough during intercourse may be a problem for men that seems trivial to you, it can be a major problem for some men and women.

The DSM-IV (a medical manual which defines every disease known to mankind) lists three other factors that might be important in a definition:

  • 1) rapid ejaculation can be either a life-long condition or it acquired after the onset of sexual maturity, perhaps even when a man has considerable sexual experience
  • 2) lack of delay may occur with all sexual partners, or might be specific to one partner, or for that matter, a set of circumstances
  • 3) and it may be psychologically caused – by one or many factors working together.

Obviously therefore, if we are to call the performance in bed of a man with little or no sexual experience “premature ejaculation”, this will be the most prevalent form of the condition.

Young men in this category have a strong sex drive and often ejaculate before they desire to do so. For men like this, lasting longer during sex may be mostly about getting more experience in bed.

Their “prematurity” is in part provoked by the emotional tension and arousal or anxiety which they may experience before and during intercourse.

Oddly, a very common contributing factor to PE is erectile dysfunction: there may be long periods of time between sex (due to the man not having an erection very often) so that the novelty and stimulation of the situation cause an over-rapid climax; the man will often lose his erection just as he ejaculates.

There are many other definitions of PE: one that we have mentioned elsewhere on this site is when ejaculation takes place with a delay of less than two minutes after penetration more than 50% of the times when a couple make love. Most men in this situation would want to last longer than two minutes before they came during sex.

Another very vague definition is that sex lasts for less than one hundred thrusts after penetration. And yet another centers on a man’s lack of voluntary control over his ejaculatory reflex.

Some clinicians have suggested that release (of semen during orgasm) is “premature” if it occurs before a man’s partner experiences a vaginal orgasm. As one critic responded, every man in the world would be considered a premature ejaculator if this was the case.

But maybe there is a glimmer of truth in that suggestion – the art of lasting long enough during intercourse to fully satisfy a female partner is not something most men even think about.  Pioneering sex therapists Masters and Johnson’s definition depended to a large extent on the level of satisfaction of the woman during sex.

They talked about delayed ejaculation as being something done by the man that meant a woman could not achieve orgasm in 50% of intercourse attempts. Well, as we know all very well, few women ever reach orgasm through intercourse, so this definition is highly questionable.

delayed ejaculation

Delayed Ejaculation

Bernard Apfelbaum has done a lot of research on sexual dysfunction in men.

He believes that some men who have trouble reaching their climax during partnered sex actually have an “autosexual orientation”.

In other words, they prefer masturbatory stimulation by their own hand rather than any kind of sex with a partner.

He says such men are not being selfish. Rather, he suggests, they may be over-concerned with pleasing their partners, because they focus too much on their partner’s pleasure at the expense of their own.

That means they are unaware of their own sexual pleasure or arousal and don’t “notice” or respond to the stimulation they are experiencing.

Apfelbaum called this “partner anorgasmia”, because the symptoms of delayed ejaculation only show up in the presence of a partner.

The difficulty that a man with delays in his ejaculation has in obtaining sexual satisfaction (or even sexual arousal) with his partner is hidden behind a hard and prolonged erection, but this physical sign of apparently high arousal is actually associated with low levels of sexual arousal.

Apfelbaum believes that such an erection is not really an expression of sexual desire and excitement, but an automatic mechanism which the man uses to fulfill his partner’s expectations.

He suggests men with delayed ejaculation (also called retarded ejaculation) may be driven by a desire to satisfy their partner rather than to obtain their own satisfaction or take care of their own sexual needs and desires.

They are in effect too conscientious, too controlled, and too aware of their responsibilities during sex – which they see as satisfying and pleasing their partner.

This, suggests Apfelbaum, makes the man unable to satisfy himself, and gives the man an aura of being unable to enjoy sex, which in turn makes his partner feel that she cannot do anything pleasing for him.

This idea has a lot to support it; a recent study seemed to show that men with delayed ejaculation have lower levels of sexual arousal than men with other sexual dysfunctions and men who come easily during sex.

An Interesting Way Of Looking At Delayed Ejaculation (DE)

The simplest and most common definition of delayed ejaculation is the inability to ejaculate during intercourse, or difficulty in doing so.

Delays in ejaculation may mean a man is slow to reach (or cannot reach) his point of no return.

In days gone by, the preferred treatment was to apply highly intense stimulation to a man’s penis before intercourse, at a level which was so intense it would (hopefully) make the man ejaculate.

This so-called treatment was based on the belief that once a man had overcome his inhibitions around ejaculation, and in particular once he’d managed to ejaculate inside the vagina, he’d be able to enjoy intercourse successfully in the future.

 A Problem Like DE Needs Radical Answers

When a man is slow to ejaculate, his erection – which is usually hard and long lasting – may not represent arousal at all. It may just represent an automatic response to sexual stimulation.

Often, men with DE do not particularly enjoy intercourse, and they may even regard it with some distaste, or perhaps as a “job” which has to be done because the man’s sexual partner expects it.

And it may even be the case that a man who has difficulty ejaculating is more aroused sexually by his own touch than by the touch of a partner.  

Another person’s touch – could it be a turn-off?

More importantly, some men may even be inhibited by the touch of another person. Even more oddly, a man with delayed ejaculation may find his penis to be more or less insensitive to stimulation when he’s involved in a sexual relationship with a woman.

According to Bernard Apfelbaum’s, delayed ejaculation can be seen as a sexual desire disorder, specific to the relationship with a particular sexual partner.

This is most clear during sexual intercourse, when the man’s sexual arousal is really low – and stays that way.

Degrees of Severity

At one end of the range are men who reach orgasm and ejaculate easily during self-pleasuring [masturbation], and for whom reaching orgasm is only challenging during intercourse.

The opposite end of the range is represented by the very few men who have never had an orgasm of any kind under any circumstances.

Treatment Of Ejaculation Difficulty?

Apfelbaum says treatment strategies have usually been directed only at the man’s inability to reach orgasm during intercourse, which cuts out men who cannot reach orgasm under any circumstances.

He says that part of the difficulty of both defining and treating DE is accounted for by the fact that there are in fact two separate syndromes which we call delayed ejaculation.

He observes that one type of delayed ejaculation involves a man who can reach orgasm easily and enjoys doing so during masturbation.

The other group, he suggests, is composed of men who cannot even reach orgasm during masturbation.

That leads us to a new definition – which seems to define the condition by a single factor: that only a man’s own touch is erotically arousing, and his orientation is basically “autosexual” i.e. masturbatory.

(By the way autosexuality is not an indication of homosexuality.)

Of course there are more defining factors: one is that a man will experience sexual intercourse as unpleasant or even disagreeable.

And here’s the thing: when a therapist starts from the presumption that all men will or “should” enjoy sexual intercourse, the whole course of treatment is defined too – often incorrectly. Start from a different place, and everything that follows is different too.

Can multiple female orgasms result from delayed ejaculation during long-lasting intercourse?

In general, one oddity of delayed ejaculation is that the partners of men with this dysfunction are indeed often multi-orgasmic.

They often respond with multiple orgasms to the sexual stimulation they are receiving during intercourse, despite the fact that these women may feel rejected and frustrated during intercourse.

This is often due to the fact that a man with this condition can sustain a hard erection which can give his partner a lot of physical stimulation.

And that’s true even when psychological or emotional stimulation is missing. In Bernard Apfelbaum’s words, he is the “workhorse” of sexual relationships. And he resents it.

Finally, Apfelbaum observes that many men with anorgasmia have a kind of compulsion to please their partner sexually, and that this compulsion creates both resentment and (sometimes) pleasure for the man as he unconsciously withholds his orgasm from his sexual partner.

But of course, you have to be careful here (especially if you’re a therapist), because saying that a man experiences sex as “a continuous demand for performance” is something you can never prove.

“Apfelbaum is not only a creative theorist in the field of sex therapy; he is an innovator in the practice of sex therapy.” From Principles and Practice of Sex Therapy (2nd Ed), S. R. Lieblum & L.A. Pervin (Eds), Guilford Press: NY, 1989.

delayed ejaculation, premature ejaculation

Premature and delayed ejaculation

How fast is premature ejaculation?

Alfred Kinsey discovered that three quarters of men ejaculated within 2 minutes of penetration in more than 50% of their sexual encounters with their partner.

However, Masters and Johnson came up with a definition of PE as an ejaculation that occurred before the woman had reached orgasm. You can see, superficially at least, that such a conclusion could be inferred from Alfred Kinsey’s findings about male sexual performance, but Masters and Johnson were certainly guilty of making the assumption that orgasm through intercourse would otherwise be a natural outcome of coitus for the majority, if not all, women.

The reality is that modern research demonstrates not much has changed since Kinsey’s days, despite a plethora of works on the Internet claiming that premature ejaculation affects only 20 to 30% of men. The prevalence of PE is much higher than this. For example, research by the University of Kohn in Germany demonstrated that the majority of men who describe themselves as having premature ejaculation lasted for an average time of 2 minutes and 30 seconds from the beginning of intercourse to the point of ejaculation, while those men who did not describe themselves as having premature ejaculation managed to last an average time of only 3 minutes.

There is absolutely no reason to doubt the accuracy of this research, and so premature ejaculation is actually the normal condition of the human male! Of course, that’s a statement which only becomes meaningful when a definition of premature ejaculation is supplied! From a functional point of view such as Masters and Johnson were adopting, it’s very tempting to relate male sexual performance to the achievement of female orgasm. If we resist that temptation, and instead look at levels of partner satisfaction, a good definition becomes easier to formulate.

We could move from Alfred Kinsey’s definition of premature ejaculation – that the man’s ejaculation happens within two minutes of the start of intercourse – to a more meaningful definition, something like this: that the man ejaculates before either he or his partner are fully sexually satisfied, leaving them wishing that intercourse could continue for longer.

This definition doesn’t relate the occurrence of premature ejaculation to the female orgasm, it simply relates it to partner satisfaction with the sexual interaction. Many women report that they find intercourse enjoyable mostly because of the deep emotional connection that they feel with their male partner, whether or not they achieve orgasm.

There is, of course, an element of physical pleasure as well from the stimulation of the vagina during sexual thrusting, and it’s not unreasonable to suggest that the longer this lasts, the more satisfaction a woman will experience during intercourse, regardless again of whether she orgasms or not. For the man, satisfaction is more likely to be around the issue of how he feels about his sexual performance; if he ejaculates quickly he’s likely to report feeling less masculine, less satisfied, and less confident around his sexuality and his ability to please women.

In conclusion, you can see how the components of a practical, working definition of premature ejaculation begin to evolve when you combine both works of Alfred Kinsey and Masters and Johnson.

Helen Singer Kaplan was a sex therapist in the 1970s and 80s, who in her own way was as much a pioneer in the treatment of premature ejaculation as Masters and Johnson were, back in the 50s and 60s. Her definition of premature ejaculation centered on the man’s ability to control when he came. In other words, she was defining the sexual dysfunction in terms of how much voluntary control the man had over his orgasm and ejaculation.

Men who ejaculated rapidly and uncontrollably, often with little warning that they were about to reach orgasm and ejaculate, could therefore be defined as premature ejaculators, or or at least as severely lacking in ejaculatory control, whilst men who exercised a greater degree of choice over the point at which they came during sexual activity, could be said to have greater staying power, and would not be classed as having PE.

Now on the face of it, this seems very sensible, because one of the things that’s immediately apparent to all therapists who are working in this field is that many men who come quickly (although not all of them) certainly lack any choice or control over the timing when they ejaculate. Many men say they are taken by surprise by their “release”; that it seems to come from nowhere, without any warning. From a treatment perspective, it’s important to keep in mind that the man’s degree of control, or perceived degree of control, over his ejaculation can influence the treatment strategies which one uses. For example, delayed ejaculation involves a quite different set of criteria.

Helen Singer Kaplan used the stop-start technique, which is described on this website. Essentially, the method was based on showing a man how to identify the sensations that preceded his orgasm (in terms of Masters and Johnson’s sexual response cycle, these were the sensations that indicated the man was about to make the transition from the arousal phase to the orgasm phase of his sexual response cycle; in biological terms the sensations represent the release of semen from the seminal vesicles into the posterior urethra, prior to its expulsion from the body moment of ejaculation; in layman terms, this is the “point of no return”, or “point of ejaculatory inevitability”). In addition, a man was shown how to gauge his own level of arousal on a scale between 0 and 10, where 10 represents the point at which he would inevitably ejaculate. With these two pieces of information at hand, a man could learn to extend his sexual longevity by interrupting his “dash to orgasm”.

He could practice during masturbation by stimulating himself until he reached a high level of arousal, near orgasm, but not at the point of emission. By interrupting the cycle of his sexual arousal, simply by stopping stimulation for a few seconds so that his arousal decreased, though his erection remained hard, he would then be able to take more stimulation before reaching “the point of no return” next time. In treatment, he was instructed to continue rhythmically stroking the shaft tip of his penis until he reached the point of no return again. By repeating this process three times ejaculating on the fourth time freely and quickly, he would discover that his capacity to take sexual stimulation without reaching the point of no return, the point ejaculatory inevitability would be significantly increased.

Definction of premature ejaculation – revisited

The first question is – who or what determines what “premature” or “rapid” actually means? More to the point, perhaps, is rapid ejaculation really a sexual dysfunction, or is it merely a lifestyle condition? Is it possible that it could simply be part of the normal range of human sexuality, and if so why should we bother to treat it?

Definitions all speak of the time between penetration and ejaculation; they all speak of voluntary control of ejaculation or the lack of it; and they all refer to the occurrence of distress or interpersonal disharmony because of it. There is actually another definition of PE produced by the World Health Organization (referred to as ICD–10) which defines premature ejaculation as an ejaculation which occurs within 15 seconds of intercourse beginning – this seems so short as to be practically useless.

Any doctor or therapist who sees a man with this condition has, de facto, to make three extra judgments, including: (1)  whether or not the condition has recently risen (acquired PE) or it’s been present for the whole of the man’s life (lifelong PE); (2) whether it occurs only in specific situations or in every sexual situation a man is involved with; and (3) whether it is the result of psychological factors alone, or psychological and physical factors together.

It turns out that when you apply these additional diagnostic criteria to the definition of PE, about two thirds of men have lifelong form the dysfunction, while only a third have the acquired type. (Acquired means that PE has developed later in life, whilst lifelong means that it has been present from his first sexual encounter.)

The complexity and difficulty of diagnosis and definition of premature ejaculation is demonstrated very clearly indeed by the fact that there have been reports that lifelong “sufferers” may benefit less from treatment in the long-term with SSRI type drugs than those who acquired the condition some time after their sexual career had started.  

As you can see, adding specifiers such as lifelong or acquired, and generalized versus situational, to the basic definition of premature ejaculation produces many more problems and increases the difficulty of objectively diagnosing and defining this dysfunction.

All of this difficulty in diagnosis and definition affects not only scientific researchers but doctors and therapists too. In many studies published in scientific journals, markedly different times between penetration and ejaculation have been used to define rapid ejaculation. It’s only recently that more objective data about IELT (intra-vaginal ejaculatory latency time, the time between penetration and ejaculation) has become available. This has revealed that the average duration of intercourse in what we may call “non-premature ejaculating” men is 7.3 minutes, while among men with the condition it’s just under 2 minutes. 

In certain cases, Helen Singer Kaplan’s definition of rapid ejaculation is appropriate, where the cause of the man’s rapid ejaculation is simply the fact he hasn’t learned the techniques necessary to establish voluntary control of orgasm and arousal. In other cases, a definition that specifies a certain time for intercourse is important in determining treatment, as in the case of a man who presented himself for treatment because his girlfriend was complaining that he hadn’t been able to give her an orgasm during intercourse (and that therefore he must have premature ejaculation). On investigation it transpired this man could easily last 20 minutes before he ejaculated with no difficulty, and it was hard to convince him that he did not require treatment for PE! He certainly did not match any standard definition of premature ejaculation. This is a not uncommon phenomenon where a woman whose own orgasmic difficulties prevent her from enjoying sex blames her man and his ejaculatory capacity.