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.