Q & A: Premature Ejaculation?

pre ejaculationMark from the internet:

Hi! I have a problem when having sex. Even before we both start enjoying sex, I already cum.  We usually start with the 69  then go on to have sex.  She takes a bit long to orgasm. I really would like us both to enjoy sex. What can I do to postpone my ejaculation and make her climax earlier? PLEASE HELP!

Nessa’s response:

Hi Mark. Thank you for your question. Do you and your partner engage in any kind of foreplay? Because I noticed that you said “We usually start with the 69 then go on to have sex.” To me, that sounds like you are both stuck in a sexual routine.

First off, I applaud your desire to please her during sex. Since you said you ejaculate too early, it is obviously pleasing to you. But now you want her to enjoy it with you. I suggest changing your routine and regular methods, positions, locations – basically anything that is out of the ordinary for you. It’s not just about the orgasm for a woman. You have to take in many factors when being intimate with a woman. Begin by showering her with compliments about her body, how much you appreciate her, how you’ve thought about her all day, how you miss her smell. All these things build up an anticipation in both you and her. She will realize that it’s not just the sex that you want from her. Fuck in different places in the house. Get frisky in public (please don’t get arrested). Anything that can spice up your sex life.

Also remember that foreplay doesn’t necessarily mean the five minutes before you penetrate her. I like for Ryan to grab my ass in the middle of the store while I grope his dick. I smell his neck and kiss his ear during dinner. He squeezes my tits…well, pretty much whenever he can! And I love it! It shows me that he loves me, he’s turned on by me, and he’s ready to fuck me.

As for making her climax earlier, change your routine, as I suggested earlier. Change the actual physical contact (lick her feet and work your way up, or lick her everywhere except her tits and pussy). Use toys, massage her, build up her anticipation. Her mind is already thinking “we’re going to 69, then fuck.” Give her the unknown, the excitement of not knowing what you have planned for her.

I commend you for taking the steps in the right direction, which is to make sure she enjoys sex with you. Because if she’s bored or just not excited, she may find other ways to get excited.

Ryan’s response:

Honestly, I have never had a premature ejaculation issue.  Although I admit, Nessa will play around and give me a hard time every now and then if we experience my version of a “premature” ejaculation.  My version doesn’t happen in minutes though, it could be 30 minutes into sex and I will be grinding in and out of her body talking dirty, no orgasm feeling whatsoever.  Nessa will then give me that ‘oh god, you are doing it so perfect‘ face and quietly whisper or loudly scream, “Keep going, I’m getting that cum feeling.”   I immediately feel my body wanting to orgasm from that point forward.  Remember, this is after having sex for 30 minutes with no orgasm feeling at all.  I mean, I feel like a workhorse that can literally fuck her all night, no breaks.   If she catches me on the wrong night with, “Oh god, you are going to make me cum,” I can go from 0 to 100  in just a few seconds.   In my opinion, this is just pure excitement and anticipation.  If I know she loves it, I love it more.  If I know she feels like she is going to cum, I will also feel like I am going to cum.  Whether we are in sync or my brain overreacts to the idea of her cumming because of my dick, I can immediately get that feeling when she tells me she feels “it.”

However, there have been times when I release first.  If this happens, I will offer to go down on her afterwards or offer to let her use her toy/vibrator.  I am multi orgasmic so even if I cum once, I can go again.   Most of the time though, she reaches climax before I even start, and we do this on purpose.  I will use her vibrator or our hands during very light intercourse, to stimulate her clit.   I won’t get worked up or fuck her hard, just a real nice slow fuck while we play with her sensual spots  and get her off.  What I mean by that is, I will move slow and let her feel the sensation of my erect penis being inside her vagina or ass, whether I am sitting up or laying off to the side of her.  I will slowly dig deep inside her and grind while we stimulate her clit.  She will usually orgasm quickly with direct clit stimulation, and as she cums, she will pull me in and beg to be fucked hard.  This is when I start.  The positions change, the speed change, the shit talk starts.    Sometimes Nessa will cum again, but it isn’t on my mind.   It’s open season.

With that being said, Nessa has also told me that she is equally as satisfied feeling me cum inside her as she is when she cums herself.  Whether it be a mental thing or not, she has taught herself to enjoy feeling and seeing me at my most vulnerable moment.  She loves it.  I’ve noticed lately she will even talk me through everything she is feeling during sex:  like how it feels when my penis head rubs her walls, how she can feel the texture of the veins on my dick rubbing through her lips, and the way my balls feel slapping against her ass (warm, cold, full, heavy),  everything.  Just last night she told me she felt my penis pushing very hard against the back walls of her vagina, and as I came, she could actually feel the sperm push out of my urethra hole and grind against her back wall and my penis head.  In fact, she moaned, “Oh god, I can feel it coming out of you.”  This idea and feeling made her orgasm.   Not only that, she laid there after I was done and said she couldn’t stop her vagina from twitching.

How does that help you?  It doesn’t really.  I got carried away.

Quick ideas:  You may try numbing cream to help you desensitize your penis so it doesn’t feel “so” good it immediately makes you cum.  You can try wearing a thick condom which has been known to take a lot of the feeling away.  You can try thinking about something other than sex, like playing a round of golf in your head or saying the alphabet backwards.   You can masturbate prior to having sex.  This can naturally help you last longer even if you do not have a premature ejaculation issue.

As far as helping her enjoy sex more?  It’s a mental issue.  If she is open minded she can find a lot of reasons to love and enjoy sex.  If she sees sex as something she does at night to make you happy, and every now and then she can orgasm too, it may not be such an easy task.  Not only that, you have to find out what makes her tick.  Talk to her and find out what she likes, what turns her on, what she enjoys the most about your foreplay.  Although above was more of my own personal story, there is a lot of things you can snatch out of that story and try for yourself.

Wiki’s response:

When deciding the appropriate treatment, it is important for physician to distinguish PE as a “complaint” versus PE as a “syndrome”.  About 20 years ago, PE was classified into “lifelong PE” and “acquired PE”. Recently, a new classification of PE was proposed based on controlled clinical and epidemiological stopwatch studies, and it included 2 other PE syndromes: “natural variable PE” and “premature-like ejaculatory dysfunction”. Only individuals with lifelong PE with IELT <1 to 1.5 minutes should require medication as a first option, along with or without therapy. For those who fall into one of the other categories, treatment should consist of patient reassurance, behavior therapy, and/or psychoeducation to explain irregular early ejaculation is a normal variation.

Dapoxetine (Priligy) is a short-acting selective serotonin reuptake inhibitor (SSRI) marketed for the treatment of premature ejaculation. Dapoxetine is the only drug with regulatory approval for such an indication. Currently, it is approved in several European countries, including Finland, Sweden, Portugal, Austria and Germany. Dapoxetine is currently waiting for U.S. Food and Drug Administration (FDA) approval after concluding the Phase III study, which included participants from 25 other countries, including the United States. In this diverse population, dapoxetine significantly improved all aspects of PE and was generally well tolerated.

Tramadol (Ultram or Tramal) is an FDA approved atypical oral analgesic for mild pain. It is atypical because it is similar to an opioid, is an agonist at the mu receptor, but also is similar to an anti-depressant in that it increases levels of serotonin and norepinephrine.  Tramadol also has few side effects, low abuse potential, and increases (IELT) 4-20 fold in greater than 90% of men.

Clomipramine (Anafranil) is sometimes prescribed to treat PE. One side effect of the drug can help delay ejaculatory response. The side effect is described by the Mayo Clinic as “Increased [sic] sexual ability, desire, drive, or performance.”

Desensitizing topical medications that are applied to the tip and shaft of the penis can also be used to treat premature ejaculation. These topical medications are applied on an “as needed” basis 10-15 minutes before anticipated sexual activity and have fewer potential systemic side effects as compared to pills taken orally. However, use of these topical medications have in the past been associated with loss of penile sensation, and reduction of sensation for the partner due to exposure.  Penis insensitivity and transference to the partner are greatly reduced when using new topical anesthetic sprays based on absorption technology which enable the active ingredient to penetrate through the through the surface skin of the penis(ie stratum corneum) to the sensory nerves which reside in the dermis. Any residual surface medication can be wiped off before sexual activity to further reduce partner concerns.

Another method, intracavernous pharmacotherapy, involves injecting a vasodilator drug directly into the penis to help men control premature ejaculation and maintain their erection. It has been proven to be effective in over seventy percent of test patients.[citation needed] This method is used by companies such as Florida Men’s Medical Clinic, Boston Medical Group and others.

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