Saturday, May 29, 2010

Michael Castleman - Premature Ejaculation: The Two Causes of Men's #1 Sex Problem

Michael Castleman blogs for Psychology Today at All about Sex. In this post he reveals that PE is much more common than ED, but gets no press. He also suggests that the two biggest causes of PE are youth (kids are so damn excitable - but it often becomes a conditioned reflex) and pornography.

Premature Ejaculation: The Two Causes of Men's #1 Sex Problem

Premature ejaculation is men's most prevalent sex problem.

Ever since Viagra's 1998 approval, erectile dysfunction (ED) has dominated media coverage of men's sex problems. But ED is actually less prevalent than rapid, involuntary "premature" ejaculation (PE).

University of Chicago researchers have conducted the most widely cited research into American sex problems. Their two studies (cited at the end) are based on a representative sample of 2,865 men, 18 to 85. They show that from 18 to 59, PE is much more prevalent than ED, and that among men 60 and older, one-quarter of men continue to experience it. As a result, sexologists consider PE men's #1 sex problem. The numbers:

Erection problems*
(% reporting any during previous year)
18-29: 7
30-39: 9
40-49: 11
50-59: 18
57-64: 31
65-74: 45
75-85: 43

Premature Ejaculation*
(same criterion)
18-29: 30
30-39: 32
40-49: 28
50-59: 31
57-64: 30
65-74: 28
75-85: 22

(*One study tracked ages 18-59, the other, 57 to 85)

PE has a convoluted history. The 4th century Kama Sutra chided PE sufferers for frustrating women. However, during the Victorian era in England and America, women were not considered sexual, but merely passive receptacles for men's lust. Because women's pleasure was not an issue, neither was PE. In fact, Darwinians considered rapid ejaculation a sign of virility. Those men, they argued, were more likely to father children and pass their genes, including presumably those for PE, to future generations.

However, by the 20th century, PE was again problematic. Psychoanalytic theory blamed it on neurotic ambivalence toward women. But during the 1960s, Masters and Johnson conclusively showed that a simple self-help program could teach more than 90 percent of men to last as long as they wanted within a few months. Their success launched contemporary sex therapy.

PE has two major causes: youth and pornography. Young men have very excitable nervous systems. They're primed to ejaculate and don't even need sex to do it (wet dreams). In addition, in our culture, men are supposed to orchestrate sex, but few young men know much about lovemaking. This causes anxiety, which makes the nervous system more excitable and more prone to PE, which often becomes a conditioned reflex that can last a lifetime.

Meanwhile, pornography has become the leading sex educator of men. Internet porn is available for free 24-7. In a previous blog, I argued that porn does not cause rape (read more). But porn causes sexual harm. It teaches sex all wrong, deluding men about what good sex is. No wonder so many women complain that men are erotically clueless. Here's the deal, guys: Porn is almost entirely genital. Boy meets girl, and faster than dropping a zipper, they're deep into oral sex and intercourse. Porn-style all-genital sex puts tremendous pressure on the penis, which reacts by ejaculating quickly. Porn-style sex cements PE.

Fortunately, in just a few months, the vast majority of men can break the PE habit and learn to last as long as they'd like. The cure combines deep breathing and relaxation with doing the opposite of what you see in porn, namely embracing leisurely, playful, massage-based, whole-body sensuality that spreads erotic arousal from just the penis to every square inch of the body, taking pressure off the penis.

Many surveys show that women prefer lovemaking based on leisurely, playful, whole-body sensuality. Of course, this lovemaking style includes the genitals, but unlike porn, is not fixated on them. Men who embrace the self-help PE cure gain not only ejaculatory control, but also happier lovers. Ironically, women become happier not just because the man lasts longer--only 25 percent of women are consistently orgasmic during intercourse no matter how long it lasts (read more)--but because the program that cures PE teaches men to make love the way women prefer, with the emphasis on whole-body sensually.

Anyone interested in the self-help cure for PE can visit my site,, and read the article on the self-help cure for premature ejaculation.

Studies cited:
Laumann, E.O. et al. "Sexual Dysfunction in the United States: Prevalence and Predictors (Age 18-59)," Journal of the American Medical Association (1999) 281:537.

Laumann, E.O. et al. "Sexual Dysfunction Among Older Adults: Prevalence and Risk Factors from a Nationally Representative U.S. Probability Sample of Men and Women 57-85 Years of Age," Journal of Sexual Medicine (2008) 5:2300.

His "cure" for PE costs $1.99 for a PDF download - payed through PayPal.

My opinion is the changing the focus from intercourse to intimacy - emotional and physical - goes a long way toward improving the love-making experience for both partners, whether PE is an issue or not. Just being naked together, enjoying each other's sensuality, scent, appearance, taste, and so can be very rewarding, no intercourse required. My guess is that this is part of most PE treatments these days - a form of desensitization to reduce arousal and/or anxiety. My guess also is that most women would love this experience, especially if intercourse isn't on the agenda.

OK, that said, here is WebMD's solution for PE.
Faced with premature ejaculation, most men try to distract themselves during intercourse, believing that by thinking about other things, they can trick themselves into lasting longer. Usually, that only makes things worse.

Don't tune out your body. TUNE INTO IT. You need to become more familiar with your different levels of sexual arousal. You also need to recognize how you feel as you approach your point of ejaculatory inevitability, the "point of no return." Once you recognize how you feel close to your point of no return, it's not difficult to make small sexual adjustments that allow you to remain highly aroused without ejaculating.

Sexual arousal is a four-phase process. In the Excitement Phase, breathing deepens and erection begins. In the Plateau Stage, erection becomes full and you feel highly aroused. When arousal builds to a certain point, the next phase occurs, Orgasm with Ejaculation. Then during the Resolution Phase, breathing returns to normal and erection subsides. The key to ejaculatory control is to extend the Plateau Phase, to maintain arousal without triggering Orgasm and Ejaculation.

To learn ejaculatory control:
  • Don't use drugs or alcohol. They're distracting and they interfere with the self-awareness crucial to learning ejaculatory control.
  • Appreciate whole-body sensuality. Men often think sex happens only in the penis and only during intercourse. That view is a one-way ticket to premature ejaculation (not to mention erection problems, and women with those proverbial headaches). The best sex involves head-to-toe arousal. Men learning how to approach -- but not arrive at -- their point of no return, need to appreciate whole-body sensuality, the pleasure potential in every square inch of the body. Whole-body sensuality releases tension. Tense bodies that have no other outlet often find release through involuntary ejaculation. But as you learn to appreciate sensual pleasure from head to toe, whole-body arousal takes the pressure off your penis, and you last longer.
  • Whole-body sensuality means relaxation, but the "relaxation" involved in great sex is not the kind that includes an easy chair, a six pack, and Monday Night Football. It's the kind you feel after a hot bath or a good massage. In fact, bathing or showering together before lovemaking can help men relax and appreciate whole-body sensuality -- and last longer.
  • Breathe deeply. One very easy way to stay relaxed while making love is to breathe deeply. The body has a natural tendency to breathe deeply during sex. But many men fight it. They think they should stay in control by not breathing deeply and making the little love-moan sounds that go along with it. But when men work to control their breathing, they often sacrifice ejaculatory control. Try breathing deeply. Let your breath go. Many men are amazed how much this one little change improves their premature ejaculation.
  • Start with masturbation with a dry hand. By varying how you caress your penis, you can learn to stay highly aroused for quite a while without coming. When you feel yourself approaching your point of no return, simply back off a bit, stroke yourself more gently or not at all, and stay aroused without ejaculating. Then as you feel yourself getting a little distance from your point of no return, return to more vigorous self-stimulation. Repeat this several times over several sessions. Approach your point of no return, then back off. For most men, it doesn't take long to develop good ejaculatory control while alone.
    Then move on to masturbation with a lubricated hand. Use saliva, vegetable oil, or a commercial sexual lubricant. For most people, lubricants increase the sensual intensity of erotic fondling. Follow the same program: Masturbate until you approach your point of no return, then back off. Repeat this several times over several sessions.
  • Once you have good control during masturbation, and appreciate whole-body sensuality, and feel comfortable breathing deeply during lovemaking, then you're ready for the couples program -- if you're in a couple. The couple approach is called the "Stop-Start Technique." First, arrange "stop" and "start" signals with your lover, for example, a light pinch or tap, or a tug on an ear.
    Then, your lover strokes your penis by hand as you lie still. When you approach your point of no return, give the "stop" signal. Your lover immediately stops stroking you and simply holds your penis gently, as you continue to breathe deeply and pays close attention to the sensations you're feeling. When you no longer feels close to ejaculation, gives the "start" signal, and your lover begins stroking you again. How many stops and starts should you do? A half-dozen over a 15-minute period works well for most couples. Do what feels comfortable for you.

    With stop-start, the focus is on the man. He's the one learning the new skill. But don't forget the woman's sensual needs. As part of each practice session, she might guide your hand over her to show you what she likes.

    Once you've gained good ejaculatory control with your lover's hand, try the same stop-start procedure with oral caresses. Again, you begin by lying still.

    Once you've gained good control orally, feel free to start moving. You're making love again -- but now you have ejaculatory control. Congratulations.

Here are some other suggestions for lasting longer:

  • The man-on-top (missionary) position can be fun, but it's harder for most men to control their ejaculatory timing, because they have to hold themselves up. Try making love with the woman on top. This position is more relaxing for men, and it often helps ejaculatory control.
  • Make some noise. Love moans help men (and women) relax, and they often help men last longer.
  • It's important to understand that learning ejaculatory control takes time and practice. You may feel a little awkward along the way. Try to maintain a sense of humor about any accidental spills.
  • Some penile skin creams advertise that they help a man last longer. These products contain topical anesthetics that dull sensation in the penis. If you like to play with penile sensation, there's no harm in using them. But they're not a good idea for learning to last longer. They dull sensation. But the key to lasting longer is for the man to become more familiar with what he feels so he can back off from his point of no return while still remaining highly aroused.
  • Finally, the program we recommend for learning ejaculatory control is very likely to provide your lover with greater sexual enjoyment -- but not just because you last longer. Women generally prefer leisurely, playful, whole-body, massage-oriented sensuality that includes the genitals but is not limited to them. Women's main complaints about men's sexual style are that it's too rushed, too mechanical, too eager for intercourse, and that it focuses only on the breasts and genitals. Women generally feel that the whole body is a sensual playground and can't understand why so many men explore only a few corners of it. Like women, penises generally prefer leisurely, playful, whole-body, massage-oriented lovemaking. The rushed, penis-centered, intercourse-fixated sex style puts a lot of pressure on the penis, and leads to premature ejaculation. But when men make love the way women prefer, whole-body arousal takes the pressure off your penis and you last longer. Basically, if men would make love the way women prefer, women would have fewer complaints, and men would have fewer sex problems.

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Eivind F S said...

It's great that you bring up the issue of PE, William, and ways to resolve it. The issue with pornography teaching men sex in ways that are all wrong is a concern of mine too. The heart disconnect is almost complete and the goal is ejaculation. I am concerned that it turns boys into premature ejaculators who can't feel their bodies and can't connect intimately with their partner.

I saw an interesting documentary about the porn industry and the dangers of consuming porn some time back. I even posted about it on my blog (

Great site you have here, William.


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Sexual health is a state of physical, emotional, mental and social well being related to sexuality; it is not merely the absence of disease, dysfunction or infirmity.

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