Dr Phil: Premature ejaculation

Do men who suffer from premature ejaculation turn up early to their appointments?

Dr Phil Yes, a feeling of time pressure is often at the heart of the matter.

Do you need a stopwatch to diagnose premature ejaculation?

No. Someone on the sidelines shouting 'ready, steady, cock' and waving a time-piece is only likely to make it worse. Of course it's happened, because doctors are anal about measuring things for research purposes only. This is because when you ask men about their performance, they may deliberately lie or just not be aware of the time. Even so, the famous Hite Report on Male Sexuality (1981) found that most of us lift off fairly quickly. Of the 11,239 men aged 13 to 97, 62% said they came within five minutes of penetration, 21% didn't last a minute and one lost his dentures. 7% claimed they did not ejaculate before 15 minutes, but that probably included a 10-minute kip in the middle.

In a recent stopwatch multinational study of a random heterosexual population the most common intravaginal ejaculation latency time (IELT) was 5.4 minutes. Or as the O'Jays famously put it, when people all over the world join glands and start a love train, it usually doesn't last much longer than this song. The researchers proposed that coming within a minute of penetration was definite premature ejaculation.

But it's not that simple. If you're happy with just a minute, and your partner is too, then you have absolutely nothing to worry about. You'd be surprised how many people want to get it over fairly quickly so they can turn on Radio 4. Especially if you're bending over in the bushes on Bushey Heath. So, to recap, you've got a touch of the PEs if you usually come before you want to, you can't delay it by thinking of the day your dog died, and you lie awake bothering about it afterwards, stop enjoying sex or stop sex altogether.

Premature ejaculation only matters if your partner would like you to stay a little bit longer. So what matters is whether your partner is satisfied, and a surprising number of women (and men) are quite happy for it to be over quickly.

How hard should you squeeze to stop premature ejaculation?

Woah. Hang on. There are a few things to work through before we get onto the squeezing bit. Getting it out in the open is a good start, but many couples don't talk much before, during or in-between sex. They don't look each other in the eye to spot the anguish. If one tries to talk, the other rolls over and turns on Radio 4. So the problem may only fully surface when you split up. As Loudon Wainwright III once put it:

'We used to be in love
But now we are in hate
You used to say I came too early
But it was you who came too late.'

Note: Loudon Wainwright (father of Rufus and Martha) is a star, not least for his honesty and humour in articulating a man's lot. I once followed him into a toilet in Edinburgh and said as we peed together 'Loudon, you're my hero'. He said 'Steady, boy'. But I got his autograph.

If you always come quickly, and always have done with all partners, and you see a doctor who's on the case, you're likely to be offered a drug called an SSRI. If you have lots of sex, you may decide to take one every day, or just take one 6 hours before you need it (not always easy to plan). In one study, they helped men hang on nearly nine times longer, but three to four times would seem to be the average. SSRIs can have side effects (fatigue, yawning, mild nausea, looses stools, perspiration, agitation, diminished libido and erectile dysfunction). For some men, they're a life changer, others can't take them.

Alternatively, you can buy a local anaesthetic spray (subtly called Premjact. Just the thing in a busy Boots). This gets sprayed on the head of your penis 10 minutes before sex and takes away a bit of sensation. If you cover it with a condom too, you'll lose a little bit more friction and the anaesthetic spray won't rub off on your partner. Alternatively, buy a condom with anaesthetic already in it. Durex Performa is one, although may end up uncomfortably numb.

If you've only recently started coming quickly with a new partner, or if you don't fancy taking any drugs, then you can have a lot of fun learning to hold on, provided (as with all sex) you keep a sense of humour and perspective.

Things you can do for yourself include masturbating before sex (only really works below a certain age), wear a condom (easier to put on with three hands), make shorter thrusts or circular motions, have a break, take it out quickly and squeeze the head, go fishing for the condom, remember to hold onto the base of the condom when withdrawing next time, put on a new condom, pop it back in, name the 1966 world cup winning team (preferably not out loud), laugh, take a deep breath and clench your buttocks repeatedly near climax. Go again as soon as you're up to it.

The anus tightening exercise is good for men (to hold on longer) and women (to keep their pelvic floor intact). If you're competitive, you can have a clench off in the queue at Tesco (tip: make sure you've mastered the neutral clench-face first). A hundred clenches a minute is a fantastic score (and the same rate you pump a heart after a cardiac arrest).

Other things you can do together include talking, listening, laughing, looking at each other. foreplay, more foreplay for her and afterplay if required. The squeeze technique is much more fun together, provided it isn't done too hard. Just as some men try to find the G spot by turning their hand into a human egg whisk and hoping for the best, many women 'stroke' a man as if they were de-rooting a tree in double-time. Handle each other's parts with care. Start slow and gentle, and use eye contact and consent to change the pace.

The squeeze technique: chat, kiss, cuddle, hand-stroke the penis, feel the pleasure but give the stop sign before you come. Gesturing with a down-turned palm is a good sign. Or shouting Nobby Stiles. Quickly but gently squeeze just below the head of the penis for twenty seconds. Chat, laugh, do fifty anal clenches, remember Jimmy Greaves or relax for 30 seconds. Start again. Repeat three times and then come. If you come sooner, who cares? Next time, try it with some lubricant or a soft fruit to simulate the vagina. When you've built up a bit of stamina, have sex with your partner on top (or underneath if you'd prefer) and use the same stop start signals.

The good news is that nearly all couples find this method helps, the bad news is that it takes a lot of patience and you need to persevere several times a week for several months. Not really something for a one night stand. In the longer term, the mere fact that you're concentrating on each other's pleasure and looking at each other will do more for your sex life than an extra minute staring at a pillow.

Dr Phil Hammond is a medical doctor, comedian and commentator on health issues. http://drphilhammond.com

Written by: Dr Phil Hammond
Edited by: Dr Phil Hammond
Last updated: Friday, August 13th 2010

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Comments on this article

Posted by Optional on 06/01/2012 at 06:53

i have mastrubated a lot. Now I am having problems with premature ejaculation and there is no pressure when I urinate, meaning I have drops of urine after I am finished peeing. I am under thirty. Can you give me advice and treatment to correct these problems?

Posted by Optional on 05/02/2011 at 08:37

I have mastrubated a lot. Now I am having problems with premature ejaculation and there is no pressure when I urinate, meaning I have drops of urine after I am finished peeing. I am under thirty. Can you give me advice and treatment to correct these problems?

Posted by hopeless on 19/09/2010 at 02:33

struggled all my life with PE now have ended up with ED have felt useless all my life.can you help?