Premature Ejaculation and Erectile Dysfunction

Medical Perspective:

Almost every friend of mine has told me about at least one sexual experience that was unsatisfactory because they/their partner came too quick; and I always thought I had a couple experiences like that myself. So imagine my surprise when I looked up 'Premature Ejaculation' and found out that only 2-5% of men actually experience this as a physiological anomaly! According to recent scientific data, although it is a common male sexual disorder, very few men have 'definite premature ejaculation', that is, ejaculation within 1 minute of vaginal penetration. Many agree, though, that even those who ejaculate in under 2 minutes do have a serious biological problem.

A number of claims have been made regarding the reason for this. Because I am not an expert in the field, I'll tell you about the most popular one: Serotonin inactivity. Studies have shown that serotonin (the neurotransmitter that helps in the communication of sex and appetite-related information) is less active in the part of the brain concerned with erection formation in people with biologically-determined Erectile Dysfunction and Premature Ejaculation. This is the reason why anti-depressants, specifically, SSRI's (Selective serotonin re-uptake inhibitors), seem to help those with the condition.

Another reason for the presence of Erectile Dysfunction in men is cardiovascular disease. The arteries in the penis are one-fourth the diameter of those in the heart, and so, when diabetes or cardiovascular disease cause the arteries to constrict, the symptoms show up much earlier around the penis than the heart. Some doctors even say that every case of erectile dysfunction should be considered a case of cardiovascular disease or diabetes until proven otherwise. So, if you think you have any of these conditions, it is good to go to the doctor first.

The only thing we don't have a god for is premature ejaculation... but I hear that it's coming quickly.

Mel Brooks

Psychological Perspective:

It seems that it's not just women who think a problem exists when it does not; even men, between 20 and 30%, believe that they ejaculate prematurely. This is the issue I'm here to address.

Even doctors and researchers working on the problem believe that premature ejaculation (PE) and erectile dysfunction (ED) almost always come with significant psychological burdens. Some of the most common of these burdens are:

1. They believe they can't satisfy their partner because they always come first.
2. Extreme stress messes with most things in life, but especially things that require a strong mind-body connection like sexual desire.
3. Anxiety around performance
4. Depression
5. Relationship disequilibrium
6. Losing confidence because they think they're small (know more about it here)

While some of these can't be helped, many can. Let's begin with the idea that men who come first are leaving their partners dissatisfied. There are two things to remember here:

One, women's bodies are complicated and highly individualized. Some women can't achieve orgasm through penetration, even if it goes on for hours! It's important to converse with your partner about what actually makes them come before such assumptions are made.

And two, for most women, sex is not governed by orgasms. Women don't need an orgasm to have fun in bed. It is fun when it happens, of course. But what's more important for most women is that their partners care about satisfying them and make an effort to do so. All you need to do is try other methods to satisfy her, and once you see that she can be pleasured by you, you'll automatically let go of this kind of performance anxiety.

So my wife said she read this article in a magazine and she said: "You know, maybe you're suffering from premature ejaculation." I said, "Yeah, does it look like I'm suffering? Those aren't tears on your belly!"

Robert Schimmel

Performance anxiety can also arise from insecurities about one's fitness levels and body image. If your body makes you feel undesirable, start using it! It's not necessary for you to look like a model to feel sexy. There is ample evidence to suggest that simply using your body regularly, for any kind of physical activity, can help you connect better with it, and feel better about it.

Exercise, therapy, and productive venting can also help with extreme stress. If the source of the stress is clear, like work or children, it might also be good to get away from it and rejuvenate.

Finally, relationship problems that are kept hidden or repressed can also cause sexual dysfunction. If you know something is bothering you about your partner's behavior, tell them! If it causes a fight, so be it. Fights are stressful, but we are biologically programmed to deal with short lived stress much better than long drawn stress. The relationship is much more likely to recover after a heated argument than it is if years of repressed feelings show up in consistent passive-aggressive responses. Also, there's a reason why break-up sex and make-up sex are so great - they allow you to vent!

Instantly Gratifying Tools:

Now, while you may have heard of them already, some short-term, instant-benefit tools to help you quick are:

“Worry is to human beings … what a condom is to a man with erectile dysfunction.” 

Mokokoma Mokhonoana

1. SSRI's - as mentioned earlier, these drugs allow serotonin to remain in your brain for longer and can increase the duration of sustained erections by a few minutes.
2. Sildenafil - More popularly known as Viagra, this drug is used to treat ED and hypertension, so it actually plays on the blood flow in your body rather than your brain.
3. The pause-and-squeeze technique is one where you squeeze the top of the penis, where the head and shaft meet, for a few seconds when you feel like you are about to come. Generally, the sperm then retracts and you can enjoy sex for longer.
4. Kegel exercises also make big differences. And they're quite simple - just tighten the kegel muscles, maintain the squeeze, and then let go. Doing this a few times daily with longer contractions over time can make a difference in just a couple months!
5. Not using a condom when it's safe, or using a thinner condom, can also help greatly.

These are just some of the most effective techniques to help rid yourself of psychologically-induced sexual dysfunction. The one thing that's necessary is smooth communication between partners. As long as you have that, you can deal with any sex problem, especially those that are psychologically induced.