confused couple

Drugs to treat PE help only a minority of men last as long as they’d like

Rapid, involuntary “premature” ejaculation (PE) is men’s #1 sex problem. Erectile dysfunction gets much more publicity, but few men develop it until after 50. Meanwhile, throughout the lifespan, from teens to the elderly, the best research shows that PE affects one-quarter to one-third of all sexually active men.

PE can be treated two ways—low-dose antidepressants or the program developed by sex therapists that tinkers with how men make love. Advocates of drug treatment claim it’s effective. But a recent study shows that the drugs eliminate PE in only around half of cases and that within one year, almost three-quarters of men—72 percent—stop taking them. The sex-therapy training approach works better, costs less, and has no side effects.

The Little-Known Downsides of PE Medication

The drugs used to treat PE belong to the most widely prescribed class of antidepressants, the selective serotonin reuptake inhibitors (SSRIs): Prozac, Zoloft, Paxil, Lexapro, Luvox, Celexa, Viibri, and Brintellix.

Few PE sufferers are actually depressed, and SSRI-induced mood elevation, per sex, has no effect on PE. But soon after the Food and Drug Administration’s 1987 approval of the first SSRI, Prozac, it became clear that the SSRIs had a side effect—delay of orgasm. Users reported difficulties climaxing. Some couldn’t come at all. Drugmakers discovered that in men with PE, low-dose SSRIs could delay but not totally suppress orgasm/ejaculation. Several analyses of low-dose SSRI treatment have shown that the drugs help men last one to five minutes longer. The reviews call this “significant effectiveness.”

Actually, that’s an exaggeration that borders on medical irresponsibility. Countless pop songs tout sex lasing “all night long.” Say a man lasts a few seconds or half a minute on his own. SSRIs extend that into the range of 90 seconds to five or six minutes. But many men hope to last much longer than that.

In addition, low-dose SSRIs may cause side effects: drowsiness (8 percent of users), headache, nausea, and nervousness (5 percent each), and dizziness (4 percent). Around half of men who experience side effects call them moderate to severe, which may interfere with sexual pleasure and satisfaction.

Finally, most men don’t want to depend on costly, potentially problematic medication for life. They don’t want the hassle of managing pill use. They’d much rather learn reliable ejaculatory control. But SSRIs don’t teach it.

The new study makes SSRIs look even less attractive. The researchers, urologists at Memorial Sloan Kettering in New York, prescribed low-dose SSRI treatment to 130 PE sufferers, then tracked them for one year. Self-rated “poor” control dropped to 41 percent of the men, that is, 59 percent reported lasting at least a little longer. But after a year, only 28 percent were still popping the pills. Almost three-quarters—72 percent—had quit for the reasons just mentioned: not lasting as long as they’d hoped, side effects, and the hassles of taking the pills.

The Better Way: Learning Reliable Ejaculatory Control

During the 1960s, pioneering sexologists William Masters, M.D., and Virginia Johnson discovered that a quick, easy, self-training program could cure PE and teach the large majority of men dependable ejaculatory control. Over the past 60 years, their program has been refined. It includes:

  • Deep relaxation. Some people call erotic arousal “sexual tension,” but the word “tension” is counterproductive. Tension, anxiety, and emotional stress prime the nervous system to trigger involuntary ejaculation. To cure PE, the first step is deep relaxation—not the kind that combines beer, a recliner, and pro football, but the emotional release that results from exercise, deep breathing, hot baths or showers, and/or meditation, yoga, or similar regimens. Many men find that the most powerful approach is slow, deep breathing with extended exhalations. Deep relaxation calms the nervous system so it’s less likely to trigger quick, uncontrolled ejaculation.
  • Whole-body massage. Many men believe “sex” is what’s depicted in pornography, mostly fellatio and intercourse—penis worship. Actually, preoccupation with the penis primes the nervous system to ejaculate quickly.

Of course, in sex, the penis is important, just as fuel is important in cars. But it takes more than fuel to keep cars running smoothly. The moving parts must also be lubricated so they don’t burn up in the heat. When the heat is sexual arousal, the activity that “lubricates” the moving parts is gentle, patient, extended, whole-body caressing from head to toe.

That’s why showers/baths feel so relaxing. Immersion in hot water is only part of it. In addition, soaping up involves gentle self-touch all over the body, every square inch of skin. Whole-body touch distributes arousal all over. When the penis is the sole focus of arousal, the little guy can’t take the pressure, and men come quickly. But whole-body arousal takes pressure off the penis and helps men last as long as they want.

  • Self-sexing. If male sexuality isn’t just fellatio and intercourse, what is it? Whole-body massage that eventually includes the genitals. Once men feel deeply relaxed, it’s time to include the penis by masturbating. Many young men self-sex in a hurry, which trains them to come quickly. But slow, playful solo sex can retrain them to last as long as they’d like.

Start by masturbating with a dry hand. Tune in to what you’re feeling. When you approach your point of no return, when ejaculation feels inevitable, stop r stroking until the urge to come subsides. Then return to self-sexing. Sex therapists call this the “stop-start technique.” Practice stop-start—approaching ejaculation and backing away from it—until you can last 30 minutes. Then practice stop-start with a lubricated hand until you can last 30 minutes.

As you practice, you may lose control and come before you want. Don’t despair. When learning to ride a bike, most people fall a few times. Wait a bit, then return to practicing stop-start.

  • Add a partner. If you’re partnered and she’s willing to help, the next step involves adapting the above to playing together. Breathe deeply as you kiss, cuddle, and gently touch each other all over, but postpone genital touch for 20 minutes or so (four or five typical songs). Next, she strokes your erection with a dry hand. When you approach your point of no return, signal her to stop so you can back away from coming. Practice stop-start together until you can reliably last 30 minutes. Next, she should stroke you with a lubricated hand until you can last 30 minutes. Then do the same with fellatio and intercourse.

For more on self-training for ejaculatory control, check out my low-cost e-booklet, The Cure for Premature Ejaculation. It carries a money-back guarantee, so it’s risk-free.

What If Self-Training Doesn’t Provide Sufficient Relief/

Try working with a professional, a sex coach or therapist. Sex coaches can help when the problem is just sexual. Consult sex therapists when sexual issues become complicated by relationship strife.

To find a sex coach near you, visit the World Association of Sex Coaches. To find a sex therapist visit the American Association of Sex Educators, Counselors, and Therapists.

A small proportion of men don’t benefit from professional help. They’re free to use low-dose SSRIs. But with the self-help program or professional counseling few men need drugs.

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