What is the best way to overcome premature ejaculation?

Premature ejaculation is a common sexual problem affecting men. It is also something that in my experience men can feel ashamed about and understandably causes a lot of distress – often because men avoid sexual relationships.  Premature ejaculation is often thought of as ejaculating too quickly – in fact this is not the case.  There is no accepted “normal” length of time to last before ejaculating.  One survey found the average time to ejaculation during intercourse was two minutes.  The problem is actually one of lack of control over ejaculation.  Of course this usually means that men with this problem ejaculate before they want to and so usually report the problem as one of ejaculating too quickly. So why do some men have this problem?  The most convincing theory in my opinion is that control over ejaculation is something you have to learn and some men learn this skill while others do not.  This is probably because something stops this normal process of learning as men develop sexually such as lack of experience.  Masturbation during adolescence is an obvious way men learn to develop control and it is easy to see how if men do not practice masturbation for example, for religious reasons, they may not learn control over ejaculation.

In my experience there are a lot of myths and misunderstanding about the causes of premature ejaculation and many men suffer in silence or buy treatments online that have no evidence for effectiveness. There is no evidence that biological factors such as hormones play a role in premature ejaculation or that, treatments, such as desensitising sprays or antidepressants, solve the problem in the long-term. The good news is that there is good evidence that cognitive behavioural therapy can solve the problem.   Clients are taught to acquire control over ejaculation through a series of graded exercises that involve masturbation.  In my own clinical experience the exercises usually work well.  The skills acquired then form a solid basis on which to build upon during actual sexual encounters.  Unhelpful beliefs about the problem are also tackled during therapy.  I would recommend “The New Male Sexuality” by Bernie Zilbergeld as a good self-help book for premature ejaculation and other issues to do with sex and sexuality.  Or please do contact me to talk further.  I have worked with many men with this problem who suffered from it for many years, and overcame the problem quickly, and it was a shame that they had not accessed the right help sooner.  So I would encourage anyone with this problem to get help.

Dr Robert Watson, Clinical Psychologist, Become Psychology, October 2014.