Ejaculating too soon is often considered to be one of the most common sexual disturbance in men, and has the clinical term Premature Ejaculation (PE). The disorder can be very troublesome, both for the person suffering from PE, and the partner. PE is often followed by psychological reactions and anxiety, depression and lowered self-esteem with more is not uncommon. Very few of those who suffer from PE seek help in relation to the problem, but there are techniques that are relatively easy to implement and that can help solve the problem. What is considered to be premature ejaculation or PE slightly differs, definitions that are based on very different measures; it may be how long the intercourse or stimulation lasts before ejaculation, or the number of “shocks” before ejaculation. Measures used are typically 1-7 minutes or 8-15 “shocks”, these measurements are so different that they seem to measure different degrees of PE. Another measure is to satisfy female partner at least 50% of the time. In Norway, PE is usually defined as a subjective diagnosis, without any clinical diagnostic test. If premature ejaculation is experienced often and is a problem – PE is the diagnose. With so different diagnostic measures and definitions when it comes to PE, there are also very different estimates of how widespread this disorder is. Worldwide, it is often estimated at 30% and between the ages of 18 and 65 between 20% and 23%. PE is most common among younger men. If the criteria is for ejaculation to occur is set to within a minute, this will reduce the incidence of PE to around 5-6%, and persons in this group is probably experiencing the most severe problems. As a curiosity, it can be mentioned that men from East Asia have the highest incidence of PE, while men from the Middle East and Africa have the lowest incidence. Europeans are placed like this in the middle of the tree in this regard.
There are very few studies on the effect of non-drug treatment of PE, the only study referred to here is a randomised controlled study of 36 men. PE in this study was defined as triggering within 2 minutes of commencement of intercourse. Two groups received each type of treatment and there was a control group, The treatments that was given was a functional sexological approach, and a more traditional type of behavioural therapy that included the “clamp-” or “start-stop-” technique». Both types of treatment increased the time before ejaculation from less than one minute to over 7 1/2 minutes. The control group did not change. Unfortunately, the study is not of the highest methodical quality, but the results seem to be somewhat reliable. The functional sexological therapy of premature ejaculation is focused on recognising the body’s signals when ejaculation approaches, then cognitive skills and strategies control the sexual ignition and keep it below the level that causes triggering. Functional-sexological therapy in premature ejaculation has later been expanded, and a newer version is based on the fact that while the orgasm reflex are not voluntary, breathing and muscle-control are voluntary – and by controlling these, it is possible to keep the body and brain below the level of excitement that causes orgasm. This treatment can be summarised in some exercises: 1. Breathe with your stomach 2. Disconnect the pelvic movements from the upper body 3. DO NOT use the “buttock-musculature” 4. Breathe in when the pelvis is pulled backwards – breathe out when the pelvis is pushed forward 5. Exercise on relaxed pelvic movements in multiple positions, back, side, stomach etc. 6. Vary the speed of pelvic movement 7. Vary the intensity of pelvic movement 8. Vary rash in pelvic movement 9. Find the pubococcygeal muscle and learn to relax the muscle when ejaculation approaches 10. When ejaculation approaches – stop all movements, relax, breathe with your stomach 11. Breathe with open mouth and relaxed jaw 12. Spread your legs 13. Do not close your eyes 14. Experiments with different positions Women do the same exercises as men When it comes to behavioural therapy, it is also important for the man to listen to the body’s signals. The man must be aware when ejaculation approaches, and be able to signal the partner about this. When triggering approaches, either a: “start-up technique” or b: “clamping technique” is used. a: “start-stop technique”. When the ejaculation is approaching, a signal is given and the partner stops stimulation. Then one wait until the erection starts to resign, and start over again. This procedure is repeated four to five times. The treatment is then repeated with a gliding agent. The treatment can be performed with the woman on top. She stops when the man signals that release is approaching. The man does not move the pelvis, but with increasing control over ejaculation, the pelvis can also be involved. b: “clamping technique”. When ejaculation approaches and the is signalled is given, the partner takes hold of the tip of the penis, and instead of stopping stimulation, the partner puts the thumb on the frenulum. Frenulum is the point where the foreskin goes up in a tip on the back of the penis. The index finger and middle fingers are placed on the other side of the penis, just below the glans. A hard pressure is applied for 3-4 seconds. The pressure is released, and one wait 15 – 30 seconds before sexual intercourse or sexual stimulation of the penis is resumed. The exercise can be done a couple of hours a week for a few months. Clamping technique should not be confused with Kegel-exercises which is another type of technique or practice. Kegel-exercises can still have an effect on PE. These simple exercises can be performed at home by most couples who should experience PE problems, and some of the exercises can also be done on your own.