Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 1/07/2021
Perhaps the only thing more embarrassing for a man than not being able to perform in the bedroom is “performing” a little too quickly. Awkward as this experience might be, it’s actually not uncommon.
Though estimates vary, some research suggests up to 30 percent of men experience premature ejaculation from time to time. Even if it isn’t an issue that affects you regularly, learning the basics may help you gain a better understanding of your body and how to delay ejaculation if or when you want to.
In this comprehensive guide, we’ve broken down the issue of premature ejaculation to explore what it is, why it happens, and what you can do about it. Most importantly, we’ve compiled a list of techniques you can use to improve and extend your sexual experiences.
We’ve done our best to offer methods that are backed by science, but you may need to do a little experimentation of your own to find what works for you and your partner.
Few things are more frustrating for a man than premature ejaculation. On top of the embarrassment, it can turn what should be an intimate and mutually enjoyable experience into a disappointment.
Though there’s certainly nothing to be ashamed of, it can put a damper on your partner’s sexual satisfaction and your self-confidence may take a hit as well.
First things first, let’s dig into the details of what causes premature ejaculation (PE) and then we’ll talk about ways to work around it.
Premature ejaculation occurs when a man ejaculates sooner than he or his partner would like during sexual intercourse.
In clinical settings, it’s diagnosed when:
Ejaculation almost always occurs completely unintentionally, and usually within a minute of penetration.
Occurs for more than six months at a time.
Is not attributed to any other medical issues.
Is very distressing
Though it may not be a sign of a physical health issue, PE can be frustrating for both you and your partner if it happens regularly. PE has the potential to reduce sexual satisfaction and could have a negative impact on your relationship as a result.
Biological and psychological factors may both be responsible and could influence each other. Understanding the cause of your premature ejaculation can help your healthcare provider provide a treatment plan specifically for you.
The exact cause of premature ejaculation is unknown, but healthcare providers have come to understand that PE involves a complex interaction of both psychological and biological factors.
Psychological factors that may contribute to PE include:
Worry or guilt
Prior sexual abuse
History of sexual repression
Other factors that may play a role in PE include erectile dysfunction (ED), abnormal hormone levels, imbalanced brain chemicals, inflammation of the prostate or urethra, and even certain inherited traits. Stress can greatly increase your risk for PE by limiting your ability to relax and stay focused.
If you’re concerned about your premature ejaculation, it’s best to talk to your primary care provider or a urologist. There’s no substitute for sound medical advice and your healthcare provider will be able to help you determine whether your problem is physical or psychological.
In addition to completing a physical exam, your healthcare provider may ask questions to help identify the underlying factors contributing to the issue.
Diagnostic tests may only be required to assist in identifying the cause of your PE. In most cases, psychotherapy and behavioral therapy are used alone or in conjunction with topical anesthetics and oral medications.
There aren’t currently any drugs specifically approved by the Food and Drug Administration to treat premature ejaculation, though some are used for this purpose. You may want to try a few behavioral techniques before going down the road of medication.
Premature ejaculation is one of the most common sexual health concerns in men. Comforting as it may be to know you’re not alone in this experience, what you really want to know is how to fix it.
The Internet is full of solutions to boost sexual performance, so it can be difficult to tell which methods are worth trying. We’ve consulted research conducted by experts in sexual medicine to bring you a collection of research-backed tactics to help you last longer in bed.
If you want to have better control over when you climax during sex, strengthen your pelvic floor muscles. Pelvic floor exercises are also known as kegels and they are a proven method for improving erectile function and resolving issues with ejaculating prematurely.
In a 2014 study, 40 men with lifelong premature ejaculation engaged in 12 weeks of pelvic floor muscle rehabilitation.
At the end of the treatment period, over 80 percent of the patients had gained control over their ejaculatory reflex and increased their intravaginal ejaculatory latency time (IELT) — the length of time to climax after penetrating the vagina — from a mean time under 40 seconds to an average range between 123.6 and 152.4 seconds.
To give kegel exercises a try, start by identifying your pelvic floor muscles — they are the same muscles you use to stop the flow of urine or to avoid passing gas.
Once you’ve identified the muscles, practice flexing them for three seconds at a time then rest for three seconds. Repeat for a set of 10 and do this at least three times a day. As your muscles get stronger, you can flex them for longer — aim for at least 10 seconds during each repetition.
One of the simplest ways to increase the length of a sex session is to throw in a little foreplay. This can be particularly effective with a female partner because women become aroused in a much different way than men. It’s also helpful to give your partner some time to warm up before intercourse begins.
One way to really make this method work is to give your partner a little special attention. You may find that knowing your partner has already enjoyed an orgasm takes some of the pressure off you to last longer once you get going.
According to a survey of over 1,000 women published in the Journal of Sex & Marital Therapy, over 30 percent of women reported clitoral stimulation helped them orgasm. Only about 18 percent of women surveyed reported they orgasm from intercourse alone, so take advantage of foreplay time to use your mouth, your fingers, or a toy to stimulate your partner.
Trying out new sex positions is a great way to add variety to your sex life, but it could also help you last longer. The goal is to decrease sensitivity for yourself while increasing the sensation for your partner.
One of the best options is one you may already be familiar with — the cowgirl position. Simply lie on your back and have your partner straddle you. Because this position puts your partner in control, and because it prevents you from penetrating as vigorously as other positions, it may help delay ejaculation.
Similar to the cowgirl position, another option is to sit on a chair and have your partner lower herself onto your lap while facing away from you. Again, this gives your partner more control and keeps you from thrusting too deeply or quickly.
If you’re looking to really spice things up, try some of the trickier or more tiring sex positions. You may find that in focusing on the position you may be able to delay ejaculation a little longer.
If you want to last longer in bed with a partner, you may want to do a little solo work first. The edging method, also known as the start-stop method, is something you can practice on your own to gain better control over your orgasm.
The concept is simple — you bring yourself to the edge of orgasm then stop and wait until you get your excitement under control. By practicing this technique, you may find that when you’re with a partner you can quickly bring yourself back from the point of no return if you want to extend the experience.
An added perk of the edging method is that you’ll often enjoy a stronger orgasm when you finally get to release all that built-up tension. If you plan to use this technique with a partner, just be sure to discuss it first so they understand what’s going on.
Another way to put the brakes on an imminent orgasm is the squeeze technique. When you become sexually aroused, blood flow increases to the penis — the idea behind the squeeze technique is to push some of that blood back out to repress the ejaculatory response.
The idea is to use the squeeze technique right when you feel you’re about to climax. Immediately stop sexual contact and quickly squeeze the end of your penis right where the head meets the shaft. Squeeze hard enough to delay the orgasm and wait until you return to pre-climax level, at which point you can resume sexual activity.
Again, be sure to communicate with your partner before using this technique. You could even have your partner apply the squeeze method, though they’ll need to be quick and you’ll need to communicate how much pressure is needed.
As a man, your sexual energy tends to build up over time. The longer you go without an orgasm, the more your body craves it and the easier it is for you to climax. It stands to reason, then, that masturbating a few hours before sex could help you last longer in bed.
When it comes to masturbation, you know what feels best. If you’re masturbating with the intention of delaying ejaculation during sex, however, you may want to alter your technique.
Even if you choose not to use this particular method, you may find that masturbating earlier in the day or even shortly before sexual activity could help you last longer.
Keep in mind that all men have a period of time after an orgasm when they can’t achieve an erection or orgasm — this is known as the refractory period. The refractory period may last only a few minutes for younger men but could last as long as 12 to 24 hours in older men.
Exercise is essential in maintaining your health and wellness, but cardiovascular fitness is particularly important when it comes to sexual performance. According to a study published in the Journal of Sexual Medicine, higher levels of weekly cardiovascular exercise may have a protective effect against sexual dysfunction in both men and women.
There are plenty of ways to get your daily dose of cardiovascular exercise, whether it’s jogging with your dog, playing basketball with a few friends, or going for a hike. The key is to vary the type of cardiovascular exercise you do and do a mix of longer and shorter workouts, so your body doesn’t become too accustomed to a routine.
An added benefit to working out more frequently is that you may see improvements in your weight, mood and sleep, too. Aim for 75 minutes of vigorous aerobic exercise or 150 minutes of moderate exercise per week, and try to incorporate at least two days of strength training as well.
When all else fails, another option to help you last longer in bed is to decrease the sensation you experience during sex using desensitizing condoms, sprays, or creams.
Wearing a condom in general may provide some degree of desensitization, but you can also find condoms treated with a desensitizing gel like benzocaine.
Keep in mind that the numbing effects of the condom may take time to develop, so wait five to 15 minutes after applying the condom before having intercourse.
If it doesn’t work, try another brand that uses a different desensitizing ingredient.
Another option is to try a topical numbing agent in the form of a cream or spray.
Some of these products (like premature ejaculation pills or delay spray) can be purchased over-the-counter, or you can try a prescription lidocaine-prilocaine cream, which is designed specifically for premature ejaculation.
Just be wary of the potential for side effects and keep in mind that topical agents could affect your partner’s sensitivity as well.
If you’ve tried some of the methods above and you’re still struggling, you may want to consider seeing a sex therapist. Though it may seem awkward to talk about your sex life with a stranger, therapists are trained to handle these particular challenges. You might even consider couples therapy if your relationship has been negatively affected by your struggles.
Even if you don’t see a sex therapist, traditional psychotherapy could be beneficial, as well. Cognitive behavioral therapy (CBT) is particularly effective in treating issues with anxiety and depression.
If you think your sexual issues could have a psychological foundation, you may find this helpful.
According to the American Psychological Association (APA), about 75 percent of people who engage in talk therapy experience some benefit.
Each person’s experience with therapy is unique, however, so it’s difficult to evaluate the efficacy in the form of a scientific study.
A 2011 review found three of four studies they reviewed revealed an improvement in IELT but most demonstrated small sample sizes and some used a combination of CBT and medication.
You’ve heard of medications like Viagra and Cialis for erectile dysfunction, but there are no FDA-approved medications specifically for premature ejaculation.
There are, however, certain drugs which may delay ejaculation.
Certain antidepressants, for example, have been prescribed for this purpose and can be used daily or as needed.
A common side effect of certain antidepressants is delayed orgasm, so your healthcare provider may recommend them as an option to help resolve premature ejaculation.
Selective serotonin reuptake inhibitors (SSRIs) are the most likely to cause this effect. Common options include sertraline (Zoloft®), fluoxetine (Prozac®), paroxetine (Paxil®), and escitalopram (Lexapro®).
Because these medications are not approved for the treatment of premature ejaculation, studies are limited. We did, however, find several supporting the use of SSRIs.
In a 2019 review and meta-analysis published in BMC Urology, researchers found paroxetine was well-tolerated and more effective than fluoxetine and escitalopram in the treatment of PE.
The study mentioned in the squeeze technique section above found that sildenafil was significantly more effective than clomipramine, sertraline, and paroxetine.
Whether you’ve experienced premature ejaculation for the first time or it’s an ongoing issue, it’s important to talk to your partner about it.
Though it may be embarrassing at first, communicating with your partner is the best way to work through issues that could potentially affect your relationship.
You may even find your partner eager to help.
If you’re concerned about premature ejaculation, it’s best to talk to your healthcare provider. PE is a common condition in men and your healthcare provider can help you identify the underlying factors contributing to your issues. In the meantime, try some of the techniques above.
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