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Premature ejaculation

I have been married for 3months. I cannot consummate my marriage as the semen ejaculates before I could have penetration. My wife and I are upset and depressed. We are too embarrassed to talk to our doctor. What should we do?

A. Premature ejaculation is common among couples who just get married. It is most often caused by anxiety and rarely due to physical problems. For man, sexual responses vary. Sometimes he reaches orgasm quickly while at other times, he takes longer. On the average it takes about two to four minutes from vaginal penetration to ejaculation.

Premature ejaculation becomes an issue when couple cannot have proper sexual intercourse and feel frustrated and unsatisfied. The couple may slowly lose the desire for sexual intercourse leading to problems in marital relationship.

Fortunately, the condition improves with medical guidance. Practice makes perfect and relaxation will help you deal with the problem. You can try to distract yourself by having non-sexual thoughts to avoid becoming excited too fast. Do not be too preoccupied with sex to the exclusion of all other sexual activities and do not end a sexual encounter as soon as you have an orgasm. In marital relationship, your wife may consider affection, romance and passion more important than the physical aspects of sexual responses.

Some helpful tips:

¨ The "stop and start" technique

To delay the ejaculation, the man should first learn how to identify and control the sensations leading to orgasm. Sexual stimulation is done by the spouse with lubricant until he is close to climax. The stimulation is then stopped for about thirty seconds. This allows him to relax before starting again. Repeat the procedure few times until final ejaculation occurs.

¨ The squeeze technique

This is a variation of the above. This technique involves sexual stimulation until the man recognizes that he is about to ejaculate. At that point, the wife gently place the thumb and index finger around the tip or mid shaft of the penis and squeeze firmly for 15 second withholding further sexual stimulation for about 30 seconds, and then resuming stimulation. The sequence may be repeated by the spouse until ejaculation is desired, the final time allowing the stimulation to continue until ejaculation occurs.

¨ Sexual position can also affect a man’s ability to control ejaculation. Allowing the wife to be on top will make the man to be more relaxed and have a better control.

¨ Avoid drugs and alcohol.

¨ Antidepressants and other selective serotonin reuptake inhibitors (SSRIs) may be helpful because they may prolong the time to achieve ejaculation.

¨ Local anesthetic creams may be applied to the penis to decrease stimulation. Decreased feeling in the penis may prolong the time before ejaculation. Condom use may also have this effect for some men.

Learning ejaculatory control is like learning any skill. It requires patience and perseverance of a committed partnership.

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