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The Longer Lasting Lover A Review Of Premature Or Rapid Ejaculation Possible Treatment Methods For Premature EjaculationA) Physical approaches 1) Anesthetic on the penis Although premature ejaculation is certainly one of the most common sexual dysfunction in men, there is a definite lack of pharmacological treatments for it. Indeed Dapoxetine is one of the few licensed pharmaceuticals available for PE, and its license has only been granted in certain parts of Europe. If both biological and psychological factors are responsible for causing PE, then it's perhaps surprising that there are not more pharmaceuticals which have been developed to treat the biological aspects of the condition. However, topical desensitizing agents have been around for a long time. Indeed they are probably the longest established method of treating PE. The application of topical anesthetic, or desensitizing agent, to the glans of the penis to improve latency time is not a new idea, because back in the 1930s benzocaine or lignocaine were being prescribed for this very purpose. In Korea, a compound known as SS cream containing natural ingredients has been used for many years to desensitize the penile glans and achieve longer lasting love making. Recently there been several new compounds developed for topical desensitization including the TEMPE spray, and a mixture of local anesthetic dylonine and alprostadil. All of these trials demonstrate a significant increase in latency time, although there are some minor side-effects like penile numbness and in some cases a burning sensation. One problem has been the lack of uniformity in the delivery system of such anesthetics, a problem which is potentially overcome by the TEMPE spray. This has made a large leap forward in terms of controlled delivery and is easy to use and well tolerated. Another established method of ejaculatory control is the application of local anesthetic to the inside of a condom, where the cream is limited to contact with the man's penis. This is a definite improvement over strategies where the cream is simply smeared onto the glans, because even if the instructions suggest that it should be washed off before penetration, there is the possibility of affecting the sensation of the woman's vagina. But despite all the claims, what's interesting is that these systems haven't achieved particularly widespread acceptance or popularity, which suggests that they are either uncomfortable or impractical to use. As one female user wrote: "Did things go completely numb as the male tester feared? Apparently things felt slightly odd - more a diminished sensation but not totally numb as he'd feared! Things did last longer, but he summed up the whole thing like someone kept moving the goal posts: just as he got near ejaculating, they were moved again. It made for an interesting night, is all I'm saying...... " But another user observed: "A free sample of one of these condoms (a Durex Performa) and I discovered sensation was normal until several minutes after donning the condom, at which point the sensation slowly diminished until my glans had hardly any sensation at all. Still, my erection remained and so, remarkably, did the pleasure. Durex claims that Performa delays a man's orgasm by minutes, but in my case the effect was so strong that I couldn't ejaculate at all." 2) Condom use to reduce sensitivity Some men have tried using two ordinary condoms to reduce sensitivity - but this is a dangerous strategy since "double-bagging" can lead to condom tear and breakage. Not recommended. 3) Serotonin Uptake Inhibitors - Dapoxetine Dapoxetine received marketing authorization in Finland and Sweden in February 2009 for the on-demand treatment of rapid ejaculation (PE) in men aged between 18 and 64 years of age. It's now approved in Sweden, Austria, Germany, Spain, Italy and Portugal and Finland. Dapoxetine is not approved for marketing in the United States. Specifically developed for treatment of PE, this compound is delivered by tablet and is claimed to be a short-acting SSRI designed for to be taken between one and three hours before sex, rather than every day. There are side effects, including nausea, and the dramatic claims (a doubling of the latency time) are not so impressive when you see it only worked for about 45% of the men who took it, and they originally could only have sex for around a minute and a half before reaching climax. If you want to try Dapoxetine, you will have to see a qualified medical practitioner. 4) Training Methods THE START-STOP TECHNIQUE The original training technique for controlling premature ejaculation was developed in 1955 by Dr. James Seamans. It's based on stopping and starting sexual stimulation in a graded way, so that a man is exposed gradually increasing levels sexual stimulation. The idea is that he controls his arousal at each stage of this process so that he learns to cope with incremental increases in sexual stimulation without becoming more aroused. It's a very effective technique provided that it's used rigorously and practice is maintained. The man receives stimulation was partner until it feels that he is getting near to the point of ejaculatory inevitability. Stimulation stops at that point until the man feels that his arousal is dropped. It then begins again, and the process is repeated the number of times until he becomes much more accustomed to receiving stimulation without getting over aroused. It's possible to do this oneself without a partner using masturbation and stopping at that point we about to reach orgasm. It's entirely possible to carry the skill over into sexual intercourse if you're sufficiently disciplined. More information on premature ejaculation treatment which should enable you to overcome the condition. THE SQUEEZE TECHNIQUE The squeeze technique certainly is a development which adds to the success of the stop start technique. It does however depend on the co-operation of both partners. The squeeze is applied just below the ridge of the penile glands with the index finger just above the ridge of the glans, and the middle finger just below it. The thumb is near the man's abdomen. When the man feels that he is approaching orgasm, he tells his partner who then squeezes the penis until his urge to ejaculate diminishes. It is also possible for the man to do this himself; having tried it myself I can testify to the fact it certainly does allow you to reduce your level of arousal and even if your erection weakens it soon returns and sex can then continue for much longer. The training takes a period of weeks but it seems to be effective and certainly allows a man to extend the time for which he is able to enjoy intercourse. B) Psychological approaches 1) Psychotherapy Psychotherapy as a technique for dealing with PE is best reserved for men and couples where the origin of the premature ejaculation is clearly psychological and there are considerable psychosocial problems to deal with. For example, this would include men who had considerable performance anxiety or couples where the partner had sexual problems of their own such as anorgasmia that were perhaps secondary to the man's tendency to rapid climax. Other situations where psychotherapy is clearly called for include those where the relationship between a man and woman obviously has a number of issues that need to be dealt with. It's also useful to engage in psychotherapy where there is a lack of information about basic sexual facts between the couple: one example of this would be where a woman believes that she could reach orgasm during intercourse if her partner could continue making love for, say, 20 minutes before he came. The provision of factual information such as the percentage of women who manage to reach orgasm during intercourse can be very helpful in cases such as this. Psychotherapy would certainly be a good option for men who are not in relationships because it allows thorough analysis and effective therapy for what is almost universal in such cases -- that is to say, the reluctance of a man who has a severe case of premature ejaculation to engage in new relationships because of the potential shame and embarrassment that could ensue. Where a man is already in a relationship, psychotherapy is highly recommended if the man seems to have issues which need to be dealt with -- such as fear of sex, fear of women, or vaginal aversion. It's also possible to bring the partner into therapy at some point, and this is certainly a good idea because if behavioral training exercises are necessary, these will require the assistance of the man's partner. Therapy for both the man and his partner is recommended where both partners have good psychological health and are both highly motivated to resolve the sexual dysfunction. In such cases psychotherapy can be especially useful as treatment for primary PE. Both the precipitating and the maintaining factors behind the man's PE can be examined, the impact of the condition on both partners can be examined, and any relationship issues that may be getting in the way of a good sexual relationship can be dealt with. By contrast, pharmacotherapy is recommended when a man has had severe primary premature ejaculation for his entire life and is both sexually experienced and in a satisfying relationship. However pharmacotherapy alone is not a cure for PE because as soon as a man stops taking Dapoxetine his tendency to rapid ejaculation will rapidly return equally rapidly.....this means that a lifelong regime of drugs would be needed unless he also receives instruction in ejaculatory control techniques. It's been said by some therapists that a combination of pharmacotherapy and psychotherapy is the ideal treatment for premature ejaculation, in that it combines the best of both worlds. The pharmacotherapy rapidly controls the underlying PE to some degree at least, which allows the man to gain a sense of control and sexual self-confidence. The application of behavioral therapy and psychotherapy will show the couple the techniques that allow sex to last longer, and allows the couple to maximize the benefits of the drug therapy. In essence, any therapy for premature ejaculation is about teaching the man to attend to his sensations rather than fearing his sexual arousal; learning to pace his arousal; and expanding his sexual repertoire without becoming so aroused that he fears he will be ejaculating in no time at all. If therapy is effective the drugs may eventually be phased out, and he may be able to rely on his new-found self control alone. This is a powerful boost a man's sexual self-esteem. If you're considering therapy then you need to find a competent therapist who is qualified in sexual issues, which you can do at the website of the American Association of Sex Counselors, Educators and Therapists. 2) Hypnotherapy Although I've never tried hypnosis for premature ejaculation, and I don't have any clients who have tried it either, it seems logical that it could well help. A major factor in premature ejaculation is being tense and over-aroused, both mentally and physically. Anything that aids relaxation and promotes intimacy with his partner is certainly going to make a man more confident that he's in control of his sexual responses. If we regard anxiety as one of the major causative factors of premature ejaculation, then hypnosis could certainly be helpful: it's a powerful technique for increasing one's level of relaxation, lowering one's level of arousal, and reducing that sense of anxiety. An effective program of self-hypnosis would not just focus on losing the urge to ejaculate; rather, it would include instructions about developing more more in control of your ejaculatory responses during intercourse; it would suggest you were gradually developing a greater and greater sense of confidence, control and relaxation during sex, and that you were becoming less tense and anxious, and that you were developing a sense of greater control over your sexual arousal. I think it's well worth trying out, and I'd be grateful to hear from anyone who has done so, on the following e-mail address: rodmphillips"at"yahoo.com 3) Other self-help approaches to curing premature ejaculationMasturbation Many men have tried masturbating before engaging in sexual activity with their partner, or before going on a date. Obviously, we men believe that if we've ejaculated once, then the second ejaculation of the day will come more slowly! That may be true for men over the age of say 30, but the rampant sexual desires of a man in his 20s may be strong enough to overcome any inhibitory effect of having previously ejaculated that day. Because the only way you can actually assess the effectiveness of this technique as a cure for PE is to try it yourself, experimentation is called for! Come more than once Another approach is to have more than one ejaculation during the same session of sex. And certainly many young men are able to do this with a short refractory period of just a few minutes -- it may not even be uncommon for a man to maintain his erection after his ejaculated if his desire is high enough. This approach gives him the option of continuing to make love without a break, although my suspicion is that many young men who have rapid ejaculation issues will find that the time to their second ejaculation is probably not much longer it was to their first (i.e. too short). However, if you can keep an erection and continue to a third orgasm, you may find that it takes about 20 minutes, which ought to be sufficient time to satisfy even the most demanding woman. Try Woman On Top The use of different sexual positions is absolutely critical to curing yourself of premature ejaculation, because some sexual positions make a man come far more quickly than others: the man on top position is a major culprit here, because the position invokes muscular tension in the pelvis - this enhances your sexual arousal and speeds up your orgasm. Equally, the rear entry position may be very arousing and speed up your arrival at orgasm. Perhaps the best sex position for a man trying to control the speed with which he reaches his climax is the woman on top position. More foreplay! If you can manage a reasonable length of time between penetration and ejaculation, then one possible option for getting a woman to orgasm during intercourse is to actually ensure that she is very highly aroused before you enter. This means 20 or 30 minutes of foreplay, perhaps with finger stimulation of her G spot, certainly with continuing stimulation of her clitoris by means of oral sex or the use of your fingers, and exercising some fine judgment about the point where she is so aroused that if you enter her she will not lose her arousal but continue towards her orgasm. Less thrusting! One rather neat way of controlling the speed with which you approach the point of no return and stop yourself from ejaculating is to regulate the rate of your thrusting. You have to judge this finely, so that you can slow down your movements as you get more and more aroused and nearer the point of ejaculation, but with practice it is possible to pause your sexual rhythm, to stay still with your penis still in your partner's vagina, until your arousal has dropped. The difficulty is that when you stop moving during intercourse she may find that her arousal rapidly decreases as well -- possibly much faster than yours does -- so it's useful to find a position in which you can stimulate her clitoris with your fingers while you are resting to ensure that her arousal continues to peak. Another elegant technique is to judge the approach to your point of ejaculatory inevitability so finely that you can stop just at the point where you are about to ejaculate. If, perhaps with the additional help of the squeeze technique described above, you judge this correctly you won't ejaculate; if you then stop moving and allow a few moments for your arousal to drop you can actually experience some sensations that feel very much like the edge of a pulsating orgasm at the base of your penis, but without an ejaculation. Once this feeling has passed, you can then continue thrusting and you will find, to your delight, that while your arousal remains high, and the sexual sensations very pleasurable, your arousal will take a long time to return to the point where you are about to ejaculate. This is probably the most successful technique for men learning to control their ejaculation as it provides intense pleasure and a sense of complete self-control which boosts your self-esteem. Women come first If you simply can't control the desire to ejaculate, then the heavens sake make sure that your partner has had an orgasm through oral sex masturbation before you even enter her! Wear a condom Wearing a condom does indeed reduce the sensitivity of your penis somewhat, in that you get less of the pleasant sensations of warmth and wetness from her vagina: it's possible that you may therefore last little bit longer when you use a condom. If you don't, it's pretty compelling proof that the problem lies in your mind and not in your body..... in that you are so excited by the prospect of engaging in intercourse that you simply can't control your arousal. This implies that what you need to do is work on your attitude to sex, learn some relaxation techniques, and become more familiar and relaxed about the prospect of having sex. All that seems to suggest something about developing emotional maturity to me. Distraction may not be the answer I simply don't accept the idea that thinking about something else during sex helps you last longer. For one thing, we know that the best way to develop more control of your sexual responses is to actually focus on what you're thinking and feeling during sex, so you can adapt your sexual behavior appropriately and reduce your arousal. Thinking about something else will spoil the experience of sex, in that you're not fully engaged with your partner (and she will undoubtedly sense that and possibly resent it), and to be quite honest it just doesn't work anyway. Masturbate often You may find that frequent masturbation does help you to last longer during intercourse - try it for yourself and find out! And finally.... ... if nothing else helps you may find that simply getting older allows you to last longer: men in their 30s and 40s find that their sexual responses are slowing down, that it takes more time to become aroused, and that they can last longer during intercourse. Unfortunately, if you're a particularly red-blooded male you may not experience this change until you're 50 years or older - which is a heck of a long time to live with premature ejaculation! Premature climax in men - what is early ejaculation, and how common is it? The effect of PE on a couple and their relationship Is premature ejaculation natural?
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