Mastering the Male Orgasm

Last Editorial Review: 2/28/2005

Do you think you suffer from premature ejaculation? Don't fret -- here are some tips and techniques to help you slow it down.

By Martin Downs
WebMD Feature

Reviewed By Michael Smith

You don't have to admit it to your buddies. You don't have to stand up in a support group and say, "My name is ... " It's enough to admit to yourself that sometimes you climax too quickly during sex; or at times, you're not able to ejaculate at all.

Or perhaps your sexual performance satisfies all concerned. If that's so, you've probably heard and heeded the following advice.

Premature Ejaculation: Strategies for Staying

Are you a premature ejaculator? The answer is another question: Do you think you are? It's subjective.

A man may ejaculate before intercourse even begins. Few would doubt that counts as "premature." But what if you typically reach orgasm after only a minute or so? You may consider yourself a premature ejaculator then, if your goal is take a woman to extremes of ecstasy. But there are problems with that conclusion.

First, it assumes she'll have an orgasm if you last longer, because women tend to climax later than men do. "There's a lot more to it than thrusting," says sex educator Beverly Whipple, PhD. Many women simply don't have orgasms with their partners, while they do on their own. Second, some women don't have orgasms though vaginal intercourse. Only clitoral stimulation does it for them. So don't think that once you master your orgasm, you'll master hers, too. What's more, Whipple says, if you focus solely on your stamina during intercourse, "you miss out on a whole lot of the fun along the way."

That said, here's what you can do.

Wrap it. Some men find the sensation of sex without a condom too intense, causing them to lose control quickly. Think about when your troubles began. Perhaps you always used condoms while you were roving; then when you got a monogamous partner you shucked them.

Over-sensitivity doesn't seem to be the main cause of premature ejaculation, however. The problem is usually pinned on anxiety and inexperience.

Know yourself. It may have been in our evolutionary best interest to ejaculate quickly: Impregnate the female and move on before predators find you in a compromising position. According to this theory, "The ability to prolong intercourse is a learned response," says Drogo Montague, MD, director of the Center for Sexual Function at The Cleveland Clinic.

To learn control, you must be aware of your sexual response and recognize when you're approaching "the point of no return." Before you get there, lessen the stimulation by slowing down or stopping. Once that feeling subsides, you resume until you reach the threshold again, then slow or stop, over and over. It takes practice -- time spent experimenting with masturbation or frequent sex with a patient partner.

Anxiety is often part of the problem. You may have an underlying attitude that sex is shameful, and what's more, your past experiences have made you feel inadequate. So you're compelled to get the dirty deed done quickly, though at the same time you feel obliged to perform like a machine.

We tend to think of the male orgasm as mechanical, a simple matter of friction. "It's an oversimplification," says Richard Balon, MD, a psychiatrist at Wayne State University, in Detroit, Mich. Sex and psychology can't be separated, even for men. If nothing else helps, therapy may.

Numb it. Until recently, a popular option besides therapy and the start-and-stop technique was to desensitize the penis with a topical anesthetic. "I don't really encourage them to go the anesthetic route," Montague says. It's messy and inconvenient, and it may make you so numb you won't feel anything.

Take a pill. Doctors now prescribe SSRIs (selective serotonin reuptake inhibitors) such as Prozac to men with premature ejaculation. Delayed ejaculation is a well-documented side effect of SSRIs. The downside is that they can also dampen your libido.

Montague, who is working with a committee to draft guidelines on using SSRIs for premature ejaculation, says some men take the drugs continuously, while others are told to pop a pill when they anticipate sex. Either way, SSRIs help many men.

Let off steam. After a long period of abstinence, you may be so hot and bothered that it's difficult to control your orgasm. Calm your libido with masturbation, and the thrill of a sexual encounter might not overwhelm you. Montague says it's a good solution for some, but not all. "Men with severe premature ejaculation seem to have the problem regardless," he says.

You would have to get the timing right for it to help. Men have what's called a "refractory period" -- a length of time after ejaculation during which they can't have another orgasm. For some men, it's very short; for others, it lasts hours.

Going, and Going, and Going ...

Less common than premature ejaculation, but just as distressing, is the inability to have an orgasm -- known as anorgasmia or delayed ejaculation, and also by the ugly medical terms "ejaculatory incompetence" and "retarded ejaculation." If it's a persistent problem, consider these possible causes and solutions.

Fatigue or stress. Men aren't always up for sex. Consider the time of day. Maybe you're having sex too late at night, when you can barely stay awake, or too early in the morning. Or perhaps worries invade your thoughts, to the effect of a cold shower. Find a way to relax first, rather than having sex to relax.

Something is missing. There may be a certain turn-on that's absent from the sex you're having. Maybe you think it's kinky, and you're too embarrassed to tell your partner, so you keep having "normal" sex. Maybe you're not attracted to your partner, but you continue the sexual relationship for whatever reason. If you're not getting what you need, couples therapy or therapy for you alone may help.

Prescription drugs. SSRIs, as mentioned before, can delay ejaculation. That's good for men who ejaculate too soon, but if you're taking an SSRI for something else, it can be a problem. Some antipsychotic drugs and blood-pressure medications may have this effect, too.

Alcohol. It depresses your central nervous system, which can suppress your orgasm. Heavy drinking can also impair your ability to get an erection.

Originally published Feb. 3, 2003.

Medically updated Feb. 28, 2005

SOURCES: Beverly Whipple, PhD, professor emerita, Rutgers University • Drogo Montague, MD, director, Center for Sexual Function, The Cleveland Clinic • Richard Balon, MD, professor of psychiatry, Wayne State University • Journal of the American Medical Association, Feb. 10, 1999 • European Federation of Neurological Societies Guidelines on NeurosexologyDiagnostic and Statistical Manual of Mental Disorders, Fourth Edition, American Psychiatric Association • National Institutes of Health • The Kinsey Institute.

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