Fast Track to Disappointment
Premature Ejaculation Is Disheartening Reality For Men Everywhere,
But Simple Exercises and New Drugs Can Make A Big Difference.
June 25th, 2004
By Louis Wittig : eCureMe Staff Writer
June 23th, 2004 : Physician Reviewed
For too many couples, sex is like a roller coaster: exciting, even breathtaking,
but in the end, the ride’s over almost before it begins. When it is,
premature ejaculation (PE) is often the culprit. PE, occasionally known as rapid
ejaculation, occurs when a man reaches orgasm before he’d like to. The
scope of the problem is on par with erectile dysfunction: studies have indicated
that anywhere from 21% to 75% of men grapple with the condition. And while public
awareness of PE has lagged behind that of erectile dysfunction in the last couple
years, thanks to big budget ad blitzes for Viagra, Levitra and Cialis, that may
soon change. PE is easier to treat without drugs than impotence, and recent
pharmaceutical innovations make is possible that ad blitzes for PE drugs may be a
part of the not-too-distant future.
There isn’t a good definition of erectile dysfunction, so for many men, it
may not be easy to recognize. The American Urological Association defines it
as "the inability to maintain an erection long enough for mutual
satisfaction" while others in the field define it as the tendency of a male
to ejaculate "sooner than desired." Neither helps very much: "mutual
satisfaction" is a vague standard, and given the option, most men would likely
want to keep thrusting all night long, so in a sense any ejaculation is premature.
Some in the medical community have suggested that premature ejaculation can be
diagnosed by the number of thrusts a man can perform after he penetrates his
partner, anywhere from 8 to 15 being abnormally low. Others have suggested that
anything less than 1 to 2 minutes of penetration before ejaculation is too
According to Ira Sharlip, MD, the director of Pan Pacific Urology Associates in
San Francisco and a former president of the Sexual Medicine Society of North
America, the real problem is that "there are no studies to show how much
intravaginal time is normal [during sex]." Without knowing normal, it’s
hard to define abnormal.
The best diagnostic tool is likely the patient’s intuition. If you feel
like you’re capable of lasting longer than you usually do, it might be time
to talk to a doctor.
Many Causes, Many Therapies
Complicating things, the exact causes of PE can vary from man to man, and none
of them can be easily or definitely identified by tests. In some cases, PE may
be caused by a hypersensitivity of the nerve endings in the penis. In other
cases it’s possible that feelings of anxiety or overexcitement could cause
a man to rush through sex and cross the orgasmic finish line before he should.
In still others, a low level of sexual experience - in general, or with a
new partner - can mean that a man hasn’t learned to coordinate his
actions with his body’s reactions.
If the problem is chronic and left unexamined, consistent dissatisfaction can
build between partners and become a contentious issue in a relationship.
Approaches to treating PE are as varied as the causes. Where psychological
factors are thought to be at play, it has been standard practice to seek out
counseling from a sex therapist, however some doctors are skeptical about the
efficacy of therapy, pointing out its relatively high cost and limited success.
For many men, less formal treatment is the way to go. One of the simplest
techniques is "mind over matter". Instead of focusing on the intense
experience of sex, a man distracts himself by thinking about mundane topics
(i.e. baseball, work, etc.) and thus takes his excitement level down a notch.
Wearing a condom can also diminish sensation. Some go as far as spreading
lidocaine jelly, a numbing lubricant, on their penis or condom before sex.
Unfortunately, once the lidocaine enters the vagina, it can have the same icy
effect there as it has on the penis, potentially making the sex less comfortable
for the female partner.
Other methods succeed by bringing the man’s partner into the process.
The "stop and start" method involves the woman stimulating the man
until he’s about to ejaculate. When he gets to that point of no return,
the man tells his partner to back off the stimulation for thirty seconds, and
once he’s cooled off, begin it again. Repeating the process until
he’s ready to reach orgasm can help acclimate the man to a sustained
The same principle is behind the "squeeze" exercise. Just like "stop
and start" the man is stimulated until he nears ejaculation. Then, his
partner squeezes the head of his penis, stops stimulation and then resumes it
when he’s less sensitive.
The Next Viagra?
Spoonfuls of lidocaine and a little patience may be effective for many, but a
pill threatens to make both obsolete.
"The most important development in treating premature ejaculation in the
past several years has been the use of Selective Seratonin Reuptake Inhibitors
[SSRIs]. Two thirds of men who try them increase the length of intercourse,"
SSRIs are a class of drugs that include the popular brands Paxil and Zoloft.
Approved for the treatment of depression, doctors have been recommending them
to their PE patients for one notable side effect: delayed ejaculation.
Though it would seem to be the silver bullet, even SSRIs have their drawbacks.
In order to feel the drug’s effects, patients would have to take them
hours before sex, thus robbing the experience of some of its alluring spontaneity.
Some researchers have even looked at combining Paxil with Viagra, hoping to
create a knock out PE combination. While the results were impressive - 56 of
58 men who took the combo upped their endurance - it still requires
beginning the medication cycle up to 7 hours in advance.
A much more convenient drug is in development, and its makers are hoping that if
and when it hits the market, it will do for PE what Viagra has done for erectile
dysfunction. Currently known as LI-301, the drug, under development by
Enhance Biotech, is the first specifically geared towards treating PE. LI-301
aims to provide the delaying action of SSRIs, but without the need for impeccable
timing. It’s makers are also quick to point out that it prevents another
possible side effect of SSRIs: if the drugs build up in the system, they can
lead to a drop in libido, thus undermining the point of their use. According to
reports from Enhance management, initial trials involving 30 couples delayed
ejaculation in all the men who took it.
More trials still need to be done, however, and pending their outcome, and FDA
review, it’s likely that the drug won’t be available to consumers
Contact Louis Wittig at
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