Premature ejaculation ...

Between 30 and 40 per cent of men are believed to suffer from the frustrating condition called premature or rapid ejaculation. The good news is that it can be successfully treated.

Definitions of premature ejaculation have ranged from "coming within six thrusts" to "coming within two minutes" and even "coming before your partner". The last one can be particularly misleading if you have a partner who likes to take up to an hour to reach orgasm!

A simpler definition is that if you come before you want to and you feel you're not able to control it, then you're suffering from premature ejaculation (or PE for short).

Bear in mind that most men will come sooner than they'd like on some occasions, particularly if under stress or in situations of very high excitement. However, if you are unable to control when you come more than 50 per cent of the time, then it becomes a problem.

Some men may only suffer from PE when they're having intercourse. Some feel they come too quickly whatever the stimulation with a partner. Others feel they have little control even when they're masturbating alone.

The causes
PE sufferers aren't able to recognise what therapists call the "point of inevitability". This is a sensation that occurs just a few moments before ejaculation. Men who don't suffer from PE are able to recognise this sensation and either stop or change stimulation until the urgency has subsided.

Most commonly, men who suffer from PE will have had it throughout their sexual life and won't ever have noticed this "point of inevitability". There are a number of reasons why this might have happened. It may be that initially, sex was always rushed or was associated with feelings of guilt or anxiety.

Sometimes men become quick ejaculators because of partner pressure to "get it over and done with". Whatever the original cause, the body gets used to responding quickly and rapid ejaculation becomes the norm.

Very occasionally, premature ejaculation results from a physical condition such as a urinary tract or prostate infection

Very occasionally, premature ejaculation results from a physical condition such as a urinary tract or prostate infection. Recent research suggests that some men may have a physiological predisposition in the nervous system to ejaculate quickly. But for most men, ejaculation will often be quicker in times of stress or ill health.
Self-help techniques
There are a number of things you can do to help yourself to recognise the point of inevitability. You might choose to practise alone at first, then discuss it with your partner and ask them to help you overcome this problem. For more on ways to put these tips into action, see the section on practical exercises.

* Relax. This is the most important thing you can do. Have a bath, use deep-breathing techniques or buy a relaxation tape.
* Tackle relationship issues. Be sure that your head and heart are in the mood for sex as well as your body. If you're unhappy about something with your partner then sort it out first.
* Exercise your pelvic floor. Many men say they are able to delay ejaculation by squeezing or pushing their pelvic floor muscles.
* Stop and start. This is the most common technique used in psychosexual therapy. Practise stimulating yourself to the point just before ejaculation, then stop. Start again when the sensations have subsided. Repeat this three times. You should find the length of time before each stop gets gradually longer.
* Change strokes. If you feel you've gained more control with the stop-and-start technique, try changing your stroke to something less stimulating rather than stopping all together.
* Change positions. During intercourse, try the stop-and-start technique when the sensations become strong. When you're more confident, try changing positions rather than stopping.

Getting help
If these self-help techniques don't help - your GP(medic familie) might suggest a short course of antidepressants. The latest style SSRI's have the side affect of delaying ejaculation and may be prescribed purely for that purpose.

Further reading
There are lots of useful self-help books available on the market, including:

* The New Male Sexuality by Bernie Zilbergeld (Bantam Doubleday Dell)
* How to Overcome Premature Ejaculation by Helen Singer Kaplan (Brunner/Mazel)
* Coping with Premature Ejaculation by Michael Metz, Barry McCarthy (New Harbinger Publications)