Maths problems, football team line-ups and “Paddington Bear eating a marmalade sandwich”… Just some of the things mentioned by men in a British newspaper when asked what they thought about to try and delay ejaculation.
The idea behind this tactic is mental distraction. You cast your mind into an area that’s as non-sexual as possible in the hope that it’ll help you last a bit longer in bed.
Sure, it can prove a bit of a mood-killer, but that’s also kind of the whole point.
Men are willing to try anything because arriving too fast at the point of no return can prove devastating for their all-round confidence. The (incorrectly) stereotyped characteristic of male sexual prowess is, after all, largely focused on notions of "strength" and "control".
Premature ejaculation represents the exact opposite.
What is premature ejaculation
The International Society for Sexual Medicine defines PE as a condition “characterised by ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration”.
But this dismal scenario is familiar to a significant proportion of men. In fact, the Mayo Clinic estimates that as many as one in three experience this problem at some point in life.
The good news is that there’s real hope for PE sufferers as effective forms of treatment do exist.
“The main thing when I see patients about this issue in my day-to-day GP practice is trying to initially establish what the underlying cause is, and also to categorise what kind of premature ejaculation they actually have,” says Dr Matt Vickers.
The two types of PE
There are two primary forms of the problem, he explains.
Lifelong or primary PE is when a man has always experienced the issue ever since he first became sexually active. It’s believed this often stems from some form of disconnection between the brain and the nerves relating to the penis.
“So what happens is the man ends up with the inability to control when they want to ejaculate,” Dr Vickers says.
The second type is acquired PE, where the man suddenly develops the problem. This can regularly occur with men who are struggling to achieve or maintain an erection.
When they do manage to get it up, their brain is keen to seize the potentially fleeting opportunity while it can as Dr Vickers explains: “The natural goal of sexual activity is to ejaculate for reproduction.”
Either way, it’s vital to establish what form of PE you’re struggling with because that will ultimately determine your course of treatment.
Treating a case of primary PE usually involves trying to modulate the ejaculation reflex. The most effective way to do this is through the use of a type of medication called "selective serotonin reuptake inhibitors" (SSRIs).
These are antidepressants commonly prescribed for mood disorders, anxiety or depression. But that’s not why they’re recommended in this scenario.
“Serotonin is a neurotransmitter that's responsible for mood and anxiety, but it also uses other parts of the body as part of the nervous system to control nerve responses,” Dr Vickers says. “The ejaculation reflux is under control of serotonin to some degree.”
When these drugs were first used on the market to treat anxiety and depression, one notable side-effect was that men found they could often last longer in bed.
“Further studies revealed it's also effective for people who have PE,” Dr Vickers says. “It delays their time to ejaculate quite significantly.”
Tackling erectile dysfunction
Cases of secondary PE, on the other hand, often derive from some form of erectile dysfunction. “In younger men, in particular, erectile dysfunction is typically not due to any physical abnormality,” says Dr Vickers. “They’re more often due to confidence and performance anxiety.”
As a result, doctors often treat this underlying issue with standard ED medication.
The effectiveness of this treatment means that most erectile problems should improve, resulting in better confidence that, in turn, will help alleviate the PE.
A doctor may also decide that no prescription is necessary. “It's also important to look at other causes of ED, such as increased weight, smoking, excessive alcohol use or lack of exercise,” Dr Vickers says.
“Sometimes treatment may involve no medications at all, just recommended lifestyle changes like stopping smoking, or exercising more.”
Alternatively, your GP may suggest that seeing a therapist is a better course of action.
Some psychologists specifically offer sex therapy or couples’ counselling to work through relationship issues that may be having a diminishing impact on sex and intimacy.
Work your kegels
Once your underlying issue is being tackled, you can supplement the treatment with additional forms of behavioural exercises. One option is to do kegel exercises, working out your pubococcygeal muscles (aka your pelvic floor).
To get an idea of what these muscles feel like when they're engaged, trying cutting off the flow of urine the next time you're taking a leak.
By regularly tightening and holding these muscles you can strengthen your pelvic floor, which can have a positive effect on PE. In one study, 82 per cent of sufferers that underwent a 12-week training program for their pelvic floor muscles found they “gained control of their ejaculatory reflex”.
Experiment with edging
Another option that Dr Vickers suggests is to practise “edging”, a technique that can help you train your brain and body in order to make sex last longer.
Essentially this involves training yourself to get very close to orgasm and then stopping until you’ve got your excitement under control.
Then you go again.
“By repeatedly doing that you can train yourself to continually delay, and delay, and delay ejaculation,” Dr Vickers says.
Some people also experiment with using topical anaesthetic sprays, wipes, or creams. One small study found that applying wipes covered in benzocaine, a mild anaesthetic, can help you last longer in bed.
“Some of these over-the-counter treatments can work reasonably well and lots of men get good responses with them,” Dr Vickers says.
Just bear in mind, he adds, that these anaesthetic products can also numb your partner down there, so good communication is essential if you’re planning to try them out.
Talk to a GP
There’s no doubt that premature ejaculation can prove deeply frustrating and embarrassing. But you don’t have to suffer in silence.
Speak to a GP and take action to ensure that you achieve your own happy ending.