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Premature ejaculation

Premature ejaculation occurs when a man has an orgasm sooner during intercourse than he or his partner wishes.

Causes, incidence, and risk factors

Premature ejaculation is a common complaint. It is only rarely caused by a physical problem. Premature ejaculation early in a relationship is most often caused by anxiety and too much stimulation. Guilt and other psychological factors may also be involved. The condition usually improves without treatment.

Symptoms
The man ejaculates before he or his partner would like (prematurely). This may range from before penetration to a point just after penetration. It may leave the couple feeling unsatisfied.

Signs and tests
There usually are no abnormal findings with the condition. The health care provider can get more useful information from interviewing the person or couple.

Treatment
Practice and relaxation should help you deal with the problem. Some men try to distract themselves by thinking nonsexual thoughts (such as naming baseball players and records) to avoid getting excited too fast. There are several helpful techniques you can try.

The "stop and start" method:
This technique involves sexually stimulating the man until he feels like he is about to reach orgasm. Stop the stimulation for about 30 seconds and then start it again. Repeat this pattern until the man wants to ejaculate. The last time, continue stimulation until the man reaches orgasm.

The "squeeze" method:
This technique involves sexually stimulating the man until he recognizes that he is about to ejaculate. At that point, the man or his partner gently squeezes the end of the penis (where the glans meets the shaft) for several seconds. Stop sexual stimulation for about 30 seconds, and then start it again. The person or couple may repeat this pattern until the man wants to ejaculate. The last time, continue stimulation until the man reaches orgasm.
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