What is it?
Premature ejaculation or P.E. means 'coming too quickly'.

It's one of the commonest of all sexual problems. Recently, we did a survey of several thousand British males, and approximately 10 per cent of them said that they 'often' or 'sometimes' had this trouble.

We found that it's commoner in younger men - which is not surprising, as there's a distinct tendency for it to improve with age. Men generally get better control as they grow older.

Does it matter?
Well, in most cases it does matter - because it makes people unhappy and frustrated. And in severe cases P.E. can threaten or even ruin a marriage - simply because it spoils the sex lives of both partners. Sometimes, the condition is so bad that the man cannot even manage to have intercourse because he invariably ejaculates before he can get into the vagina. This can be devastating for a man's self-confidence. And it can be hugely frustrating and annoying for his partner, too.

However, most men merely find P.E. a considerable irritation - a condition that makes them 'come' very soon after they enter their partners (say, after only one to two minutes), so that neither party gets a lot of satisfaction.

What causes it?
For many years, sex experts have tended to say that premature ejaculation is caused by early 'conditioning'. In other words, the man's early, rushed (and perhaps furtive) sexual experiences had to be quick - so as to avoid detection! The idea is that all this hectic 'rush' conditions him to climax as quickly as possible.

However, in our own surveys we have found that many men with P.E. say that they did not have rushed, hasty early sexual experiences. They maintain that they were 'highly triggered' right from the start of their sex lives.

It's worth noting that from an evolutionary point of view, it's probable that throughout human history, males who climaxed quickly were more likely to have children. (In other words, if you were a caveman who 'came' very fast, you'd stand more chance of impregnating cavewomen and, therefore, enlarging and strengthening your tribe - than a chap who took all day about it.)

Therefore, we feel that the tendency to reach orgasm quickly may actually be inherited rather than learned.

Finally, there's no question that anxiety (or 'nerves') plays a part in many cases of P.E. If you're nervous, you're likely to come too quickly. That's why many males have discovered for themselves that a small amount of alcohol eases their nerves and makes them less likely to climax prematurely. But we wouldn't recommend alcohol as a treatment!

Treatment
So, what can be done for P.E?

(i) Very mild cases If you have very mild P.E. (for instance, if you can 'last' a good five minutes but would like to last 10), there's probably no point in going to a doctor. Why? Because you should be able to improve matters by simple 'distraction techniques'. This means turning your mind to something else when you sense that a climax is near. For instance, you can:

think very hard about something totally unconcerned with sex.

pinch yourself hard.

bite the pillow.

Some men try to treat themselves with a local anaesthetic gel. This product is advertised to the public as a good way to 'damp down' sexual sensation in the penis. But we do not advise using it firstly, because the local anaesthetic can 'dull' the sex sensation for the partner, and secondly because it can sometimes cause a distressing skin sensitivity reaction. In 1999, a product called 'S S Cream' was claimed by Chinese doctors to be helpful in treating P.E. It too carries some risk of causing skin sensitisation. At the moment, we do not recommend it.

(ii) More severe cases

If P.E. is causing you more significant problems, it is best to consult an expert for treatment. Some people claim that it's possible to 'self treat'- using the special grip mentioned later on. We don't recommend this: we think you should go to a doctor, psychotherapist or counsellor who is trained in the Masters-Johnson method of curing P.E.

(iii) The Masters-Johnson method

This method cures the vast majority of people, PROVIDED that both partners are keen to co-operate (which isn't always the case). It is based on a special 'penis grip' developed by the American therapists, Masters and Johnson. This finger-grip abolishes the desire to climax, so if the couple use it - under careful instruction - over a period of weeks, they can usually 're-train' the man so that he can last much, much longer. For instance, we have seen many men who had P.E. so badly that they couldn't even last for 30 seconds. But after careful training with their partners, they were soon able to last as long as half an hour. The programme (and the grip) work for male gay couples as well as for heterosexual ones.

The Masters and Johnson grip really needs to be demonstrated to you personally by an expert. Most couples who try to learn it from the Internet or a book get it wrong! But basically, it involves the partner placing her hand so that her thumb is on one side of the man's erect penis (the nearer side to her - when she is facing him), while her index and middle fingers are on the other side. The index finger is just above the ridge of the glans (the 'head' or 'fireman's helmet') while the middle finger is just below the ridge. When the man feels that he's near to a climax, he tells his partner. She then squeezes his shaft firmly between her thumb and the other two fingers (don't worry: it's painless!).

Unless this is done as part of a carefully organised programme, it probably won't work. Our advice: see a professional. In the UK, you can find one through Family Planning Clinics, through Relate, through Couples Counselling Scotland, or through the British Association for Sexual and Relationship Therapy (BASRT).

(iv) Treatment with drugs

In recent years, it has also proved possible to treat P.E. with antidepressant drugs. That may seem a little odd, but the reason is that certain antidepressants are well known for the side-effect of delaying male climax. For most men, that side effect is unwanted. But for guys with premature ejaculation, it's quite desirable.

Antidepressants that are commonly used for this purpose include clomipramine (Anafranil) and sertraline (Lustral). But please be warned: these are powerful drugs, with a considerable list of potential side effects. Before going on to one of them, talk it over carefully with your doctor.

(v) A new technique

At the end of the year 2000, a clinical trial of a new technique for treating premature ejaculation was published in the medical press. We must emphasise that the new method has so far only been tried on a small number of patients. It involves wearing a constricting ring below the head of the penis for 30 minutes each day, in order to try and make the organ less sensitive.

Do not attempt anything like this off your own bat, please! The new method should only be prescribed by an expert at a sexual problem clinic. It may or may not turn out to be useful.

Useful further details
Family Planning Clinics - this treatment is free. Details of your nearest clinic should be in your local phone book. Or phone the FPA on: 020 7837 4044.

Relate - find them in your local phone book. Or look at their website: www.relate.org.uk.

Couples Counselling Scotland - 0131 225 5006.

British Association for Sexual and Relationship Therapy (BASRT) - most of these therapists work privately. They are not usually medical doctors, but are highly trained therapists. You do not need a GP's referral to see a BASRT therapist. Email for more details: info@basrt.org.uk.

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