Here are a few tips that you can start to use tonight to help your man last longer:

• PE only happens when a guy is nervous. Your overall mission, tips or techniques or whatever, is to make him feel like he is “the man” in bed.
• Go easy when giving fellatio (oral sex) to your man. Some women go overboard as if there were some race to make the man ejaculate a.s.a.p. Take your time and go slowly. If your man wants you to go faster, he’ll tell you.
• For your first position of the night, let him go first. If you pounce on him and start thrusting away, he might get nervous due to feeling out of control. You can always try these positions later on anyway.
• Sex is not just oral and penetration. The best way to comfort a guy and make him less stressed and more confident is to have plenty of “extras”. Press your body against his, do some light foreplay (not too much or he’ll just get too excited), massage, kissing etc.

Talk to your man and tell him you want to help him get through this. But if it needs to take a long time then so be it. Don’t put any pressure on your man or you will only make the problem worse.

How Does Therapy Work?

Ultimately, the cause of all premature ejaculation is “performance anxiety”. This means that when a guy enters the bedroom he becomes nervous.

Usually this is because he is worried about how long he is going to last. After all, orgasm feels great but it only lasts a few seconds. Getting there is just as much fun but we all want to make it as long as possible.

The problem is that even just thinking about it will give you “performance anxiety”. Just thinking about it will actually make it happen.

Therapy works by retraining you so that you don’t think about it anymore. When you concentrate simply on the sex and your partner and enjoying the act to the maximum without any distractions of worry, your time till ejaculation will naturally increase.

Sex Surrogate

This is the best method of therapy you can get. This is where a woman who is a sex therapist has sex with you and teaches you how to naturally increase your time till ejaculation.

Unfortunately this is very taboo in medical circles and extremely difficult to obtain. You might be able to get it in The Netherlands and in Israel this service is legal. But everywhere else it is mostly illegal.

Self Therapy

The other method available to everyone but still effective is self therapy. There are a number of natural techniques that you can use yourself to naturally extend yourself.

I make a distinction here between short term methods like different positions and the “squeeze technique” for example. These are useful methods but they are only short term.

However, there are self therapy techniques that work in the long term by getting rid of your performance anxiety and are very successful for most guys.

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Masters and Johnson

Masters and Johnson were a husband-wife couple who also happened to both be sex therapists and indeed pioneers in the 1950s and 60s. Back then, they published what was one of the most revolutionary of studies where couples were hired to investigate various aspects of sex and sexual relationships. Some lucky volunteers even got to have sex in the laboratory!

They also looked into premature ejaculation and one of their findings was that the squeeze method (or technique) can be beneficial for delaying ejaculation.

The Principle

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Basically, all guys feel an increase in arousal during penetrative sex. There comes a point that can be called “the point of no return”. If you arouse yourself to this level then you will ejaculate within a matter of a couple or three seconds. However, if you apply the squeeze technique just before this point then you can immediately subdue your arousal and your reaction. After this, you can work yourself up again towards ejaculation and either go all the way or continue to use the squeeze technique again and again.

The Technique

When you are ready, quickly withdraw from your partner and then place your thumb and first two fingers around your glans. There are a few variations but most involve the thumb on the underside of your penis and the two fingers on top. Then apply a hard squeeze and immediately the blood will rush out of your penis and it will go half-flaccid. Don’t be afraid to press really hard and also make sure you hold it for enough time e.g. 10 seconds.

Discussion

The squeeze method is handy but this was used in an age when there was little else that a guy with premature ejaculation could do. These days there are far more remedies and cures that any guy can reach for or use. So today it remains a cheap (free!) method but it does lead to interruption which may be unwanted by the man or his partner.

It comes in a tiny vial of brown liquid. The cap contains a brush made from natural materials itself (it doesn’t look like a regular manufactured brush).

You apply this liquid to the head of the penis using the brush. When I bought this the guy at the store told me to apply a couple of drops to the underside of my penis (where the frenulum is). I tried that and it had no effect.

So next I coated my entire glans with this unknown liquid. No effect.

It would actually be quite difficult to use the brush to cover my entire shaft, this product is not intended that way so this was not tested.

All in all, I think China Brush is not a very good product. However, millions of units of it are sold every year around the world so it must work for some men. At a cost of a few dollars it is certainly worth a try.

The main ingredient is ginseng. While this can enhance your libido, ginseng is not know to have any ejaculatory delaying properties. It also contains garro wood, bezoar, clove, cinnamon, bovine gallstones and aloe barbadensis.

How Is It Used?

It is intended to be applied to the glans of the penis one hour prior to intercourse but washed off just before intercourse to ensure that both the man and his partner do not absorb any more of the active ingredients.

Side Effects

Reported side effects are rare and of minimal severity. The most common is a temporary mild irritation or sensation of heat, or undesired delay in ejaculation of greater than 30 minutes.

Study Outcomes

One study tested a range of doses versus placebo and found a “clinically optimal dose” of 0.20 g[1]. Several studies indicate that SS cream is useful for treating premature ejaculation whether or not erectile dysfunction is also prevalent[2]. One wide ranging study showed that SS cream can give an IELT of 11 minutes on average compared to 2.5 for placebo[3].

Mechanism Of Action

It appears that SS cream works as an anesthetic agent and desensitizes the penis in a similar fashion to lidocaine/prilocaine topical treatments. Comparison of these topical treatments in the same study would prove useful in future.

1. http://www.nature.com/ijir/journal/v11/n5/abs/3900431a.html
2. http://www.koreamed.org/SearchBasic.php?DT=1&RID=309593
3. http://www.pehomepage.com/Treating-PE/Creams/SS_cream_for_the_treatment_of_PE_17.html

Antidepressants

Antidepressants SSRIs such as paroxetine are widely precribed by doctors for premature ejaculation. We know that many of them are excellent reuptake blockers and this could explain at least part of the reason for their efficacy. Different classes of these drugs have a slightly different effect on the various receptors and this partly explains the variance in efficacy.

Other antidepressant drugs have similar properties, for example tricyclic antidepressants or unique drugs like nefazodone. Nefazodone is both a 5-HT2 antagonist and 5-HT/noradrenaline reuptake inhibitor. However, while many studies have shown success with tricyclics against premature ejaculation, nefazodone has not shown any difference to placebo.

The Future

5-HT receptors are known to be absolutely critical to the mechanism of premature ejaculation and recent studies by eminent researchers such as Dr Marcel Waldinger of Utretch University, a pioneer in premature ejaculation pharmacological treatment, appear to confirm a genetic link for men who have always had this problem.

It is likely that drugs will be specifically designed in future to delay ejaculation based on this mechanism rather than the current situation where patients may rely on drugs that have the accidental side effect of delaying ejaculation.

Daily Dose

Most studies have investigated the use of clomipramine when taken as a daily dose. One found a 25 mg bedtime dose to be effective in a single case[1]. Another study showed better performance than placebo when a course of 6 weeks was taken[2]. Yet another study showed mixed results: a daily dose of between 10 and 40 mg over 2 months showed no benefit versus placebo. However, after this double-blind period patients received clomipramine for 3 months and nearly half derived benefit[3].

On-Demand Dose

Studies have also been carried out into the efficacy of clompiramine when used “on demand”, several hours before intercourse.

One study found that a 25mg dose taken 12 to 24 hours before intercourse derived was effective for men with premature ejaculation alone (but not erectile dysfunction). Average IELT (intravaginal ejaculatory latency time) increased from an average of 2 to 8 minutes[4]. Another study encountered similar results with the same dose but also found a common side effect of nausea the following day[5].

Other studies have investigated a range of doses of between 10 and 50 mg taken between 4 and 24 hours before sex.

SSRIs

Medical professionals are now more likely to prescribe a newer class of antidepressants, SSRIs, both generally and for premature ejaculation. This is because SSRIs are considered to be just as effective and have fewer side effects and lower lethal doses. The most effective SSRI for premature ejaculation has been shown to be paroxetine.

1. http://www.jstor.org/pss/3812838
2. http://www.ncbi.nlm.nih.gov/pubmed/6751156
3. http://www.ncbi.nlm.nih.gov/pubmed/7193614
4. http://linkinghub.elsevier.com/retrieve/pii/S0022534701655769
5. http://linkinghub.elsevier.com/retrieve/pii/S0302283804002702

Sildenafil is a drug designed to combat erectile dysfunction. It is better known as Viagra and is most often prescribed to older men encountering erectile difficulties. A number of younger men are also taking this drug for recreation rather than medical reasons due to the lower refractory period that it allows. Some men have noticed that sildenafil can also prolong intravaginal ejaculatory latency time (IELT).

SSRIs have been used for many years to treat men with premature ejaculation. Doctors have tried varying doses and drugs but paroxetine has been found to have the greatest effect on prolonging IELT[1]. Unfortunately, it also produces some of the severest side effects and a number of class action lawsuits have taken place due to the possibility of SSRI discontinuation syndrome. The greatest drawback of SSRIs from a premature ejaculation point of view lies in their half-life and duration. They are most efficient at delaying ejaculation when a longer-action daily dose is used. Shorter action “on-demand” SSRIs do not give as great an increase in IELT[2] but wear off quicker and therefore have fewer effects after intercourse is completed.

The efficacy of paroxetine as a treatment for premature ejaculation is well known and beyond doubt and I will not explore it further here. However, let’s first look at the efficacy of sildenafil alone.

Sildenafil Alone

A number of studies have been done over the last 10 years to test the efficacy of sildenafil. The results are mixed but generally promising. While one study found no difference in IELT [3] they did report an increased perception of ejaculatory control, sexual satisfaction and decreased refractory period. Other studies have concluded differently. A 2001 study published in the International Journal of Impotence Research found sildenafil to be superior to other modalities such as SSRIs and the pause-squeeze technique[4]. A more recent study had similar findings and determined that sildenafil “has much higher efficacy than paroxetine and squeeze technique”[5]. However, a study by Pfizer determined that there was no direct effect on IELT after 8 weeks.

There is no effect of sildenafil on ejaculatory latency that can thus far be explained except for a few experimental studies[6]. We could conclude that any improvements may solely psychosexual such as increases in confidence, perceived ejaculatory control and reduced performance anxiety.

Sildenafil & Paroxetine Combined

A few studies have investigated the effects on IELT from combining both drugs. One concluded that combining both drugs with psychological and behavioral counseling had a beneficial effect but did not compare against either drug used on its own[7]. Another study found that another SSRI (fluoxetine) gave an increase in IELT when combined with sildenafil compared to fluoxetine alone[8].

Conclusion

More research needs to be done to confirm the efficacy of sildenafil and the mechanism that it uses to potentially prolong IELT. However, it appears so far that there is significant evidence to suggest that sildenafil alone and sildenafil combined with an effective SSRI are both good treatments for premature ejaculation.

1. http://www.medicine.ox.ac.uk/bandolier/band128/b128-3.html
2. http://www3.interscience.wiley.com/journal/118719205/abstract
3. http://www3.interscience.wiley.com/journal/118719247/abstract?CRETRY=1&SRETRY=0
4. http://www.nature.com/ijir/journal/v13/n1/abs/3900630a.html
5. http://www.ingentaconnect.com/content/bsc/iju/2007/00000014/00000004/art00013
6. http://www3.interscience.wiley.com/journal/118508165/abstract
7. http://cat.inist.fr/?aModele=afficheN&cpsidt=14488234
8. http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowAbstract&ArtikelNr=102909&Ausgabe=233211&ProduktNr=224282

Premature Ejaculation Gene Found

You may have read recently about a Dutch study of 200 men conducted by Dr. Marcel Waldinger who is one of the world’s leading researchers into premature ejaculation – for example, he defined the term “intravaginal ejaculation latency time”.

Many people have long suspected that a gene might be responsible for lifelong premature ejaculation and it appears that men with PE have less active serotonin between the nerves in the brain responsible for controlling ejaculation.

They have shown that a specific gene, 5-HTTLPR, controls the amount and the activity of serotonin and is found in 3 types.

Gene Types

So, 3 types of genes give:

• the man who has always had premature ejaculation
• the “average” man
• the man who has always lasted a long time

Remember, we are talking here about lifelong PE, not PE caused by some traumatic event.

Implications

Waldinger says that this could mean that gene therapy will be a possible cure for PE in the future. He also makes a bold claim that:

“this theory contradicts the idea, which has been common for years, that the primary form of premature ejaculation is a psychological disorder”

What I Think

One day, gene therapy may offer the “magic bullet” cure for men who have had PE their whole life.

However, for men who have suddenly started to have PE due to some traumatic event, gene therapy will not help them. Also, there are many men who have had lifelong PE that is not due to genetics – they may have suffered a bad experience early in life giving rise to anxiety that manifests itself in the bedroom. Many men have suffered in this way and have no idea why.

It’s also worth remembering that Waldinger has long been a researcher into drugs that affect serotonin such as SSRIs and this is likely to continue. You can read more of his studies here.

Plus, “blaming” your genes is no excuse to not do anything about your problem NOW, today. As we map the human genome, each day we are finding out more and more about our individual risk factors. For example, susceptibility to heart disease and cancers, propensity to commit crime, intelligence and more.

It is wise to simply look at a disadvantage that you may be born with and blame it for the rest of your life and become a victim to it? I say no – whether the odds are in your favour or against them, this should be no excuse for not striving to improve yourself.

Cure your PE today by clicking here for Ejaculation Supremacy.

One of the experts explains that premature ejaculation is caused by anxiety so it is probably the guy’s apprehensiveness about marriage that is causing his PE. She goes on to recommend the stop-start technique – personally, I think that this is only a first base in curing your PE and not very useful.

However, she does make an interesting observation – that the guy seems to have created a psychological link between smoking and his premature ejaculation. So by quitting smoking he may actually cure his bedroom problem! This is the interesting thing about this condition – and I believe it would work for this chap too.

The other resident sex expert has useless advice, mostly on the already well known link between smoking and impotence. He says that “smokers are also more likely to suffer premature ejaculation” but yet shows no evidence for this.

I decided to check out some studies^[1][2] and whilst many men who have erectile dysfunction (often from smoking) also have premature ejaculation, there is no solid evidence that the prevalence is any higher than for the general population.

Conclusion

If a guy who smokes thinks that his PE is caused by it then he might as well try to stop smoking and see if it fixes the problem. He shouldn’t be surprised, however, if there is little or no change.