Premature ejaculation (PE) affects a man’s self esteem and his sense of sexuality and attractiveness. PE may even interfere with a man’s willingness to enter into loving and intimate relations. Viagra has no effect on ejaculation. Ejaculation has more to do with nerves and muscular contractions. But Viagra can help by allowing the man to have a second erection after they ejaculate so it may be possible to have longer sexual experiences after the first brief episode.

When I ask patients how long they think the average sexual encounter lasts after penetration, they often respond “about 15-20 minutes.” Actually, sexual studies show that humans average only a minute and a half!

Some cures I have learned include thinking about death, biting the inside of the cheek to cause pain, self relations (masturbation) before sex with their partners so it will take longer stimulation to climax again, using one or more condoms to decrease sensation, using creams to anesthesize the penis, and antidepressants which inhibit climax. Some of this sounds pretty sophomoric to me but I am just reporting medical literature findings.

Before Viagra, if you can imagine such a world, the classic treatment was called biosensate treatment in combination with the “choke technique of the penis” To understand how this treatment works you need to understand that a few moments before orgasm for a man, there is a point of inevitability for orgasm —– even if there is no more direct stimulation of any kind. Most people find this to be new information.

The challenge is for the man to be able to identify when he is nearing the point of inevitability without crossing over the line. If he can do this, in theory anyway, he can stop thrusting and defer ejaculation.

One of the more effective treatments has been the use of SSRIs which are prescribed for depression. These medications can delay ejaculation. Some men take this medication only when they are going to have sex. Others require small doses every day.

Entered on May 21, 2011 by Dr. Roberta Foss-Morgan