Q:

My girlfriend and I have gotten to the part in our relationship were we want to have sex and when the time came I just wasn't quite up to snuff and came early... I sadly only lasted 30 seconds. I've been trying to do research on what to do to fix this; is there a way I can train myself to last longer?

 

A:

First, this is very common with new sexual relationships.  There is pressure to perform and anxiety that contributes to premature ejaculation so don't feel this is unusual or that it will always be this way.  It may be that you are rushing your relationship too fast for your comfort level and need to hold off from intercourse until you are more relaxed and ready.  In the mean time, from Mayo Clinic, are the following suggestions.  We rarely need to resort to the medications mentioned but if the behavioral training doesn't help, then you could consider a short term prescription.

In some cases, sexual therapy may involve simple steps, such as masturbating an hour or two before intercourse so that you're able to delay ejaculation during sex. Your doctor may also recommend avoiding intercourse for a period of time and focusing on other types of sexual play so that pressure is removed from your sexual encounters.

The squeeze technique
Your doctor may instruct you and your partner in the use of a method called the squeeze technique. This method works as follows:

• Step 1. Begin sexual activity as usual, including stimulation of the penis, until you feel almost ready to ejaculate.
• Step 2. Have your partner squeeze the end of your penis, at the point where the head (glans) joins the shaft, and maintain the squeeze for several seconds, until the urge to ejaculate passes.
• Step 3. After the squeeze is released, wait for about 30 seconds, then go back to foreplay. You may notice that squeezing the penis causes it to become less erect, but when sexual stimulation is resumed, it soon regains full erection.
• Step 4. If you again feel you're about to ejaculate, have your partner repeat the squeeze process.

By repeating this as many times as necessary, you can reach the point of entering your partner without ejaculating. After a few practice sessions, the feeling of knowing how to delay ejaculation may become a habit that no longer requires the squeeze technique.

Medications
Certain antidepressants and topical anesthetic creams are used to treat premature ejaculation. Although none of these drugs is specifically approved by the Food and Drug Administration to treat premature ejaculation, some are used for this purpose. You may need to try different medications or doses before you and your doctor find a treatment that works for you.

Antidepressants
A side effect of certain antidepressants is delayed orgasm. Your doctor may suggest that you take an antidepressant to benefit from this specific side effect. Other side effects of these antidepressants can include nausea, dry mouth, drowsiness and decreased libido.

Your doctor may prescribe one of several selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft), paroxetine (Paxil) or fluoxetine (Prozac), to help delay ejaculation. It may take up to 10 days for these drugs to take effect. If the timing of your ejaculation doesn't improve, your doctor may prescribe the tricyclic antidepressant clomipramine (Anafranil), which also has been shown to benefit men with this disorder. You may not need to take these medications every day to prevent premature ejaculation. Taking a low dose several hours before you plan to have sexual intercourse may be enough to improve your symptoms.

Antidepressants are not approved in the treatment of premature ejaculation. They work by taking advantage of a side effect common to these medications. Talk with your doctor about whether the risk and benefits are worth it in your case.

Topical anesthetic creams
Topical anesthetic creams containing lidocaine or prilocaine dull the sensation on the penis to help delay ejaculation. Applied a short time before intercourse, these creams are wiped off when your penis has lost enough sensation to help you delay ejaculation. A lidocaine-prilocaine spray is currently being studied.

Some men using topical anesthetic creams report reduced sexual pleasure because of lessened sensitivity. Although the cream is wiped off before intercourse, in some studies female partners reported that it also reduced their genital sensitivity and sexual pleasure. In rare cases lidocaine or prilocaine can cause an allergic reaction.

Cognitive behavioral therapy
This approach, also known as counseling or talk therapy, involves talking with a mental health provider about your relationships and experiences. These talk sessions can help you reduce performance anxiety or find effective ways of coping with stress and solving problems. Counseling is most likely to help when it's used in combination with drug therapy.

Many men who experience premature ejaculation feel frustrated and even ashamed. It may help you to know that this problem is common and often very treatable. Talk to your doctor if it's causing relationship problems for you or your partner.

While you explore treatment options, consider lifting the pressure off the sexual side of your relationship. Some doctors recommend avoiding intercourse entirely for a short time and sharing other forms of physical pleasure and affection instead. Connecting in this way can help you re-establish a satisfying physical bond with your partner.

Taking the emphasis off intercourse can remove the worry about ejaculating too soon — and it can help lay the foundation for a more fulfilling sexual relationship.

In some cases, premature ejaculation may be caused by poor communication between partners or a lack of understanding of the differences between male and female sexual functioning. Women typically require more-prolonged stimulation than men do to reach orgasm, and this difference can cause sexual resentment between partners and add pressure to sexual encounters. For many men, feeling pressure during sexual intercourse increases the risk of premature ejaculation.

Open communication between sexual partners, as well as a willingness to try a variety of approaches to help both partners feel satisfied, can help reduce conflict and performance anxiety. If you're not satisfied with your sexual relationship, talk with your partner about your concerns. Try to approach the topic in a loving way and to avoid blaming your partner for your dissatisfaction.

If you're not able to resolve sexual problems on your own, talk with your doctor. He or she may recommend seeing a therapist.

~The Doc