Premature ejaculation • This is how a man learns to "come later"

When do we even speak of premature ejaculation? There is no time value for this because foreplay and sex last different lengths for each couple. On average, it takes a man almost five and a half minutes for the actual act, i.e. the moment from penetration to orgasm.

If the man is constantly struggling to prevent orgasm, the act becomes torture rather than pleasure. If just a few movements lead to such a strong stimulation that it comes to orgasm well below the average five and a half minute limit, or if the impending climax cannot be stopped by slowing movements or even a pause, it is a sexual dysfunction that can be treated by means of sexual and couple therapy measures or drug therapy options.

Coming later is a partner task

The psychological forms of treatment for premature ejaculation focus on couples therapy. Although the success of the Praecox treatment does not depend on the involvement of the partner, working together and looking for solutions in partnership has been shown to have a positive effect on the treatment.

No premature ejaculation: how to come later

Techniques are often used in sex therapy to help affected men to perceive and influence ejaculation up to the point of time known as the "point of no return". The squeeze technique and the stop-start technique according to Masters and Johnson are particularly well known. In the lifelong form of premature ejaculation, these two techniques do not help permanently. Here, drug therapy approaches are recommended, ranging from applying sensory-reducing creams to taking drugs that delay orgasm.

Come later thanks to squeeze technology

The squeeze technique is preferred for couples therapy. The sexual partner, or the sexual partner, assumes the control function for the arousal of the man.

This is how the squeeze technique works

At the beginning, the partner stimulates the man until he gets an erection. The stimulation is continued with the hand or mouth until the man feels an impending orgasm. The man and the partner signal this, stop the stimulation, grip the penis with their fingers and press it together for several seconds, without pain for the man, until the excitement and the urge to ejaculate subside. Stimulation will start again after about 20 seconds. This should be done over a period of about 20 minutes, but also no longer and should be completed with an orgasm in the desired position.

Over time, the compression can be reduced in length and intensity. If the man cannot suppress the orgasm on his own, the partner always helps. Once the man has learned to control the time of ejaculation through the squeeze technique, the next step can be to stimulate the penis again, for example by inserting it into the partner's vagina. Active penetration, for example in the missionary position, is not recommended. Here, too, the partner should remain in the acting role. For example, if the woman assumes the riding position, she can control the intensity of the stimulation and, in response to a signal from her partner, reduce it at any time, break it off and, if necessary, suppress the urge to ejaculate again using the squeeze technique. Then she reinserts the penis and the process starts all over again. Later the man is allowed to move himself again, and finally to actively penetrate himself. Here, too, 20 minutes should not be exceeded initially and should be concluded with an orgasm in the desired position at the end.

Most couples describe the stop-start technique as being much more comfortable compared to the squeeze technique.

This is how the stop-start technique works

At the beginning, the man masturbates alone (i.e. without the partner under pressure to succeed) and stops masturbation shortly before the critical threshold, the "point of no return", after the orgasm can no longer be stopped for the man. He repeats this stopping and starting process over a period of around 15 minutes.

Once the man has learned to suppress orgasm in this way, the technique can be used during sexual intercourse with the partner. Both agree on a stop signal, or the man clearly indicates when the urge to ejaculate becomes too strong and further stimulation should be avoided. Only when he is again at a significantly lower level of arousal do both continue the act. A change of position can also cause the necessary interruption or stimulus reduction and delay the orgasm.

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Come later: reduce sensitivity with active ingredients

The active ingredients lidocaine, benzocaine or prilocaine, which have been tried and tested in medicine for local anesthesia of the skin, can help against premature ejaculation as a medicinal aid.

Active ingredients for the treatment of Ejaculatio Praecox

With benzocaine and prilocaine, some patients reported up to four times the orgasm delay. The effect already sets in one minute after application, so that sexual intercourse is possible almost immediately. With lidocaine, however, it usually takes about 20-30 minutes for the anesthetic to set in.

In Europe, a combination preparation consisting of the fast anesthetic prilocaine and then longer lasting lidocaine is approved for the treatment of lifelong premature ejaculation. The application takes place 5 minutes before sexual intercourse. The active ingredient is sprayed onto the glans.

Condoms with benzocaine-containing lubricant gel

The leading manufacturers of condoms not only offer condoms for pleasure, but have also adjusted to the opposite case – when men always come earlier than their partner. For this case, there are condoms that are coated on the inside with a benzocaine-containing lubricant gel. The active ingredient does not completely numb the skin nerves, but can reduce the sensitivity of the penis at the tip and shaft in a proportion of around five percent to such an extent that the pleasure does not suffer, but the stimulation required for an orgasm cannot occur.

The local anesthetic breaks down within a period of around 20 minutes and the penis is fully excitable again. The erection does not suffer. An intolerance to the active substance is rare, but skin irritation, itching, burning and even breathing problems can occur. Then it is not advisable to use these condoms as well as with open or inflamed skin areas.

A combination of a coated condom and the stop-start technique or the squeeze technique is possible.

Medication

Medicinal treatment of premature ejaculation is always useful when techniques such as the squeeze technique, the stop-start technique, sensitivity reduction with coated condoms and sex or couples therapy are unsuccessful. Medicines can also be used independently of the alternatives mentioned. These are drugs that were not specifically developed for this purpose, but whose ejaculation-inhibiting properties were initially described as side effects. The active ingredient dapoxetine is approved for the targeted treatment of premature ejaculation.

Controlling orgasm with medication in mind

Drugs from the class of psychotropic drugs often have an ejaculation-inhibiting side effect. These were examined in more detail in representative studies. For example, a drug like clomipramine, which is used to treat obsessive-compulsive disorder, is known to delay orgasm 1.4 times. Similar properties apply to heart drugs such as the beta blockers, which are often prescribed for high blood pressure, or the selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine or setralin. With these, a reduced sensation of pleasure (libido) was found as a frequent side effect, which in turn has a positive influence on an existing ejaculation praecox. These drugs are not approved for direct treatment, but are often prescribed as so-called off-label use, i.e. use beyond the intended purpose.

Later come with the active ingredient dapoxetine

An active ingredient specially developed for the treatment of ejaculation praecox and approved in Europe is dapoxetine. This is a very short-term effective SSRI, which can be taken as a tablet if necessary an hour before sexual intercourse. It will delay ejaculation by up to a minute.