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What to Do About Premature Ejaculation: Possibly Nothing?

What to Do About Premature Ejaculation

Premature ejaculation was described in medical books almost 100 years ago.   In the past, men who had this problem were considered weak or selfish.  This could not be further from the truth according to all the latest research.  Whereas the main past theories of what causes this issue were psychological, more recently, the research clearly points to more biological reasons.  For example, variances in central neurotransmission and serotonin receptor functioning are contributors to how long a person can delay ejaculation (according to M.D. Waldinger in a 2007 article in Drugs Journal).  That is why some people are treated with SSRI’s, (selective serotonin reuptake inhibitors), antidepressants that affect serotonin transmission and may help in delaying ejaculation.  Many of these researchers agree that the use of the term “dysfunction” is inaccurate and just leads to more performance anxiety and couple distress.  They even go so far to say that there may be an evolutionary advantage to quicker ejaculation as it increases the chance of conception.  As a matter of fact, the majority of mammals ejaculate at time of penetration or shortly thereafter.

The newest edition of the Diagnostic and Statistical Manual that those of us in the mental health field use for diagnosing claims that people that have an IELT (intravaginal ejaculation latency time which is the time between penetration and ejaculation) between 1 and 10 minutes fall into the natural variance of ejaculation times.  Most of the clients that have come into my office presenting with premature ejaculation fall into this category and as the newest definitions (based on research and prevalence) claim- they do not have a dysfunction.  Only those with an IELT of less than a minute may be considered to have a problem but even in this situation, there are different ways to look at it.

When people come to see me with this problem, I still do some of the things I always do such as help the man relax, teach him about body awareness and helping him shift from a performance/outcome focus to a connection/pleasure focus.  However, I educate the couple on the research and help them see that there are many ways for couples to have sexual pleasure including orgasm even if a man has a shorter ejaculation time that “mainstream society “ would say is normal.  We need to not go by the sexual myths that have prevailed and instead get educated and pay attention to the latest research so that we don’t cause unnecessary pain and so that we are all free to enjoy our sexuality despite differences in desire, arousal and ejaculation/orgasm.

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