Sensuality and sexuality are important elements of our being. In addition to a means of obtaining pleasure and physical satisfaction and being an essential part of the mechanism by which we propagate the species, these elements are deeply related to the way we relate, to the point of to be in a large part of the cases an important point in the relations of couple.
However, some people sometimes have difficulty in this area, such as erectile dysfunction, hypoactive sexual desire, aversion to sex, anorgasmia, vaginismus or premature ejaculation.
The latter is one of the most common sexual problems in men, and is often experienced with guilt and shame, in addition to being able to pose a difficulty in their relationships. How to avoid premature ejaculation? Throughout this article we will discuss some of the most used techniques in sex therapy to prevent or delay the moment of climax.
Before you start: what is premature ejaculation?
Consider premature ejaculation or rapid ejaculation in situations where the man always or almost always ejaculates either before penetration or about one to three minutes (baseline would be one minute) from the onset of penetration. here, passing the ejaculation before this one. who wishes without delay and which can lead to negative consequences for him or his relationship as a couple.
While the definition itself and the concern of most men who suffer from it may be focused on the duration, the truth is that it should also be noted that the difficulty lies in the lack of control.
Some of the difficulties this can cause include conflict in the relationship, loss of self-esteem, shame, guilt, worry, or even avoiding sex. It is common for there to be resistance to acknowledging the problem due to fear of rejection and social ridicule, although this is a condition that in many cases can be treated successfully.
It is one of the so-called sexual dysfunctions, understood as all those alterations in the cycle of the sexual response which do not allow to participate in the relationship in the way the subject would like or which implies the appearance of pain in the sex. And which implies discomfort at the subjective level for the individual or in the relationship. Specifically, it is the second most common in men, only behind erectile dysfunction. In this case, we would be faced with an orgasmic type dysfunction.
It should be noted that since the existence of premature ejaculation is considered a dysfunction, this difficulty must occur continuously or in about three-quarters of relationships maintained for at least six months, otherwise it would be of a one-time or sporadic difficulty sexual relationship.
It should also be borne in mind that the problem may be generalized or limited to a specific partner or situation, and that aspects such as basic self-esteem, anxiety, insecurity, personality patient or partner may be involved. type of relationship they have, medical issues or even cultural and religious elements.
the main reasons
Premature ejaculation can have several possible causes, Which can be both biological and psychological.
At the organic level, some of the causes can be the presence of injuries, illnesses or a side effect of the consumption of certain drugs or medicines. Also for a possible neurological predisposition, which is the most common organic cause.
However, it is more common to find that the causes of premature ejaculation are psychological, including lack of psychosexual skills, problems in the relationship or strong impulsivity and anxiety.
In addition to this and largely related to the causes, it is possible to establish the existence of different types of premature ejaculation.
There are cases where the person has had this difficulty throughout their life and from the first sexual encounter, which is usually more correlated with a problem of organic origin. There may be alterations or injuries to the nerve pathways that control ejaculation or there may be some type of genetic inheritance. The criterion in this type of case is that premature ejaculation occurs before one minute. In these cases, pharmacological treatment may be of benefit.
Another of the most common types is that acquired throughout life, which can have mixed causes between biological and psychological or directly psychological (in this case, it is established in a reduction of the duration in the environment of three minutes or less)
Another group is made up of men who have latency in the normality most of the time with a one-time rapid ejaculation, or restricted to a specific partner or situation. In this case, we would be in a problem of psychological origin.
Finally, there are also men who consider themselves to be suffering from premature ejaculation but who may nevertheless have a typical ejaculatory capacity or even greater than the usual. In this case, the difficulty would be at the psychological level or at the level of the relationship with the partner. Usually it is considered the average in terms of penetration time before ejaculation it is seven minutes for men up to the age of thirty, decreasing with age.
Basic program for this and other sexual dysfunctions
We have already mentioned that rapid or premature ejaculation is considered to be one of the main sexual dysfunctions. Treatment for this disorder and others in the same group can vary widely depending on each case and its characteristics.
However, different researchers have developed a basic sex therapy methodology that allows working all the sexual dysfunctions at the same time that in different phases specific techniques for the problem in question are incorporated. More specifically, the basic program includes the following phases.
1. Non-genital sensory focus
This first phase of the program is based on performing erotic massages, without at any time stimulating the genitals. The two members of the couple will alternate, so that both alternate between a more active role and a more passive / receptive role, at least three times and running all over the body. The massage can be given with different parts of the body and in different places, including the bed and the shower..
The person receiving the massage and the caresses can indicate whether they like it or not, guide their partner and even lead their hand. But at this point, you can never stimulate the couple’s genital area, nor seek penetration or orgasm. The goal is to learn to focus on bodily sensations, as well as to learn that the sexual encounter is not just the moment of orgasm. It also helps curb impulses.
2. Genital sensory focus
This second phase is probably the most complex, and this is where the techniques specific to the case of rapid or premature ejaculation will be introduced..
In the same way as in the previous phase, the massages are carried out by varying the person who gives them and receives them, at least three times. In this case, however, contact with the genitals and achieving orgasm is allowed, but not penetration.
3. Vaginal confinement
The third phase of the basic program is a continuation of the previous one but in this case make the caresses at the same time. On this occasion, penetration is authorized. However, the restraint must be done (with the specific techniques which will be explained later) at least three times before reaching orgasm, which must also be outside the body of the recipient (whether the vagina, anus or mouth).
Postures will be used in which the person receiving the penetration is on or on their side.
4. Restraint vaginal moving
The last phase of the basic program is an extension of the previous sequence, in which different postures and types of sexual practices will also be tested.
Specific techniques to delay ejaculation
Throughout the above sequence, we have repeatedly mentioned the application of specific techniques depending on the type of sexual problem that may exist. In the case of so-called premature ejaculation, these types of techniques are based on that person as the victim gradually acquires greater body awareness of their sensations while learning to keep better control over them
In this sense, two of the most common specific techniques are mentioned below, which can be practiced both in couple and in masturbation (it is possible to start masturbation alone and then join the couple) although they usually have been designed for couple practice. The ideal is to perform them in masturbation to gain some control, and at this point, start incorporating them into penetrative sex.
1. Stop and start technique
One of the most common and well-known specific techniques is the stop and start technique. This technique is based on stimulating the penis until it reaches the point or time before ejaculation, when the penis must be stopped. There is a shutdown lasting about two minutes. After that, the same technique is repeated up to three times. In the last of the occasions it is possible to be continued until ejaculating.
This technique seeks to train the person to recognize the sensations of the penis and to begin to establish some control over them., Which over time can lead to an increase in the duration of penetration. It can be done in masturbation or during penetration, and is generally the most recommended in the phase of vaginal restraint with movement.
2. Compression technique
The second most common and best known specific technique is the compression technique, in which we try to reach by stimulation the point preceding ejaculation for this time to compress the glans with the fingers, between fifteen or twenty seconds. This exercise should be repeated up to three times before finally ejaculating
A variation is the basilar compression technique, In which the part of the penis that is compressed is not the glans but the base of the penis shaft, around the point where it joins the testicles. It is generally more recommended in motionless vaginal restraint or in masturbation.
Other techniques to consider
Beyond the above, people who suffer from rapid or premature ejaculation may benefit from other techniques, not so directly related to intercourse itself.
In the first place, those of relaxation stand out, in cases where there is great anxiety. Sex education and psychoeducation may also be necessary to combat myths and beliefs that can be dysfunctional and make it difficult to manage the difficulty. Another element to consider is couples therapy and the work of communication between its components.
Likewise, the application of drugs and items such as anesthetic creams that reduce sensitivity can also be evaluated in some cases, although these should be guided by a professional and are not always recommended.
Althof, SE, McMahon, CG, Waldinger, MD, Serefogba, EC, Shindel, AW, Adaikan, PG, Becher, E., Dean, J., Giuliano, F., Hellstrom, WJG, Giraldi, A., Glina, S., Incrocci, L., Jannini, E., McCabe.
M., Parish, S., Rowland, D., Segraves, RT, Sharlip, I. & Torres, LO (2014). An update to the International Society of Sexual Medicine guidelines for the diagnosis and treatment of premature ejaculation (PE). Journal of Sexual Medicine, 11: 1392-1422.
Leiblum, SR (ed.) (2006). Principles and practice of sex therapy. New York. Guilford Press. (4th ed.).