How to Last Longer in Bed

What Is Ejaculation?

It is natural that male sexual arousal ends up with ejaculation. The majority of men have it right after orgasm. In fact, ejaculation has neurobiological nature and is controlled by the central nervous system in the first place.

The process of ejaculation is connected with the brain and spinal cord the regulation is carried out via various neurotransmitters such as serotonin and dopamine, and others. There is a common supposition that 5-HT receptors are the primary ones to be responsible for ejaculation activation. Right after cerebral and spinal centers pelvic floor muscles (bulbocavernosus (BC) and ischiocavernosus (IC) become activated and semen is ejected.

What Is Premature Ejaculation?

There are four main stages of a male sexual response:

It is most frequent that male sexual dysfunction happens on the first three stages. In some men it is low sex drive, others have problems with arousal (which is well-known as erectile dysfunction or impotence) and many have problems with orgasm, or ejaculation (it can be in the form of inability to ejaculate, or premature/retarded ejaculation – inability to last longer in bed).

In case of premature ejaculation it is not low or absent sexual desire or inability to get or maintain erection that is the key problem. Rather, it is connected with low levels of serotonin in the brain and spinal cord regions that are responsible for the ejaculation.

Premature Ejaculation or How to Last Longer?

A great number of men over 60 suffer from this sad condition – premature ejaculation. More precise statistics says that it is one of five men who can’t enjoy sex life because of it. Premature ejaculation means that the whole intercourse is finished within 1-2 minutes after penetration happens as a man is unable to control ejaculation in any way and is just unable to last longer no matter how hard he can try. Sexual arousal is far too short and it is impossible to enjoy the intercourse.

There several definitions of premature ejaculation and before trying to understand what to to do last longer it is important to understand the problem as it is.

The International Society of Sexual Medicine has states the IELT of 1 minute not just out of thin air. Such numbers appear the average time reported by many men in the course of mass epidemiological studies. There are 10% who reported the time of 2 or 3 minutes, but they are in clear minority. Inability to last longer in bed or short duration of the intercourse – such terms are not always clear because of their very broad sense; that is why premature ejaculation definition is also accompanied with the explanation that a man is unable to control ejaculation; which is another reason for stress and frustration apart from mere short intercourse.

Types of Premature Ejaculation

Premature Ejaculation can be of two major types: primary and secondary.

Primary PE

Secondary PE

PE-related Disorders

Premature ejaculation is directly related only to thyroid disorders. Hyperthyroidism is able to cause it as a symptom and in this case the problem is solved by treated the thyroid problem. As soon as the major issue is resolved, the sexual problem disappears as well.

Prostatic problems can become the reason for PE as well as erection issues. The same approach is effective here: when the major condition is treated, PE is treated as well.

What Can a Man Do to Last Longer?

Premature ejaculation is a very common condition among men; however, the problem with its diagnosis and treatment is in the nature of the condition – it is very embarrassing for a man to admit that he has got any problems in the sphere and many just choose to suffer in silence. Besides, men are frequently unaware of the fact that there are special therapists as well as treatments for the condition. In fact, as little as 9% of men actually report recognizing the problem and applying for professional assistance. The majority just try to ignore and hope that it’ll sort itself out.

Consequences of PE

The condition of premature ejaculation can evoke several consequences and they are both of physical and psychological kind. First of all, it is lack of control over ejaculation and high levels of anxiety before the intercourse. Besides, inability to find ways to last longer decreases the pleasure and satisfaction with the intercourse and a man becomes very frustrated, especially if the condition takes a chronic turn. In some cases it can lead to serious depression.

Besides, inability to control ejaculation becomes the problem of a couple and not only a man’s one. It is only natural that a female partner also feels the effect of the condition as they are also unable to get satisfaction from the intercourse. PE also affects negatively the quality of relationships between the partners and many men state they wished they were able to perform better. In fact, many man admitted that they would be ready to get medical treatment if their partners asked them for it. There are also many men who actually tried to do something about their condition notwithstanding the fact that it was embarrassing.

Diagnostic Approach

Most commonly, a sexual history will cover such issues as when the first problem occurred and what may have triggered it. Besides, facts about the length of the relationship and its quality and significance are also important as well as questions about physical aspects of the intercourse.

Next step is clinical examination and it is also very important as apart from psychological triggers there can be easily some health issues underlying the condition. As it has been mentioned, thyroid problems can have PE as a symptom and some other health conditions as well. In order to understand what the actual trigger is, tests should be undergone. One of them is hormonal thyroid tests, for instance.

Therapists usually ask their patients to go through a questionnaire about the condition in order to create the most complete picture of the condition and how to deal with it.

PE Treatment Options

For quite a long time male sexual health issues were referred to his psychological state only and in this respect there was no other treatment than to improve mental state and various psychological approaches were used, and sometimes, effectively. However, as it appears, the problem is not always, and not only of the psychological sort. It can have neurobiological origin and in such a case, it can be treated as any other health conditions. There are many therapeutic options for the treatment nowadays and especially if a man has got the case of primary PE.

What about Self-help?

Double condom or delay condom techniques are the most frequent techniques that men tend to try when they come up with the problem. However, it usually helps but for a short period of time. As long as these are not treatments, these approaches just alleviate the issue rather than deal with it.

Masturbation is also very popular especially before the intercourse. After it the second erection is longer and ejaculation takes more time to achieve. Some men try to get distracted during the intercourse and think of something else instead in order not to focus on the act itself. These ways are helpful in some way; however, they can lead to erectile dysfunction as well.

Men also tend to try various medications that claim to help with their unlucky condition and some of them do; however, it is important not to try any doubtful self-treatments that can harm.

What Are Pharmacotherapy Options?

Among the most frequently and successfully used medical preparations for PE are the following:

Local Anaesthetics

These are mostly offered as creams and sprays and are supposed to be applied topically – locally to the penile area. They are supposed to make the glands of the penis less sensitive and thus help in delaying ejaculation. However, these creams and gels do not always work; besides, it is hard to actually measure the right supply of the preparation. In case of insufficient amount, there will be no effect and when there is too much of the anaesthetic, the latter can cause penile numbness and erection loss. There is also the risk of anaesthetic appearing the vagina of a partner and this is not a really good scenario for fulfilling and pleasurable intercourse.

SSRIs or Selective Serotonin Reuptake Inhibitors

SSRIs are presupposed for oral administration in case of premature ejaculation. They affect the cerebral and spinal centers and by doing so they help to delay ejaculation, which is exactly the thing needed to last longer. However, these particular drugs are not directly indicated for the treatment of this particular disease and this creates a complication. Dapoxetine is the only PE treatment recently developed in Europe. It is believed to increase the IELT up to 3 times and is effective during one hour after the administration. It is believed to be able to improve the control of a man over ejaculation and by doing so helps a couple to have the most satisfying intercourse. It is possible to combine Dapoxetine with other treatments as well; however, it should be taken only with the doctor’s prescription and after thorough examination and consultation about both effects and side-effects of a drug.

Psychosexual Therapies to Last Longer?

A sexologist can be really helpful in dealing with the problem of PE. After the consultation a man will find it easier to recognize the signs of ejaculation and he will also learn some techniques how to gain better control over it.

Among the most popular techniques that are offered in the therapies are the ‘squeeze’ of the glands technique and the ‘stop-start’ technique. They have got certain differences; however, they have been reported at 60% successful by the man who used it.

However, these techniques are not always the ones that are able to guarantee a satisfying intercourse. Sexologists also recommend to breathing deep and slow while making steady sensual movements in order not to raise the level arousal too high. Breath-Control techniques are generally moderately effective. There are also various desensitivization exercises that can also help in delaying ejaculation and allow a man lasting longer in bed. These exercises presuppose the use of devices during masturbation or right during the intercourse.

PE Therapeutic Goals

The approach to the treatment of premature ejaculation should have a uniform nature as the focus on the ejaculation time extension alone won’t be effective; moreover, one-sided approach can cause other problems. By focusing on a man’s sexual health in general and not just on the issue of how to last longer in bed is more effective and allows improving sexual life of a man to a much greater degree.