What can one do about premature ejaculation?

From "Human Sexuality" a brief edition by James Leslie McCary. D. Van
Nostrand Company, Copyright 1973, ISBN 0-442-25236-6

The Treatment of Premature Ejaculation

Given the cooperation of his lover, a man can train himself (except
when the cause is purely physical) to withhold orgasm until both want it
to happen. The main enemy is the fear and anxiety engendered in the man
by previous failures. Once he gains confidence in his "staying power"
and accepts the fact that all men face the problem at one time or
another, the battle is half won. To assist him toward confidence in his
abilities, several routes can be taken.

Some counsellors recommend that a local anesthetic (for example,
Nupercainal) be applied to the penile glans--care being taken not to
smear any of the ointment on the woman's vulva--a few minutes before the
beginning of intercourse. The assumption is that the deadening effect
will decrease the sensitivity of the penis and delay ejaculation.
Others prescribe the wearing of one or more condoms to reduce the
stimulation generated by the friction of intercourse and the warmth and
moisture within the vagina. Since muscular tension is a notorious
catalyst in ejaculation, premature ejaculation my be prevented by the
man's lying beneath the woman and thus taking a more passive role in
coitus. (Sexual intercourse in the cramped confines of an automobile is
unsatisfactory for many reasons, one of which is that it often creates
muscular tension that terminates in early ejaculation.)

Some men also find that taking a drink just before coitus helps, since
alcohol is a deterrent in all physiological functioning. Other men
claim similar success through concentrating on singularly unsexy
thoughts, such as their income tax payments. (It is suggested, however,
that these men take care not to let their partners know of their
diversionary thoughts, lest they be dumped from the bed before
ejaculation, premature or otherwise!) Having an orgasm and, after a
short rest, attaining another erection often permit a man to experience
a more prolonged act of coitus the second time. Some men masturbate
shortly before they expect to have sexual intercourse; because their sex
drive will thereby be decreased, they can then prolong intercourse
later.

The technique of delaying the man's orgasm can be learned, and
probably the best method is one requiring the cooperation of both the
man and his sex partner. The best chance of success lies in both
partners' consulting a psychotherapist who will, first of all, assure
the couple that premature or early ejaculation is a reversible
phenomenon. The couple will then be instructed in the somewhat
complicated technique of bringing about the reversal of premature
ejaculation.

The technique requires that the woman manually stimulate her partners'
genitals until the point that he feels the very earliest signs of
"ejaculatory inevitability." (This is the stage of a man's orgasmic
experience at which he feels ejaculation of seminal fluid coming, and
can no longer control it.) At that moment he signal the woman with such
a pre-agreed word as "now", and she immediately ceases her massage of
the penis. She then quickly squeezes its glans, or head, by placing her
thumb on the frenulum (on the lower surface of the glans) and two
fingers on the top of the glans, applying rather strong pressure for 3
or 4 seconds. The pressure will be uncomfortable enough to cause the
man to lose the urge to ejaculate. Such "training sessions" should
continue for 15 to 20 minutes, with alternating periods of sexual
stimulation and squeezing.

In later sessions, the man inserts his penis in the woman's vagina as
she sits astride him until he senses impending orgasm, at which point he
withdraws and she once more squeezes the penis to stop ejaculation. Use
of these techniques is continued un further sexual encounters until,
progressively, the man is capable of prolonged sexual intercourse, in
any position, without ejaculating sooner than he wishes.

Two notes of caution should be sounded to those using this technique.
First, the technique will be unavailing if the man himself applies the
pressure to his penis; and, second, the couple must not treat this new-
found sexual skill as a game and overdo it. If the technique is
overused, the man may eventually find that he has become insensitive to
the stimulation and unable to respond to it. He may then develop new
fears, this time about his potency, and risk developing secondary
impotence. The guidance of a therapist is strongly recommended in the
treatment of premature ejaculation to prevent such secondary problems.

Masters and Johnson report a 97.8% success rate in the treatment of
premature ejaculation.

In any discussion of premature ejaculation, a word of caution must be
injected. It is important to understand that at any one time or another
almost every man has experienced ejaculation more swiftly than he or his
partner would have liked. The essential thing is that the man not
became anxious over possible future failures. Otherwise what is a
normal, situational occurrence may become a chronic problem.