The Truth About Premature Ejaculation
What you need to know if you think you're finishing too fast

September 7, 2015

Whether it’s horny lions on the Serengeti, red deer in heat on the Island of Rum, or snow monkeys humping on Mount Fuji, every species of mammal seems to share a common sexual practice. Intercourse is stunningly quick.

The males thrust and growl just long enough to satisfy instinct and make delivery before withdrawing and heading back to hunting, running, or sleeping.

The only mammals who work to extend sexual congress for longer periods purely for the sake of pleasure are humans. That’s right, guys like you and me. And when we’re not able to hold off on our orgasms, ejaculating quicker than our partners might enjoy, we blame ourselves.

According to the Mayo Clinic, premature ejaculation curses one in three men nationally. That’s about 50 million anxiety-riddled guys thinking about baseball, or starting and stopping endlessly just to hold it together. Every time a guy has an orgasm quicker than he or his lady might have wanted, he feels like a failure.

But what if he’s wrong? What if the exact opposite is true?

“Only in human society is fast orgasm undesirable,” says Dr. Brian Steixner, M.D., Director of the Institute of Men’s Health at Jersey Urology Group in Atlantic City. “If we all had fifteen inch penises and could last two hours like porn stars, we would never have kids and our species wouldn’t survive. Lasting 10 seconds means more chances of kids—more offspring. Our species endures.”

Dr. Steixner explains that a man’s ability to become aroused, stimulate and ejaculate quickly grew out of the darkest periods of human evolution, when we were under constant threat from predators, rival tribes, the elements, and everything else we’ve more or less conquered these days.

Unfortunately, male physiognomy didn’t get the memo yet that our modern bedrooms are generally free of saber tooth tigers, so it’s OK to relax and enjoy sex a little longer.

“PE is far and away the most common male sexual dysfunction I see in my practice,” Dr. Steixner admits. “It’s also the most tragic. It trumps erectile dysfunction exponentially and is more difficult to treat, because men’s expectations for performance are impossible.”

Dr. Landon Trost, M.D., a urologist and Head of Andrology and Male Infertility at the Mayo Clinic in Rochester, Minnesota, says the average “normal” American man lasts 13 minutes. Europeans only last 10, and the always-efficient Germans just 7 minutes.

“Every day I have to consider how to tell some [PE patients] that they don’t really have a problem,” Dr. Trost says.

The really serious cases—guys who can only last less than one minute, have “higher rates of depression and experienced bedwetting,” says Dr. Trost. “Those cases are pathological, but that’s only 1% of the instances we see.”

Dr. Steixner says he regularly meets with patients desperate to be “cured.” He tells those guys that their condition is normal. In fact, evolution says PE sufferers are actually more evolved than other men. But that doesn’t solve much.

“I don’t expect that me saying, ‘Congratulations. You’re evolutionally superior. You’re the strongest wolf in the forest’ helps at all. Our society says we need to perform, so I offer treatment options.”

Options like muscle development to delay climax—a form of pelvic floor training that are basically Kegel exercises for men. But Dr. Steixner reports most men won’t commit to such a program because of desperation. They want a quick fix.

Most of the quick fixes aren’t especially tempting, ranging from numbing topical sprays to Selective Serotonin Reuptake Inhibitors—pills usually prescribed for depression and anxiety, but with the common side effect of prohibiting or delaying orgasm—to, scariest of all, surgery that cuts nerves on the penis to deaden sensation and allow a man to last longer.

There’s another, less invasive option: Learn to realize that your ejaculations are functions of the nervous system. It’s largely out of your deliberate control.

A pill like Viagra might temporarily “cure” erectile dysfunction, but there’s no 100% effective medical treatment for a bodily operation that’s working not only properly, but too efficiently.

If a man can’t forgive his own evolved biology and his partner is unwilling to accept that he’s simply not going to roll for an hour, it might time to consult a different kind of doctor.

Dr. Claudia Ressel-Hodan, Psy.D., is a St. Petersburg, Florida-based cognitive and behavioural therapist working with men and couples across the country. She says that a man experiencing PE needs to explore the origins of his anxiety.

“Is the man comparing himself to what he has seen in porn movies?” she asks. “Or has his partner imposed some unrealistic expectation?”

Decreasing the anxiety often means developing realistic beliefs and expectations. “I have couples focus not on intercourse but rather pleasuring each other,” Dr. Ressel-Hodan says. This means both partners learning that sexual pleasure can occur even without an erect penis inside a vagina.

When the whole show doesn’t depend on your penis, it takes some of the pressure off. “The anxiety is then decreased because the fear of not meeting an expectation that was unrealistic is gone,” Dr. Ressel-Hodan says.

And when there are no more expectations, you just might find that little problem starts to disappear all on its own.

“Without anxiety, better control is obtained,” Dr. Ressel-Hodan says.

Dr. Trost employs similar methods, and reports between 45% to 98% success combating PE over the short term. The key is letting guys figure out on their own that difficult truth Dr. Trost wants to tell every PE patient during his first appointment with them:

“There’s nothing wrong with you, man. That’s just how you’re supposed to work.”