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October 28th, 2010
03:37 PM ET

Men and sex: Survival of the quickest

Even though it’s often the butt of many jokes, premature ejaculation (PE) is no laughing matter. It’s the most common type of sexual dysfunction a man can have, with many  experts estimating that up to 30 percent of men have PE. In my new book Overcoming Premature Ejaculation, I use the latest research to distinguish myth from reality and offer a new approach for managing a condition that has left many men, myself included, feeling like a sexual cripple.

There’s been a lot of disagreement and discussion in the medical community about how we should define PE. But the latest, most widely accepted definition—from the International Society for Sexual Medicine (ISSM)— says that PE is a male sexual dysfunction characterized by:

  • ejaculation that always or nearly always occurs prior to or within about one minute of vaginal penetration;
  • inability to delay ejaculation on all or nearly all vaginal penetrations;
  • and negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy.

To say that it’s tough to talk about PE is an understatement. Most guys don’t want to admit that they’ve got any kind of sexual problem, especially one as sensitive as ejaculating too soon. It doesn’t help that stereotypes about PE tend to label it as a problem limited to  teenagers (just take a look at movies like "American Pie" or "Fast Times at Ridgemont High") or selfish jerks (Lorena Bobbitt famously claimed, after cutting off her husband’s penis, “He always has an orgasm and doesn’t wait for me”).

The truth is that PE can happen to anyone. It doesn’t matter how old you are, how much experience you have, or how much you know about sex. What was once believed to be an anxiety disorder is now thought to include not just psychological factors but biological origins as well. Most guys with PE have chronic PE—they’ve never known any other way.

Do you suffer from chronic PE?

1.      Are you unable to control how long you last during sex?

2.      Do you climax within a minute or less of starting intercourse?

3.      Have you tried various methods to deal with PE, only to have your hopes dashed?

4.      Are you dissatisfied with your sex life?

5.      Do you often worry about pleasing your partner?

6.      Does even foreplay often lead to “end of play?”

7.      Do you avoid intimate situations because they could lead to premature ejaculation—so why even bother?

8.      Has PE damaged your relationships with women?

If you answered “yes” to most of these questions, you could have chronic PE. And you’re not alone.

Although the stereotype of PE tends to be a  teenager who can’t control himself, nothing could be further from the truth. Because lifelong PE is chronic, it’s a problem in young and old men alike. It’s true that your ejaculatory control does get a little better with age, but that’s because your body is getting older, not because your PE is improving. In fact many older men with PE face the double whammy of erectile dysfunction.

Researchers now believe there well may be a genetic basis for chronic PE, not unlike congenital heart problems and other conditions present at birth. Studies of twins show an increased risk of PE in families, and one Dutch study found that men with PE were likely to have at least one first-degree relative (such as a father or brother) with PE, too. This tells us it’s possible that PE is has a genetic basis and that your risk for it may be inherited, just as your risk for heart disease and some types of cancer.

In my book Overcoming Premature Ejaculation the  program I recommend is biopsychosocial, or combination therapy, which combines behavioral, medical, and interpersonal approaches. That means there are:

1.      Behavioral techniques - things you can do during sex. For years sex therapists have been advising men that PE can be cured with two techniques that focus on arousal-awareness and postponing climax.  But  in fact, those techniques have limited efficacy. If anything, they often interrupt sex. Instead, I suggest a unique series of sexual positions that allow men to maintain sexual interaction without the interruption of more commonly recommended techniques.

2.      Medical therapies - medications such as SSRIs that  help to delay ejaculation and other medical approaches that are on the near horizon. While pharmaceutical solutions shouldn't be relied upon on their own, they can help guys to get a jump-start on managing PE and developing sexual self-esteem.

3.      Interpersonal methods  - changes to the way you relate during and around sex. For example, many women don't understand PE and often think that men with the condition are sexually selfish. In fact, this couldn't be further from the truth. Men with PE care greatly about their partners' sexual satisfaction, and need to be able explain the issue without shame and develop alternative paths to pleasure with their partners.

For best results, you need a combination of all three. While we can’t cure PE – because there frankly is no cure – we can learn to manage and ultimately “overcome” it.

Ian Kerner is a sexuality counselor and New York Times best-selling author. Read more from him at his website, GoodInBed.


soundoff (314 Responses)
  1. Fun Guy

    And I just remembered that there's a strain of the proper variety nicknamed "Penis Envy" for how they look, and most people who talk about this sort of thing ironically call it "PE" for short. So, PE will cure PE. Find out more at an online mushroom forum near you!

    October 28, 2010 at 21:54 | Report abuse | Reply
  2. Tom

    If you want to last longer just switch up positions... I like to go missionary, doggy style, then jackhammer... Sometimes girls can be stubborn though so if your chick takes a long time, get her off during foreplay, and then she will be so appreciative that she will let you get yours how ever you want it!!! (So then you can be quick)

    October 28, 2010 at 21:54 | Report abuse | Reply
    • Tom

      So if you cant last very long and she takes forever to get off in my opinion investing more time in foreplay is the equalizer!!!

      October 28, 2010 at 21:58 | Report abuse |
    • MXD

      Agreed – that's why God invented foreplay.

      October 28, 2010 at 22:14 | Report abuse |
  3. spikette

    hey rad, you have it all over these other guys. they are fools, and are the ones truly not getting it. they tell good lockerrom tales. even my teenage son has figured these guys out. he treats the girls well, and has them calling at home asking him out.

    October 28, 2010 at 21:58 | Report abuse | Reply
  4. spikette

    actually a study recently came out and surprise, women need variety adn guys pretty much want same olde. i think these guys have been pulling our leg all along

    October 28, 2010 at 22:03 | Report abuse | Reply
  5. dumbchuck

    how about pulling out before pm occurs and going oral until she reaches her peak? then insert member and she won't give a care how fast you get there.

    October 28, 2010 at 22:07 | Report abuse | Reply
  6. spikette

    internet. saves on thsoe embarrassing moments. as a woman though, .... i wish the guys the best, accept and embrace and work around it. all kinds of things they can do, and enjoy with mate.... and never feel bad.

    October 28, 2010 at 22:11 | Report abuse | Reply
  7. MXD

    My guess is that MOST of us guys could finish in the first minute – sometimes it just feels TOO GOOD! It's only through SHEER WILLPOWER and DOGGED DETERMINATION – and possibly an earlier session – that we can hold out for ANY length of time. Sorry, gals – you just GOT IT like that.

    October 28, 2010 at 22:13 | Report abuse | Reply
    • spikette

      wow. i mean, just wow. not only are you a guy, talking about sex, but you did it in a way that was COMPLIMENTARY to females adn not an insult. it has been so long since i have heard a man with your skill, your style. YOU are all that. hm. damn impressed. your a keeper.

      October 28, 2010 at 22:39 | Report abuse |
    • setter123

      I agree with Spikette. It's all about communication and not being selfish.

      October 29, 2010 at 10:08 | Report abuse |
  8. Hung Lo

    What about Post-Ejaculatory Remorse? Sometimes when I get with some Heffer.... after the fact im sitting remorsing, wishing I can just have alone time and she go away? I don't understand why I felt so different before? 😉 Whats wrong!

    October 28, 2010 at 22:17 | Report abuse | Reply
    • Shadow

      You have no respect for women. That is very wrong.

      October 29, 2010 at 04:55 | Report abuse |
    • mok

      Your buzz wore off?

      October 29, 2010 at 15:08 | Report abuse |
  9. AKQJT

    Chandler's knees... Chandler's ankles... Chandler's ankle hair...

    October 28, 2010 at 22:17 | Report abuse | Reply
  10. Claudia, Houston, Tx

    When you have the right mate, love making is always like the first time. Trust me, there is no prescription or technique, it's just the two of you loving one another. Stop thinking and listening to others who don't share your bedroom because you will never experience what you already have; let others have their experience, you have yours and keep smiling as they talk.

    October 28, 2010 at 22:25 | Report abuse | Reply
  11. Lucky Wife

    That's probably why she married you. 😉

    October 28, 2010 at 22:36 | Report abuse | Reply
  12. Fun Guy

    Well, I did warn that it could get weird.

    Just turn off the lights if you get the "my partner looks like Satan!" thing popping up. Actually it's best to turn the lights off just before that point, but it's kind of hard to predict.
    And come to think of it (grin), doing it on mushrooms in total darkness can be downright telepathic, which is also why it's best to only do it with someone we truly love (I've never had a lover morph into Satan, but I've heard some funny stories). The way their power manifests in a sexual context is really more tactile than visual anyway.

    October 28, 2010 at 22:53 | Report abuse | Reply
  13. ron

    Try a double vodka and water---about 20 min before "the deed"
    WORKS FOR ME

    October 28, 2010 at 22:59 | Report abuse | Reply
  14. longtimer

    Been married 30 years and unfortunately have always been a bit quick on the draw, so to speak. Here's a tip I've learned over the years- fake it! If women can fake it men can too. The orgasm I have and the one my wife *thinks* I'm having are hardly ever one and the same. You'd be surprised how long you can keep going if you want to, and it can be very enjoyable watching her have a good time after you've had yours. And every once in a while you get a very pleasant surprise... don't knock it till you've tried it!

    October 28, 2010 at 23:04 | Report abuse | Reply
  15. Fun Guy

    Absolutely not!
    In the very first line of the article, he clearly stated that "...Even though it’s often the butt of many jokes, premature ejaculation (PE) is no laughing matter."

    But you wouldn't have guessed that it's no laughing matter from reading the comments, lol (oops, sorry). So come on people, knock it off! (whoops, sorry again. can't seem to help it, it just comes out)

    October 28, 2010 at 23:05 | Report abuse | Reply
  16. baz

    Women ussually do not initiate and therefore men as the iniatiators are always ahead in the game. Imagine someone coming to play when the game is already in the fourth quarter.

    October 28, 2010 at 23:06 | Report abuse | Reply
    • setter123

      For me, I'm a female and I have a sex drive similar to most teenage guys, so I'm usually the initatior.

      October 29, 2010 at 10:22 | Report abuse |
  17. Frank D.

    Dear Claudia in Huston Texas,.....It sounds as though you have never lived with / or been married before?.......It sounds like you you have not got to that very intimate moment when your partner breaks wind in bed?....That is the true reality of relationships,....You see ladies, this is the reality you don't find in those romantic, delusional romance novals.

    October 28, 2010 at 23:09 | Report abuse | Reply
  18. Hung Lo

    Wow, he said most men last a minute, some women are just lucky!!!!!

    October 28, 2010 at 23:18 | Report abuse | Reply
  19. musings

    Is this a disorder? A heredity disorder? Too bad we are so willing to consign evolution to the distant past or to books or to deny it entirely. I was struck by the title: "Survival of the Quickest". Well, doesn't that just about give the game away? Maybe PE has survival value. The guy who actually ejaculates fast is the one who reproduces, especially if he does this a lot, maybe with multiple partners. If he can decide when and where to ejaculate during the act, then he can "hold back" (an ancient form of birth control). The controlled ones will reproduce less. I'm not even sure PE is only in the 30% realm – I'll bet it is more common than that in the ages of peak reproduction.

    October 28, 2010 at 23:22 | Report abuse | Reply
  20. darwin

    From the title I thought this article was going to be about PME being more effective trait for passing genes than the love me long time trait and therefore more common now.

    October 28, 2010 at 23:24 | Report abuse | Reply
  21. Francesco Bravo

    I am sorry but having sex with a PE man is the worst thing there is. I just don not like the fact that they do not last but 2 minutes. To me it is disgusting.

    October 28, 2010 at 23:29 | Report abuse | Reply
    • mok

      He must have been mexican...arent they bred to multiple like rabbits? Either that or he saw your mustache in the early morning light

      October 29, 2010 at 15:12 | Report abuse |
  22. Problem?

    Since when is premature ejaculation a problem? I thought I was setting records!

    October 28, 2010 at 23:31 | Report abuse | Reply
  23. MarioVanPeeples

    Masturbate 2 or 3 times before you have sex. PE cured.

    October 28, 2010 at 23:37 | Report abuse | Reply
  24. O-O

    What dudes like you are – are immature, inadequate men, stuck in your preteens. Not all men have this problem, only you geek, hipster winnie and overly-compensating aggressive insecure tough-guy/thug types. Sad bunch.

    October 28, 2010 at 23:39 | Report abuse | Reply
    • Shadow

      You sound bitter toward men. Instead of trying to make them feel bad, try having some understanding.

      October 29, 2010 at 05:01 | Report abuse |
  25. ambulance

    how about circumcision anyone?

    October 28, 2010 at 23:50 | Report abuse | Reply
    • mok

      I will say thank you to the doctor that fixed up my crank and got rid of that ugly head-wrapping...yikes. Ive heard about the benefits of it but sill...no thank you. Not to mention some women Ive spoken with say they would run if that saw that undocked skin headed their way.

      October 29, 2010 at 15:17 | Report abuse |
  26. V Saxena

    I have the opposite problem, lol. Once I get goin', I'm like an energizer bunny. I just keep goin', and goin', and goin'.

    October 28, 2010 at 23:53 | Report abuse | Reply
  27. That Guy371

    Personally my theory is it's a vaginal plot. It vexes us when their owner has more important things to do.

    October 29, 2010 at 00:02 | Report abuse | Reply
  28. MrBig

    I enjoy sex very much, look you bunch of morons, you fail the minute you worry about performance, or how well your doing (just let it happen). I met these two asian broads near the college and we've had a terrific sex life now for about 3 years. We role play and pace ourselves. It's all about the fun, the minute you start screwing with some dam mental thing som idiot Wiki'd, your chimi will fail you. Sex is all about friction between a woman's legs, not your mind. Enjoy

    October 29, 2010 at 00:13 | Report abuse | Reply
  29. yahwehufos

    exercise the PC muscle

    October 29, 2010 at 00:14 | Report abuse | Reply
  30. sombody

    kagel exercise

    October 29, 2010 at 00:16 | Report abuse | Reply
  31. confident john

    thanks prettybunny, advice from an insider is always helpful. Now if you could just tell these kids how to get women to the finish line, that would be priceless...

    October 29, 2010 at 00:16 | Report abuse | Reply
  32. ok

    I dont understand why premature ejaculation is considered a problem, or even why it is called pre-mature?? The whole reason for having sex is to PRO-CREATE. Whether you come in 2 seconds or 2 hours, it has the same affect as far as making a kid

    October 29, 2010 at 00:20 | Report abuse | Reply
  33. Hellbeer

    I think it's hilarious when guys hate on other guys for making sexist jokes etc, but what cuts the cake is the lectures they try to give. If you are blaming your inability to get laid on another man you've got some serious issues. Step your game up, if you are so smart then why are you letting the girl go home with him and not you? Tell one of your witty, smart jokes and then woo her with a dashing smile. But we both know thats not the real problem. You just tell yourself that it's "the jerks" fault. It's not that when a woman looks at your she doesn't see the life of the party, or an outgoing personality, or a man who takes control. She definately doesn't see a shy, timid pushover (even if you do have better looks and are smarter) whos "respect" for women comes off as a desperate plea for sex where she would probably bend you over. Women really don't care all that much about looks, or smarts, they care about laughs, personality and CONFIDENCE. Once you get a little bit of these qualities you'll find that the "jerk" at the bar who always gets the girls isn't a factor anymore, you won't even notice him or clearly envy him. Stop lecturing us, we are grown men and don't need your take on how we conduct ourselves; you're pathetic. That 90s act is over, be a man.

    October 29, 2010 at 00:26 | Report abuse | Reply
  34. Vas Deferens

    Life if tough, we're all stressed out, everyone has demands, we all have 10,000 things to do. Maybe some guys come quickly on purpose. A couple tongue depressors and some duct tape and you keep going afterward if it makes you feel all warm and fuzzy. Just watch out for splinters.

    October 29, 2010 at 00:28 | Report abuse | Reply
    • solivita

      LOL...I wonder if any will know what your screen name "Vas Deferens" is...lol

      December 21, 2010 at 11:20 | Report abuse |
  35. Javier

    why is it that it is considered a problem?? for all we know, that is the natural function...to quickly ejaculate, to impregnate a female. Think about the evolutionary process. Maybe these men are actually genetically superior in their ability to ejaculate quickly. I think that society has created this myth that sex, that for it to be normal, has to be pleasurable for the female, and last a long time, as well as for the man. But I suspect, thousands of years ago when mankind was evolving, the quick ejaculating man was probably the most successful at procreating.... especially if she put up a fight.

    October 29, 2010 at 01:14 | Report abuse | Reply
    • Javier

      and here's another thought..... just like mankind evolved from lower animals, and mankind evolved into different races, skin color, hair etc... maybe sexuality isn't the same for everyone.. size differs, girth differs, body chemistry differs... why not sexual function evolved differently...??? Huh??? Huh???

      October 29, 2010 at 01:28 | Report abuse |
  36. Slick

    Worst sex I ever had was still good for me. Who cares if she wanted it longer, I am in it for ME.

    October 29, 2010 at 01:25 | Report abuse | Reply
    • Shadow

      How do you feel deep down inside, caring only about yourself?

      October 29, 2010 at 05:07 | Report abuse |
  37. Guy

    I love how we can all get along at the PEing guy's expense.

    October 29, 2010 at 01:38 | Report abuse | Reply
  38. John

    I wish i had PE! It takes me forever to finish.

    October 29, 2010 at 01:40 | Report abuse | Reply
  39. bewitched

    Best news since viagra! So what's the problem?

    October 29, 2010 at 01:43 | Report abuse | Reply
  40. Jenine

    If I were a woman who couldn't keep her vagina open for more than a minute I wouldn't expect any man to want sex with me.
    Why do you?

    October 29, 2010 at 01:44 | Report abuse | Reply
    • Javier

      that's probably why the "quick man" evolved... just for those cases... 😉

      October 29, 2010 at 01:48 | Report abuse |
  41. Evian

    Am I really one of the rare few who think of their partner and only their partner while having sex?

    October 29, 2010 at 01:49 | Report abuse | Reply
  42. sam

    Who said this is even a problem? Probably the same people that say a man has to spend three month's salary on a engagement ring. If I shoot early or later, It's certinly not MY problem!

    October 29, 2010 at 01:55 | Report abuse | Reply
  43. K

    The problem for me was lack of sex. I had an ex-wife who wasn't all that into it. So, sex once a month caused PE EVERY TIME. I now have a g/f...a real horn dog (sex everyday or other day). At first, yes, there was PE. Maybe the first 4 or 5 times. After that...problem solved!! From 2 pump chump to porn star. My advice, find a horny girl.

    October 29, 2010 at 02:00 | Report abuse | Reply
    • Javier

      I agree.. same situation with ex wife... maybe man just adapts to get off quicker when the female doesn't want it... when you find the compatible woman... things work great.

      October 29, 2010 at 02:17 | Report abuse |
  44. stoner

    If you have sex more often it helps. Give it the old could we try that again. Once a month or even once a week will back a man up to explode fast. More sex more often is the key. The mushrooms are a great time too.

    October 29, 2010 at 02:14 | Report abuse | Reply
  45. Chuck

    Treat ladies with respect, don't BS them and be yourself...as far as the PE goes....work on doing push-ups with your tongue and holding your breath for 5 minutes at a time....she wont care about the PE...that will just be the cherry on top....cheers.

    October 29, 2010 at 02:22 | Report abuse | Reply
  46. ikantraed

    If you can't last as long as you want... you need to start jerking it more often or something...

    How come people don't know their bodies at all? What is wrong with you people?

    It didn't just appear after being alive for decades... It shouldn't need a manual to use it.

    October 29, 2010 at 02:57 | Report abuse | Reply
  47. Fernando

    When you consider that you're thinking about it all day, it really isn't so premature.

    October 29, 2010 at 02:59 | Report abuse | Reply
  48. John Doe

    this article points out the problem and offers zero useful solutions that would create lasting change. I myself suffer from this and i'm tired of these so called experts giving no real advice that anyone else can make up.

    October 29, 2010 at 03:29 | Report abuse | Reply
  49. Javier

    good article....I feel better now that I know I won't go blind.

    October 29, 2010 at 03:29 | Report abuse | Reply
  50. GBM

    Supposedly the problem with PE is that a man can't continue after orgasm so everyone just gives up and gets frustrated. Try ignoring the social conditioning and just keep going.

    I can continue through several orgasms and don't have to stop until I or the lady desires to. I think other men can as well if they shake off the stereotypical concepts of performance and just enjoy the journey.

    October 29, 2010 at 03:35 | Report abuse | Reply
    • GBM

      By the way, I am 65 years of age.

      October 29, 2010 at 03:37 | Report abuse |
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