PE: The 'other' male sexual problem
May 3rd, 2012
11:00 AM ET

PE: The 'other' male sexual problem

Ian Kerner, a sexuality counselor and New York Times best-selling author, blogs about sex weekly on The Chart. Read more from him on his website, GoodInBed.

Given the ease with which the average person can rattle off brand names like “Viagra” and “Cialis,” or joke about “four hour erections,” it would seem that erectile-dysfunction drugs are just about as common as ibuprofen.

We take it for granted, but the little blue pill has drastically changed the way we think about erectile disorder (ED).

Once known as “impotence,” ED was originally thought to be caused by anxiety, nerves, or low self-esteem; now it’s commonly known to be a health issue that hinges on the flow of blood to the penis and taking a pill to deal with the issue is often no big deal.

Don’t get me wrong: this is not to say that Viagra and its brethren – Levitra, Cialis and the new FDA-approved Stendra – are the be-all end-all, or even that they’re unequivocally effective. It’s just that these medications have helped to spur a national dialogue (and often a debate) that has changed the way we think about sexual problems.

But now that ED has come out of the shadows, what about the other major male sexual issue — premature ejaculation (PE)?

As I discussed in an earlier column, PE, (the inability to maintain intercourse for more than a minute without ejaculating) is known to affect up to a third of all men, making it even more prevalent than ED. And yet we tend to think about PE in much the same way we once thought about erectile disroder - shrouded in myth.

Most still think of PE as a function of psychology or behavioral conditioning, rather than physiology and neurochemistry. For example, many wrongly assume that:

  • PE only affects young men who are sexually selfish or immature
  • it's the result of early masturbation habits
  • it hints at deeper, psychological issues

But in my professional work, I’ve observed that men who struggle with PE don’t do anything differently than men who don’t have the problem. They don’t masturbate differently; they don’t have different psychological issues; they don’t approach sex differently.

Much like a predisposition toward right-handedness, premature ejaculators are often just born that way.

Fortunately, PE is increasingly recognized as a health issue, and this is a relief to those men who struggle with it and can’t help but ask themselves: What’s wrong with me?

As with the little blue pill, the pharmaceutical industry has been on the hunt for a PE drug. Just as the discovery of Viagra was somewhat of an accident (its erectile-enhancing qualities were only discovered after the drug was being developed as a potential heart medication), it’s been observed that certain SSRI-based medications can delay ejaculation.

Ironically, what is a sexual side-effect to many may actually be a sexual boon to the man who suffers from PE, and so some doctors will prescribe the off-label use of an SSRI to help manage the condition.

One drug – Priligy – is a short-acting selective serotonin reuptake inhibitor that is being marketed in parts of Europe as a premature ejaculation pill, but it has not yet received FDA approval here in the U.S..

Another medication potentially awaiting FDA approval is PSD502, a topical numbing agent that can be applied to the penis to decrease penile sensitivity. The use of such numbing agents as a treatment for PE dates back to 1943, but these products have had their limitations.

  • For one thing, it’s been difficult to establish a recommended dosage.
  • For another, these topical solutions need to be applied at least 20 to 30 minutes before intercourse in order to be effective.
  • Additionally, if numbing agents are being used, the man may be required to use a condom to ensure that his partner’s genital area does not also become numb.
  • While helping to diminish penile sensitivity, a numbing agent does not address a man’s “ejaculatory trigger” which is neurochemically activated.

Still, those behind PSD502 claim to have developed a formula that doesn’t suffer from many of these drawbacks. Like Priligy, PSD502 is not yet available, but a very similar product has been FDA-approved based on a pre-existing monograph.

Dubbed Promescent, this product carries many of the same benefits of PSD502 and effectively decreases penile sensitivity without transmitting any numbness to a man’s partner.

But as helpful as a product like Promescent can be, I still counsel men to focus first on partner-communication, as well as “sex scripts” that de-emphasize intercourse while vouchsafing female pleasure – both of which I discuss exhaustively in my e-book, “Overcoming Premature Ejaculation.”

From there, many men who suffer from PE may find that they still need to pursue a broader “biopsychosocial” approach: one that combines behavioral, medical, and interpersonal approaches. In the absence of a single “silver bullet” to do away with PE, it’s often necessary to do a little bit of everything.

Let’s not wait for the next blockbuster drug to arrive in order to have a meaningful, well-informed conversation about PE. It may never come, but the conversation should.

Post by:
Filed under: Men's Health • Sex

soundoff (1,160 Responses)
  1. Rman

    Charlie Sheen had it right... He gots his rocks off, She gets paid...Both are happy. Whats the Problem?

    May 7, 2012 at 16:38 | Report abuse | Reply
    • markspeaksup

      i was devastated after my operation for my prostate, I could not perform my duties as effectively as before, I lost total interest in sex because my manhood kept failing me, but I am totally better now and free from Erectile dysfunction, just by using herbal drugs I purchased from this great doctor, Dr Jose Alessio,the truth about ED is that it can only be tackled using herbs, my libido is higher and at my age I have great sex, you can contact him via email on joseherbals28@gmail.com

      June 11, 2017 at 03:56 | Report abuse |
    • peter

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      November 1, 2018 at 16:53 | Report abuse |
  2. william shakespeare

    Has anyone out there developed aprotocol through Neurofeedback to treat ED? seems that it would work..

    May 7, 2012 at 17:24 | Report abuse | Reply
    • Naughty

      Does it involve leather and whip?

      May 7, 2012 at 19:39 | Report abuse |
    • hallin

      hi,really??>? http://thechart.blogs.cnn.com/

      December 25, 2016 at 23:44 | Report abuse |
  3. TOM-TOM

    Though I do not suffer from PE, I'm glad this problem is being addressed, as far as women commenting on this important subject, well, they need to butt-out! They don't want men involved in "their" bodies,or birth control issues...therefore they need to let us men talk about this & they can work out their own problems...

    May 7, 2012 at 17:26 | Report abuse | Reply
    • 4barblues

      Tom Tom,

      If women "butted out" wouldn't that leave a guy, well, alone? Couples should talk about birth control, stds and so on and agree on protection, etc.... It the government that women want to butt out of their bodies.

      May 8, 2012 at 22:01 | Report abuse |
    • Bob


      July 29, 2012 at 23:37 | Report abuse |
    • Marie

      Tom it has everything to do with women! How can a woman help a man she loves if she is not fully aware of what he suffers and how she can help? Woman who are giving hostile answers don't represent the majority of us in loving relationships. If you are trying to solve this issue on your own, then my suggestion is don't. I think you will find that opening up to your partner will be more fruitful. Women don't understand PE any more than men. But I bet you will find that many woman are willing to understand and to work on a mutually satisfying sexual relationship out of love.

      August 18, 2012 at 13:45 | Report abuse |
  4. Maureen

    Hey TOM-TOM it IS our problem when our men are finished before we even get started! How long do you think we're gonna hang with you? My first husband had PE (notice I said my FIRST) husband? Of course had he pleased me in another way, I might have hung around longer. Try giving your woman oral sex for an hour or so, and you can ejaculate in two seconds for all we would care. You see, YOUR problem is our problem. Get it?

    May 7, 2012 at 17:52 | Report abuse | Reply
    • TOM TOM

      Well MAUREEN,
      Seems like YOU have the el problemo...how many husbands have you gone thru?--

      May 8, 2012 at 11:19 | Report abuse |
    • Mary

      Right on, sister! I should have left my husband years ago. First, he had PE, then later on, ED. Can't win for lose!

      May 24, 2012 at 09:00 | Report abuse |
    • Clay

      If you stay with a man just for sex then there is SOMETHING WRONG WITH YOU, something you should get checked before you move on to another relationship, because if you are just in it for the sex you might as well move into the field of selling yourself. To be with someone is not all about the sex, it is about the love, which you seem not to have with anyone.

      May 29, 2012 at 19:11 | Report abuse |
    • MARIA

      WELL SAID !!!

      May 30, 2012 at 14:17 | Report abuse |
    • Dabababado

      If a woman would give me oral for an hour I would be more than happy to return the favour

      August 18, 2012 at 12:08 | Report abuse |
    • Billyboy

      Maureen, you are correct. Its my favorit starting point. The ladies will fight for guy who give them good OS. after all they have sex for there little nutty nut. If you take it to her, she could give whoot about your short coming

      October 20, 2012 at 08:53 | Report abuse |
  5. Chris

    There are solutions but it takes practice and unfortunately most Americans don't have the time or want instant solutions. Read tantric yoga,solutions is to sit in cross leg position and suck up your testicles and hold for count of ten and release. Do this for at least ten minutes every day and learn to control your actions. Next start taking ginseng root. Not only will it help PE it also helps with penile dysfunction. I use it everyday and wake up with an erection every day. I can perform with no problems whether I ejaculate or not. Its safer than taking some drug and you don't have to worry about performance or a four hour erection. I'm 63 years old and no one is complaining!

    May 7, 2012 at 18:01 | Report abuse | Reply
    • RS

      Wow, you are a 63 years old man and the fact that you are getting up everyday with an erection tells me about your strong health. You must care about your healthy life styles and exercise well- and also eat right. I haven't heard the tantric yoga but I can understand your point of how crossing legs to sucking up testicles will help one with one's PE problem. By practicing to sucking up testicles will prevent the rapid ejaculation because it will make testicles to work extra hard to create enough sperms to signal to penis to ejaculate. Cheers to your good health.

      June 3, 2012 at 04:16 | Report abuse |
  6. Henry

    Well, women who are always complaining about men should turn to lesbianism and stop talking about us. We are really tired of listen to women whining 24/7......

    May 7, 2012 at 19:21 | Report abuse | Reply
    • 4barblues

      Careful, if too many women turn lesbian, you may have to resort to other men....

      May 8, 2012 at 22:03 | Report abuse |
  7. Jerry Travelstead Jr.

    Maybe these so-called dysfunctions are just the natural order of things? Maybe we men are supposed to be "in and out" quickly so that we are vulnerable to predators for the shortest time possible? Maybe ED is just what naturally happens when a male ages? We humans are the ones calling it a dysfunction or a problem.

    May 7, 2012 at 19:40 | Report abuse | Reply
  8. Dr. bob

    When i read these forums it never ceases to amaze me how much misinformation is out there. A guy taking tantric yoga and taking ginseng may have a slight effect on a persons ejaculatory response if they are perfectly healthy in all other respects. If the problem is one of 5-7 other clearly identified physiological issues then it will have NO effect. Prostate issues, genetic predisposition, nerve damage or sensitivity, and a host of other problems are all contributors. How about if a guy just wants to take the edge off and not worry about switching positions or holding out until his woman is done?

    SSRI's and the whole anti depressant group of options are not a good choice for most folks, regular creams that have a numbing effect are full of side effects as well. (transference to the female partner) This author has done his homework, myself and all 3 of my Urology practice partners send our patients to Promescent, it is the best option in play right now. It is really starting to get recognized and will be the standard very soon. i wish it were a public company and I could buy stock. in it....LOL

    May 7, 2012 at 19:57 | Report abuse | Reply
  9. mariepaul@me.com

    My boyfriend in high school had this problem... the sex was just awful cause of it. it was just a disapointment.. wish I had waited for a real man

    May 8, 2012 at 12:03 | Report abuse | Reply
    • RS

      Please understand that most guys' first sexual experience start in high school. Guys learn how to control their speed of ejaculation through experience. Maybe you were his first.

      June 3, 2012 at 04:21 | Report abuse |
    • Dabababado

      I had assumed men learned to control the speed of their ejaculation through masturbation, the more the practice the better the control

      August 18, 2012 at 12:12 | Report abuse |
  10. monarch811

    My boyfriend in high school had this problem... the sex was just awful cause of it. it was just a disapointment.. wish I had waited for a real man

    May 8, 2012 at 12:04 | Report abuse | Reply
  11. Jasse

    Not sure about this article but Every time I had sex, the women I've been with push me over because I can go for hours and they are on the 5th or 6th time lol Havent seen one that can handle me 😛 and yes I have to move on cause I need a fighter! lol

    May 21, 2012 at 02:18 | Report abuse | Reply
  12. Professor

    We have heard a lot of suggestions that MEN should address the issue beforehand either by self relieving in order to last longer or with their talented mouths and tongue so their woman is not frustrated by an early exit. However, I have not heard the suggestion that perhaps the WOMAN could address the issue beforehand with their own talented mouth and tongue. To be clear I am NOT talking about using the mouth for complaining, criticizing, comparing, listing, commanding, demanding, or whining even though that might also slow- and even eliminate- male orgasm.

    ED is often caused by medical issues and I understand insurance payments. However, PE is normal male response in most cases and men can change their behavior through learning and practice. If you have 2 orgasms a day before having sex for an entire week (that is 3 per day for any Speedy Gonzalez keeping track) chances are you will discover your "little" timing problem is anything but.....

    May 24, 2012 at 02:09 | Report abuse | Reply
    • Marie

      Since your moniker is professor, I thought you would know. In partnered sex, mutual satisfaction sustains a lasting relationship. Thus the problem with PE – orgasms for the man and frustration for his partner. It would be difficult for an already frustrated woman to provide "relief" for her partner. It may be a pleasurable solution for him but I cannot see what his partner would get out of it, do you? Indeed, why would she continue to have sex with him? Partnered sex remember – two people – mutual satisfaction. The onus of finding a workable solution is with the man who loves his partner, along with the help of that loving partner That, or he can accept a life with mostly self stimulation and the same hostility that you seem to have towards woman. 90 seconds to orgasm may be normal in a sexually inexperienced man but he soon learns that repeat performeces will not be welcomed if he does not mature and work on control.

      August 18, 2012 at 13:33 | Report abuse |
    • Billyboy

      This is for the ladies. First, take the matter in hand, and find out the amount of stimulation it takes to draw your man to the " point" of delivery, then have him tell you to back off to a firm squezz, as opposed to dowanward presure. Contiue to do this until you have acheived a rock hard errection, jump on board an ride it out. Notice i said " jump on board" . When we are on our backs, presure is forced away from the head, allowing less stimulation to area just below the phallus head. Enjoy

      October 20, 2012 at 09:16 | Report abuse |
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    Good post. I learn one thing more difficult on talotly different blogs everyday. It can at all times be stimulating to learn content from other writers and follow a little bit something from their store. I’d choose to use some with the content on my weblog whether you don’t mind. Natually I’ll provide you with a link on your internet blog. Thanks for sharing.

    May 24, 2012 at 12:42 | Report abuse | Reply
  14. LRenteria

    I have suffered with P.E. for all of my adult life. I had read stories about psd502 and was waiting for its approval. I was unaware of Promescent until reading this article. 3 weeks ago when this was first prineted I ordered a trial size of Promescent and 4 days later it arrived ithe mail. The first time I used it there was a dramatic improvement in my ejaculatory control. Since then I have actually dialed the doseage into a perfect scenario for me(about 10-12 minutes). What is even better is that before at about the 90 second mark I got an uncontrollable sensation and it would just trigger ejaculation. Now it is a gradual buildup with a powerful finish. Why aren't more physicians aware of this product? Why isn't more info about it on the web? I have tried Stud 100, Rizer, Mandelay, SSRI's and none worked for me. Thanks to the wirter of this article for bringing this to my attention.

    June 16, 2012 at 13:12 | Report abuse | Reply
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    August 18, 2012 at 11:14 | Report abuse | Reply
    • Aziz

      I have two kids and my first is a daughter. I grew up in Mumbai, which was coeredisnd relatively safe for women (atleast back then), but yet I encountered several cases of what you can call mild abuse growing up -such as perverts in the road, eve teasing in the bus, a particular roving relative etc-things we all have no doubt dealt with. While I agree that no place in the world can be secure from such B@$(@*$$...in India harrassment is so open and acceptable that I dont feel safe bringing up a daughter here anymore.

      September 12, 2012 at 04:14 | Report abuse |
  16. Dabababado

    If a woman, Maureen, could give me oral for an hour I would be more than happy to return the favour

    August 18, 2012 at 12:10 | Report abuse | Reply
  17. veyromax

    Causes of erectile problems to young men:
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    2. It can be happened because of obesity,heart disease, high blood pressure, hypertension, high cholesterol and diabetes.
    3. Obesity can lead to erectile problem for the 20-30 years old men.
    4. Taking of viagra when they supposed not be can also lead to erectile problem sometime. More importantly viagra can cause damage to the blood vessels and nerves in the penis, which can cause permanent erectile problems.
    5. Excessive drink or use of drugs are more likely to experience symptoms of erectile dysfunction, because drugs and alcohol have an effect on the central nervous system.
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    November 24, 2012 at 15:20 | Report abuse | Reply
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  25. Johnny P

    This is great. I have been using Promescent since I first heard about it on CNBC. I absolutely love the product and so does my wife. I have tried a number of creams on the market but all of them seem to either make me go to "numb" or transfer to my wife and cause her discomfort. Promescent is a spray rather than a cream and you are able to personalize the number of sprays to your individual needs. It's lidocaine based with an absorption molecule so it should be able to decrease the sensitivity you are experiencing. I really like the product and I believe it could help others out.They just recently had articles on CNBC and Business Insider, they are the real deal.

    December 18, 2013 at 20:15 | Report abuse | Reply
  26. Scott

    I suffered with premature ejaculation – I tried a number of creams on the market but all of them seem to either make me go to "numb" or transfer to my girlfriend and cause her discomfort. I use Promescent and I have been extremely happy with it. It's a spray rather than a cream and you are able to personalize the number of sprays to your individual needs. I really like the product and I believe it could help others out

    February 18, 2014 at 20:37 | Report abuse | Reply
    • James

      Dude, I use Promescent too. It works like a champ. I am lasting 3x longer. It really works. http://www.Promescent.com. I am glad I found it. Here is a great youtube video by Jane Wells:


      November 10, 2015 at 19:39 | Report abuse |
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    November 25, 2020 at 00:15 | Report abuse | Reply

    hello everyone i am so much in joy to share this marvelous testimony of DR SALATO who helped me to enlarge my penis from 2.5 inches to 10 inches and save my marriage with his herbal cream within two weeks of using his herbal cream when i almost lost my marriage because i was having a very small penis,my wife always complain that i cannot satisfy her in bed the way she want because my penis size was 2.5 inches long on erection and it was causing a lot problem between me and my wife also my wife wanted to divorce me because of the issue but my problem was solved when i was searching through the internet for a solution to my problem then i came across a testimony of one MR JACKSON from USA testifying on how DR SALATO enlarged his penis from 2.5 inches to 10 inches with his herbal cream .then i decided to give him a try by contacting him on his website https://drsalatosolutionte0.wixsite.com/drsalato and he replied also gave me some things to do,which i did and it was only 7 days of using his medicine and my penis has increased to 5 inches.now it is two weeks and my penis size is now 11 inches and i now last longer in bed more than before and my wife enjoy me more than before.i am so thankful to Dr Salato for what he did in my life. If you are having problems with your penis enlargement then you can contact him on his email drsalatosolutiontemple@gmail.comwebsite https://drsalatosolutionte0.wixsite.com/drsalato also you can call/whatsapp him +2348103629945 THANKS

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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.