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Men's Sexual Health > Premature Ejaculation

Breakthrough Book For Couples Suffering Premature Ejaculation

Understanding Female Sexuality

The major sexual complaint of men that the woman is not orgasmic during intercourse is not a sexual dysfunction but a normal variation of female sexuality. Female sexual response is more variable and complex than male sexual response. This does not mean better or worse. The man usually has one orgasm which occurs during intercourse. The woman might be singly orgasmic, nonorgasmic, or multiorgasmic, and orgasm might occur during the pleasuring or foreplay phase, during intercourse, or through after play.

Rather than expecting that the woman respond like him have one orgasm during intercourse without needing additional erotic stimulation the man needs to understand and accept that only one in four women respond in that manner (Foley, Kope, and Sugrue 2001). Orgasmic response is a healthy, integral part of female sexuality, but orgasmic response patterns are variable. Few women are orgasmic 100 percent of the time. For women, sexual satisfaction includes orgasm but is less rigidly tied to it. The majority of women find it easier to be orgasmic with manual, oral, rubbing, or vibrator stimulation than through intercourse. In fact, the most common sexual response pattern is for the woman to be orgasmic with manual or oral stimulation during the pleasuring phase, with the man being orgasmic during intercourse.

To develop the intimate team approach that will help you overcome Premature Ejaculation effectively, you will need to understand, accept, and affirm your partner's patterns of arousal and orgasm. She has to develop her sexual voice, not in reaction to what you think is right, but as a way to express her feelings and preferences. Together, you create a sexual relationship which is equitable and respectful of individual preferences rather than based on a simplistic view of male-female sexual differences.

Men grow up with the idea that they are supposed to be the sexual experts and it is their job to be sure the woman is sexually satisfied. We encourage you to consider a very different way to be in an intimate relationship. Your partner is the expert on her sexuality. Her desire, arousal, and orgasm are her responsibility, not yours. The old definition of a good lover was a man who took responsibility for the woman's sexual satisfaction and was able to last long enough so that he could give her an orgasm through intercourse alone. The healthier, more realistic definition of a good lover is the man who accepts the woman as an equal sexual person and intimate partner.

As a good lover, you are open to her sexual requests and guidance. Each person's sexual enthusiasm and arousal feeds the other's desire, arousal, orgasm, and satisfaction. The man enjoys intercourse for himself and the relationship. He is aware and involved in giving and receiving pleasure during intercourse. Intercourse can involve a range of positions and movements that add to the intimate, interactive process. Being orgasmic is a natural extension of the arousal process. Sex does not end with his ejaculation. There is an after play phase in which he is open to her feelings and requests.

The man who is learning ejaculatory control with the goal of ensuring that the woman has an orgasm during intercourse is setting himself and the relationship up for failure and frustration. The reason to improve ejaculatory control is to make the sexual experience more pleasurable and satisfying for both partners, not to prove something to yourself or your partner. If she is orgasmic during intercourse and that is her preference, enjoy it. However, it is poison for you, the woman, and the relationship to put pressure on yourself to last longer so you can give her an orgasm during intercourse. The focus of ejaculatory control is to enhance the entire sexual experience: awareness, comfort, intimacy, pleasure, eroticism, intercourse, orgasm, and after play.

Premature Ejaculation and Other Sexual Problems

Although it might feel overwhelming to tackle more than one sexual problem, Premature Ejaculation often involves other sexual problems too, and you'll be more successful in dealing with Premature Ejaculation if you consider these problems along with Premature Ejaculation.

Coexisting Sexual Problems in Men

For men, the most common coexisting sexual problems are acquired inhibited sexual desire and acquired erectile dysfunction. Acquired means that the man once experienced desire and erections, but now they are problematic or nonexistent. Couple sex therapy is the treatment of choice for both of these problems. Many men would rather first try to resolve the problem using this book's guidelines and exercises. If that is not helpful within three to six months, then agree to consult a sex therapist.

Acquired Inhibited Sexual Desire

The key to sexual desire is positive anticipation and feeling you deserve good sex for you and your relationship. The usual reason for male inhibited sexual desire is frustration and embarrassment over a sexual dysfunction, especially erectile problems. Occasionally, inhibited desire may be caused by medical illness or side effects of medications, disappointment with the partner or relationship, alcohol or drug abuse, depression or anxiety, relationship stress or alienation, lack of couple time or energy, and preoccupation with children, extended family, or career. You'll need to identify the factors that inhibit your sexual desire and actively confront and change them.

Many men feel so badly about Premature Ejaculation that they fall into the cycle of anticipatory anxiety, tense and unsatisfying sex, and sexual avoidance. Sexual desire cannot be treated with benign neglect.

Avoidance just feeds the negative cycle. The hormone which most influences sexual desire, testosterone, works on a feedback system. Sexual activity enhances testosterone, while stress and sexual avoidance decrease testosterone.

In rebuilding male sexual desire, the key is to reinforce the cycle of positive anticipation, pleasure-oriented sexual experiences, and a regular rhythm of sexual encounters. You subvert your own sexual desire when you view sexual intercourse as a pass-fail test or tell yourself that anything less than a perfect sexual performance means you are less of a man. Desire is about connecting with your partner and sharing sexual pleasure.

Acquired Erectile Dysfunction

Erection problems are a major cause of male inhibited sexual desire. The traditional view of male sexuality is that a real man is able to have sex with any woman, any time, in any situation. This unrealistic demand is self-defeating for the man and his penis. In fact, by age forty, 90 percent of men have had at least one experience in which they did not get or maintain an erection sufficient for intercourse. So the most feared male sexual problem is in fact an almost universal experience.

A common non-medical cause of erectile dysfunction is trying to cope with Premature Ejaculation by decreasing arousal to slow ejaculation. Approximately one in three men with Premature Ejaculation also report erectile problems (Loudon 1988). The man feels caught between a rock and a hard place: if there is a lot of stimulation he will quickly ejaculate, but lack of stimulation results in erectile dysfunction. So the man rushes to intercourse because he fears losing his erection before he ejaculates.

Most men would prefer to take a medication like Viagra (sildenafil) or Cialis (tadalafil) to solve the erection problem, rather than address it with the partner. In fact, Viagra or Cialis can be a valuable resource by increasing blood flow to the penis and reducing performance anxiety. However, a pill cannot return the male to the easy, automatic, autonomous erections of his youth. The key to regaining erectile comfort and confidence is to relax, slow down and enjoy the pleasuring process, take in erotic sensations, and not rush intercourse or orgasm. It is crucial to be aware that the erection can wane but will become easily erect again if you stay relaxed and actively participate in the pleasuring and erotic process. You cannot be a "spectator" of your penis; sex is an involved, interactive experience.

Coexisting Sexual Problems in Women

Common female sexual problems that coexist with Premature Ejaculation are inhibited sexual desire (acquired or lifelong), difficulty reaching orgasm (at all or during partner sex), dyspareunia (painful intercourse), difficulty becoming aroused, and vaginismus (constriction of the muscles of the vaginal opening making penetration for intercourse difficult or impossible). Premature Ejaculation and female sexual dysfunction are often interrelated; one problem may contribute to the other. As a couple, you'll be most successful at improving your sexual relationship if you each take responsibility for communicating your needs and commit to working together as an intimate team.

The Resources section at the end of this book lists a number of excellent self-help sources for understanding and changing female sexual problems and dysfunction. If you desire more help, we recommend consultation with a credentialed sex therapist (see Choosing an Individual, Couple, or Sex Therapist for guidelines). Seeing a sex therapist is a sign of good judgment, not a sign that you are crazy or that this is an overwhelming problem. A professional therapist assesses the sexual problems and helps design a change program that addresses the female problem, male problem, and couple problem. Ongoing therapy helps the couple stay focused and motivated.

Additional resources on premature ejaculation are available from MayoClinic: Erectile Dysfunction.

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