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Senior Sex: How to Maintain or Improve Intimacy

Sex in the Senior Years

By Mark Stibich, PhD | Updated on August 13, 2023
Medically reviewed by Isaac O. Opole, MD, PhD

This article is a repost which originally appeared on verywell health

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Key takeaways:

‧ People in their 70s and 80s and beyond can continue to enjoy sex.

‧ Striving for optimal physical and mental health can allow one to continue to enjoy sex in older age.

‧ Issues you cannot resolve on your own should be brought to the attention of a qualified medical professional.

Many people in their 70s and 80s are not only sexually active, but satisfied with their senior sex lives.1 Though the frequency or ability to perform sexually may decline with age due to physiological changes, these don’t necessarily affect how a person experiences or enjoys sex.

Aging-related problems like erectile dysfunction (ED), vaginal dryness, or urinary incontinence can affect sex. But their impact can also be minimized by using medication, managing chronic conditions, seeking individual or couples counseling, and changing sexual practices.2

This article explores the sex lives of adults 65 and over and the problems that can interfere with sex as the body ages. It also discusses the various treatment options and ways to maintain—or even jumpstart—your senior sex life.

Sexual Activity in Older Adults

Studies suggest that men are almost twice as likely as women to still have sex or masturbate in their later years. A British study found close to 60% of men ages 70 to 80 and 31% of men ages 80 to 90 are still sexually active. In women, those figures drop to 34% and 14%, respectively.3

This lower rate of sexual activity in older women may be due to a lack of opportunity rather than a lack of desire. Research shows that older women are less likely to have partners (due in large part to the fact that they often outlive their partners). This is sometimes referred to as “the partner gap.”1

Sexual Health Problems in Older Men

It is common for men to experience sexual problems after age 40. Reasons include a natural decline in testosterone levels, heart disease, and prostate problems. The inability to achieve or sustain an erection or reach orgasm or ejaculation are common concerns.4

Erectile Dysfunction

Erectile dysfunction (ED), formerly known as impotence, is the inability to achieve or maintain an erection firm enough for sexual penetration and long enough to achieve orgasm.

While ED is more common in older men, aging itself does not cause the problem. ED is related to conditions, sometimes several at once, that directly or indirectly interfere with erections.

Risk factors include high blood pressure, diabetic nerve damage, smoking, obesity, Peyronie’s disease, depression, and even certain medications. An accurate diagnosis is needed to ensure the right treatment.5

ED drugs like Viagra (sildenafil), Levitra (vardenafil), and Cialis (tadalafil) are often the first-line treatments for ED. Lifestyle changes and counseling can also help. For some men, hormonal therapy, penis pumps, and penile implants may be recommended.
Is There a Female Viagra?

Benign Prostatic Hyperplasia

Benign prostatic hyperplasia (BPH) is a non-cancerous enlarged prostate and one of the most common health problems in older males.6 BPH can cause symptoms like difficulty urinating, frequent urination, or waking up in the middle of the night to urinate (nocturia).

On top of this, BPH can cause sexual problems like low libido (low sex drive) and delayed ejaculation (difficulty reaching orgasm).

Among the treatment options, testosterone therapy may help restore libido. There are also certain drugs used off-label that may help with delayed ejaculation, including cabergoline (originally marketed as Dostinex) and Wellbutrin (bupropion).7

Because some BPH medications can also cause sexual dysfunction, a change in the dose may help resolve these concerns.8

Sexual Health Problems in Older Women

More than a third of older women experience sexual problems. These are typically due to menopause, when estrogen levels steeply decline. Hormonal changes can lessen sexual desire and make it harder to become aroused.9

Sexual organs also change as a person gets older. A woman’s vagina will shorten and narrow. The vaginal walls become thinner and less flexible, tearing more easily. Vaginal lubrication decreases, making vaginal intercourse more painful.10

Hypoactive Sexual Desire Disorder

Hypoactive sexual desire disorder (HSDD) is diagnosed when an absence of sexual fantasies, thoughts, and desires causes personal distress. It is a problem that is common among many older women.

A medication known as Addyi (flibanserin) is used to treat HSDD in women. It is currently only approved for premenopausal women, but research shows that it can also improve libido in older women as well.11

Vaginal Dryness

Vaginal dryness is uncomfortable and can make sex painful. Over-the-counter (OTC) remedies that can help relieve irritation and itching from vaginal dryness include lubricants such as K-Y Jelly or vaginal suppositories like Replens.

If OTC remedies don’t help, your doctor may prescribe estrogen cream as well as estrogen-containing vaginal rings and vaginal suppositories.

There are also plant-based products, like black cohosh, that have estrogen-like effects. These should be used with caution in women who have had or are at risk of breast cancer.12

Pain With Sex

Painful intercourse is more likely in older women as vaginal tissue tends to thin and tear easily after menopause. Standard treatments for vaginal dryness can often help ease pain during sex.

If that is not effective, prescription drugs like Osphena (ospemifene) and Intrarosa (prasterone) can treat thinning vaginal tissues and help relieve moderate to severe vaginal dryness.12

Pelvic Organ Prolapse

The pelvic floor muscles and tissues hold the bladder, uterus, cervix, vagina, and rectum in place. Pelvic organ prolapse (POP) occurs when the pelvic floor weakens, causing the pelvic organs to drop and bulge (prolapse) in the vagina. This can cause pelvic pain and pressure, pain with sex, and urinary incontinence.13

POP is often treated with pelvic floor physical therapy to strengthen the supporting muscles. In some cases, surgery may be needed.14

Other Health Concerns

Chronic medical conditions become more common as a person ages. Many of these can interfere with an older person’s sex life.
Arthritis and Chronic Pain

Arthritis and other chronic pain conditions are common among older adults and can make sex very difficult. Depending on the cause, doctors may recommend physical therapy to strengthen muscles and improve flexibility.

Nonsteroidal anti-inflammatory drugs (NSAIDs), both over-the-counter and prescription, can be taken before sex to help ease the pain. Opioid drugs, while effective as a pain reliever, can cause a drop in testosterone and contribute to ED.15

If the pain only occurs in certain sexual positions, let your partner know and try different positions. Bolstering your bodies with pillows and cushions can also help.

Diabetes

In the United States, almost one-third of adults over 65 have diabetes. Approximately half of these are undiagnosed.16

Diabetes can cause sexual dysfunction in both men and women. This can be due to circulation problems, medication side effects, or nerve damage. Problems include:17

‧  Low libido
‧ Difficulty with arousal
‧ Erectile dysfunction
‧ Painful intercourse
‧ Reduced genital sensation
‧ Urinary tract infections
‧ Yeast infections

The best way to reduce the impact of diabetes is to gain control of your blood sugar. Speak with your doctor if you have difficulty managing your blood sugar, and be sure to mention any sexual health problems you may be having. It’s important for your doctor to know.

Heart Disease

Older age is the greatest risk factor for heart disease.18 Heart disease causes problems as arteries start to narrow and harden (referred to as atherosclerosis). This reduces blood flow throughout the body, including the pelvis and genitals, resulting in sexual dysfunction in both men and women.

Heart disease is one of the leading causes of erectile dysfunction in men. It can also cause women to have difficulty achieving orgasm due to the decreased blood flow to the genitals.

There is no one way to resolve these issues, but there is evidence that statin drugs used to reduce the risk of heart disease can improve erectile dysfunction in some men.19 Some studies suggest that similar approaches may improve sexual function in women with heart disease.20

People with heart disease may also be nervous about sex due to fear of a heart attack. While sexual activity is generally safe, talk to your health provider if you are concerned.21

Obesity

Today, more than 40% of adults over 65 meet the definition of obesity.22 Research shows that women who are obese are more likely to experience sexual dysfunction than non-obese women.23 In addition, obesity increases the odds of erectile dysfunction in men.20

These issues may be directly related to higher rates of diabetes among people who are obese as well as reduced blood circulation due to atherosclerosis.24

Weight loss, achieved with a healthy diet and routine exercise, is considered the best strategy to overcome obesity. It may also improve a person’s self-image and sense of well-being while making sex easier to navigate.

Urinary Incontinence

Urinary incontinence is the loss of bladder control. This becomes more common with age, especially in women.

Incontinence can be embarrassing and make sex awkward. Women who experience stress incontinence may be afraid to orgasm. Extra pressure on the abdomen during intercourse can also cause urinary leakage.

If you have incontinence, empty your bladder before sex. Changing sexual positions can help prevent urinary leakage by avoiding the compression of the bladder. Pelvic floor exercises can also help strengthen the muscles that aid with urine control.

Medications

Some medications used in older adults can cause sexual dysfunction in both men and women. These include:25

‧  Antidepressants
‧  Antihistamines
‧  Chemotherapy
‧  Diuretics (“water pills”)
‧  High blood pressure medicines
‧  Opioid painkillers

If you are having sexual difficulties, let your doctor know and advise them of any drugs you are taking, including over-the-counter, prescription, or recreational.

Lifestyle and Mental Health

Lifestyle and mental health issues can also contribute to sexual problems in older adults. These issues can be just as difficult—and sometimes even more difficult—to overcome than physical ones. If you are faced with any of these issues, there are things you can do to turn them around.
Alcohol

For some people, drinking a glass of wine helps them relax and get in the mood. However, too much alcohol can end up impairing sexual function. According to the National Institute on Drug Abuse, alcohol is the most-used drug among older adults, with 65% of people 65 and older reporting high-risk drinking.26

Alcohol can impair a man’s ability to get an erection, cause premature ejaculation, or delay orgasm.27 In women, too much alcohol can make it difficult to climax.2

Reducing the amount you drink can help, but if you are unable to control your alcohol use, speak to your doctor about treatment options.

Depression

In the United States, between 5% and 10% of adults over 65 are estimated to be depressed.28 This can lead to many health concerns, including sexual dysfunction.29

In people with depression, neurotransmitters—chemical messengers that send signals between the brain and body—are out of balance. This can affect sexual desire, arousal, and orgasm. Ironically, medications used to treat depression can have the same effects.

While the benefits of antidepressants often outweigh the risks, therapy and counseling may offer a reasonable option for those with mild depression.

Stress

Stress can be a contributing factor to sexual dysfunction. Financial worries and health concerns are just some of the common stresses affecting older adults.

To relieve stress (and the effect it has on your sex life), consider stress management techniques like mindful breathing, tai chi, yoga, and meditation. Research shows practicing mindfulness and meditation can ease the effects of stress and improve overall feelings of well-being.30 This alone may help improve sex.

In addition, seek professional assistance from financial advisors, health advocates, and social workers to help better deal with the other stresses in your life.

Relationship Issues

Lack of sexual intimacy is often related to relationship problems. If you are and your partner are not connecting emotionally, it can lessen your desire to be intimate.

On the flip side, studies show that older couples who engage in sexual intercourse with their partner are likely to share a closer relationship. Moreover, closeness to one’s partner has been shown to increase overall well-being.31

While this issue is not unique to older couples, many people find talking to a marriage counselor can help them work through relationship issues and rekindle sexual feelings and attraction.

Self-Image

With age can come weight gain and other body changes that may affect one’s sense of physical attractiveness. Self-consciousness can spill over into the bedroom and affect a person’s confidence during sex.

A 2019 study among older women found that those who were self-conscious about their bodies reported less sexual satisfaction. By contrast, those who had greater self-acceptance of their bodies irrespective of weight or aging-related changes had a more satisfying sex life.32

Self-acceptance is ultimately the key. Working with a therapist, either alone or as a couple, can help you discuss your feelings openly and find a way to embrace a more positive self-image.

How to Maintain a Healthy Sex Life

The benefits of maintaining your sex life as you age are physical and emotional. Being sexually active is associated with a lower risk of medical conditions and a longer life. It’s also associated with a greater sense of happiness and overall well-being.3

If your sex life has become stagnant and you’d like to rev it back up, here are a few things you can do.

Communicate

Good sex begins with good communication. Couples who have been together a long time often think they know what the other is thinking. But no one is a mind reader.

Talk to your partner about any concerns you have. You may feel as though your mate is no longer attracted to you because sex has become infrequent, when in fact they are experiencing a decline in sexual interest.

In addition, as sex organs change with age, what felt good before may no longer feel good or may even be painful. Be open with your partner about these changes.

Communicating about sex can be challenging at any age, however. If you and your partner struggle to talk about sex, consider seeing a sex therapist.

Redefine Sex

Sex, as you get older, may need to change. But different can still be good, if not better. With an empty nest and possibly retirement, there’s more time and privacy to explore.

Research shows older adults have a broader definition of sexual activity than younger adults.33 In other words, they better understand that there is more to sex than just intercourse. Foreplay on its own can be quite satisfying.

Be creative and willing to try new things.

Rethink Intimacy

Sex isn’t just physical. It’s an emotional expression of intimacy. As you grow older, sexual intimacy changes. What this means to you and your partner may need to be redefined.

Emotional intimacy can be expressed through non-sexual physical touch. Examples of non-sexual physical touch include:

‧  Back rubs
‧  Cuddling
‧  Holding hands
‧  Hugging
‧  Placing your hand on your partner’s shoulder or arm
‧  Playful nudges
‧  Sitting next to each other
‧  Touching feet under the table

Another non-sexual way to build emotional intimacy is spending quality time together. Things you can do:

‧  Go out on dates with other couples.
‧  Look through old photos and reminisce.
‧  Play cards, board games, or word games.
‧  Read aloud to each other.
‧  Play music together.
‧  Travel, explore new places.
‧  Visit with friends or family.

Just Do It

Instead of waiting for the desire to strike, experts recommend that older adults just go for it. This is because sex has physical and emotional benefits. Orgasms release oxytocin, a hormone that induces a state of calm and improves sleep.

Even if you’re not in the mood, having sex can set the stage for more sex in the future. This is especially true for women. Having sex regularly helps increase natural lubrication and vaginal elasticity. It may also improve erections in men.

Summary

Older age can lead to sexual problems in different ways. Age alone increases the risk of erectile dysfunction, delayed ejaculation, low libido, vaginal dryness, and pelvic organ prolapse. Medical conditions like arthritis, diabetes, heart disease, obesity, and incontinence can also directly or indirectly interfere with sex.

Lifestyle and emotional issues that can impair sexual function in all ages can become even more profound in adults 65 years and older. These include stress, depression, negative self-image, relationship problems, and alcohol abuse.

By working with a doctor or therapist, you can overcome many of these concerns and improve not only your quality of life but your sex life as well. Keeping open lines of communication and embracing change as a natural part of life can also help keep your sex life fresh as you approach your later years.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. University of Michigan Institute for Healthcare Policy and Innovation. Let’s talk about sex.

2. National Institute on Aging. Sexuality in later life.

3. Lee DM, Nazroo J, O’Connor DB, Blake M, Pendleton N. Sexual health and well-being among older men and women in England: findings from the English longitudinal study of ageing. Arch Sex Behav. 2015;45(1):133-144. doi:10.1007/s10508-014-0465-1

4. Shigehara K, Kato Y, Iijima M, et al. Risk factors affecting decreased libido among middle-aged to elderly men; Nocturnal voiding is an independent risk factor of decreased libido. Sex Med. 2021 Oct;9(5):100426. doi:10.1016/j.esxm.2021.100426

5. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms & causes of erectile dysfunction.

6. National Institute on Aging. Prostate problems.

7. Abdel-Hamid IA, Elsaied MA, Mostafa T. The drug treatment of delayed ejaculation. Transl Androl Urol. 2016;5(4):576-591. doi:10.21037/tau.2016.05.05

8. National Cancer Institute. Understanding prostate changes: a health guide for men.

9. Harvard Health Publishing. Yes, you can have better sex in midlife and in the years beyond.

10. Szymański J, Słabuszewska-Jóźwiak A, Jakiel G. Vaginal aging—What we know and what we do not know. Int J Environ Res Public Health. 2021 May;18(9):4935. doi:10.3390/ijerph18094935

11. Portman DJ, Brown L, Yuan J, Kissling R, Kingsberg SA. Flibanserin in postmenopausal women with hypoactive sexual desire disorder: Results of the PLUMERIA study. J Sex Med. 2017;14(6):834-842. doi:10.1016/j.jsxm.2017.03.258

12. Naumova I, Castelo-Branco C. Current treatment options for postmenopausal vaginal atrophy. Int J Womens Health. 2018;10:387-395. doi:10.2147/IJWH.S158913

13. Department of Health and Human Services: Office on Women’s Health. Pelvic organ prolapse.

14. Duralde ER, Rowen TS. Urinary incontinence and associated female sexual dysfunction. Sex Med Rev. 2017;5(4):470-485. doi:10.1016/j.sxmr.2017.07.001

15. Marudhai S, Patel M, Valaiyaduppu Subas S, et al. Long-term opioids linked to hypogonadism and the role of testosterone supplementation therapy. Cureus. 2020;12(10):e10813. doi:10.7759/cureus.10813

16. Kalvani RR, Golden SH, Cefalu WT. Diabetes and aging: unique considerations and goals of care. Diabetes Care. 2017 Apr;40(4):440–3. doi:10.2337/dci17-0005

17. American Diabetes Association. Sex and diabetes.

18. Steenman M, Lande G. Cardiac aging and heart disease in humans. Biophys Rev. 2017 Apr;9(2):131–7. doi:10.1007/s12551-017-0255-9

19. Kosti JB, Dobrzynski JM. Statins and erectile dysfunction. World J Mens Health. 2019 Jan;37(1):1–3. doi:10.5534/wjmh.180015

20. Nascimento ER, Maia ACO, Pereira V, Soares-Filho G, Nardi AE, Silva AC. Sexual dysfunction and cardiovascular diseases: a systematic review of prevalence. Clinics (Sao Paulo). 2013 Nov;68(11):1462–8. doi:10.6061/clinics/2013(11)13

21. Penn Medicine. Sex and your heart: What to know about intimacy and heart disease.

22. Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity and severe obesity among adults: United States, 2017-2018. NCHS Data Brief. 2020;360.

23. Mozafari M, Khajavikhan J, Jaafarpour M, et al. Association of body weight and female sexual dysfunction: a case control study. Iran Red Crescent Med J. 2015;17(1):e24685. doi:10.5812/ircmj.24685

24. Ho JH, Adam S, Azmi S, et al. Male sexual dysfunction in obesity: the role of sex hormones and small fibre neuropathy. PLoS One. 2019;14(9):e0221992. doi:10.1371/journal.pone.0221992

25. Conaglen H, Conaglen J. Drug-induced sexual dysfunction in men and women. Aust Prescr. 2013;36(1):42-45. doi:10.18773/austprescr.2013.021

26. National Institute on Drug Abuse. Substance use in older adults DrugFacts.

27. Prabhakaran DK, Nisha A, Varghese PJ. Prevalence and correlates of sexual dysfunction in male patients with alcohol dependence syndrome: a cross-sectional study. Indian J Psychiatry. 2018;60(1):71-77. doi:10.4103/psychiatry.IndianJPsychiatry_42_17

28. Cheruvu VK, Chiyaka ET. Prevalence of depressive symptoms among older adults who reported medical cost as a barrier to seeking health care: findings from a nationally representative sample. BMC Geriatr. 2019;19(1):192. doi:10.1186/s12877-019-1203-2

29. National Institute of Aging. Depression and older adults.

30. Goyal M, Singh S, Sibinga EM, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014;174(3):357–68. doi:10.1001/jamainternmed.2013.13018

31. Smith L, Yang L, Veronese N, Soysal P, Stubbs B, Jackson SE. Sexual activity is associated with greater enjoyment of life in older adults. Sex Med. 2019 Mar;7(1):11–8. doi:10.1016/j.esxm.2018.11.001

32. Gillen MM, Markey CH. A review of research linking body image and sexual well-being. Body Image. 2019;31:294-301. doi:10.1016/j.bodyim.2018.12.004

33. Hinchliff S, Tetley J, Lee D, Nazroo J. Older adults’ experiences of sexual difficulties: Qualitative findings from the English longitudinal study on ageing (ELSA). J Sex Res. 2018;55(2):152-163. doi:10.1080/00224499.2016.1269308

 

 

 

 

 

 

Sexual Stamina: 10 Tips to Last Longer

Kristopher Bunting, MD

Updated on October 17, 2022

This article is a repost which originally appeared on healthnews.

Edited for content. The opinions expressed in this article may not reflect the opinions of this site’s editors, staff or members.

Whether you have problems with premature ejaculation or you simply want sex to last longer, there are many ways to last longer in bed. Making sex last longer can involve maintaining an erection for longer, delaying ejaculation, and reducing the time to achieve another erection after ejaculating. There are a variety of ways to improve your sexual stamina and make sex more satisfying for both you and your partner.

Key takeaways:

‧ There are many ways to improve male sexual stamina, including medications and sexual techniques. Increased foreplay and emotional intimacy may also improve sexual performance.

‧ Medications for erectile dysfunction and premature ejaculation can improve stamina and sexual performance.

‧ Controlling sexual stimulation by using numbing sprays or gels, certain sexual positions, and other techniques can help men control when they orgasm.

How long should sex last?

Ideally, sex should last for as long as you want it to. Many people think of sex as penetration, but it can (and should) involve much more. Research shows that the average time until ejaculation during penetrative sex is between 5 and 6 minutes. For most people, achieving orgasm is the goal of sex. While 5 minutes of penetration (or less) will get many men where they want to get to, it takes longer for women to climax from penetration alone. So, how can you make sex last longer?

Foreplay

There is more to sex than just penetration and orgasm. Foreplay is important for mutual arousal; it gives you and your partner time to stimulate yourselves and each other. Take time to use all of your senses to get excited and prepare for the main event.

Kegel exercises

Kegel exercises can help both men and women strengthen pelvic floor muscles, improving continence and sexual function. A strong pelvic floor can help you control when you ejaculate.

Work on your relationship

Sex is both physical and mental. Both the body and the mind need to be stimulated and aroused to enjoy sex. Emotional intimacy plays a role in sexual arousal, especially in long-term relationships. Research has shown that emotional intimacy is linked to sexual desire. Furthermore, good communication in a relationship is linked to improved sexual satisfaction and decreased sexual dysfunction. Communicating sexual needs with your partner can improve sex and may help you last longer.

Medication

Medications used to treat erectile dysfunction (ED) and premature ejaculation (PE) can also improve sexual stamina. Commonly used antidepressants such as Prozac (fluoxetine), Paxil (paroxetine), Celexa (citalopram), and other drugs that raise serotonin levels in the brain can help delay ejaculation. While this can be an unwanted side effect for some, it can help people with PE have more control over when they orgasm.

ED medications can help some men recover more quickly after ejaculating and may improve sexual performance in men without erectile dysfunction. Viagra (sildenafil), Cialis (tadalafil), and other erectile dysfunction medications improve blood flow to the penis. This allows men with mild to moderate ED to have firmer, longer-lasting erections. Remember, these are prescription medications; you should not take them without first being evaluated by a doctor. They can have extremely dangerous interactions with other medications, including nitrates taken for chest pain or amyl nitrate and amyl nitrite (poppers) taken recreationally.

Reduce stimulation

Topical anesthetics are used to treat PE and can help men delay orgasms. A variety of topical numbing creams, sprays, and personal lubricants are available that reduce stimulation of the penis, including condoms with numbing lubricant. However, these can cause skin irritation and discomfort in some people, so check with your partner before using a topical anesthetic.

Other ways to reduce penile stimulation and delay orgasm include wearing a condom and using more lubrication. Wearing a condom not only helps prevent sexually transmitted diseases and unwanted pregnancy, but it can also decrease stimulation of the penis, especially thicker condoms. Using lubrication during sex can reduce friction and stimulation.

Techniques to delay orgasm

There are a variety of techniques that can be employed to help delay orgasm and ejaculation. Techniques recommended for people with PE include the squeeze technique (gently squeezing the head of the penis for several seconds) and the start and stop technique (stop penile stimulation for 30 seconds). Other techniques include pausing and taking a deep breath or shifting your focus away from sexual sensations during sex. In other words, slow down and take a moment to rest before you reach orgasm.

Masturbating before sex can help delay ejaculation, but timing is important. Practicing edging, bringing yourself to the brink of orgasm while masturbating, can help you learn how to recognize when you are about to orgasm and allow you to practice techniques to delay orgasm.

Try something different

There are many Tantric and Taoist sexual practices that can help control ejaculation and improve sexual pleasure for men and their partners. The “sets of nines” technique is an easy way to control mutual stimulation. It involves performing 9 sets of 9 controlled thrusts, beginning with 9 shallow thrusts, followed by 8 shallow thrusts and 1 deep thrust, then 7 shallow thrusts and 2 deep thrusts, and so on, ending with 9 deep thrusts. It is a simple technique, but it is very effective for controlling ejaculation and building up sexual excitement.

Certain sexual positions can help control ejaculation, especially positions that allow for grinding, as opposed to thrusting. Partner on top positions, the lotus position, and the Coital Alignment Technique can maintain constant stimulation for your partner while limiting stimulation to the penis from thrusting. Explore the Kama Sutra and other books for tips on which positions can help you control when you orgasm.

Get healthy

Overall health affects sexual function; eating a proper diet and getting enough exercise can improve your sexual health. Obesity, type 2 diabetes, high blood pressure, heart disease—all of these conditions can affect sexual function and they can all be improved or prevented through diet and exercise.

You can improve your sexual stamina

There are many ways for men to improve their sexual stamina. Foreplay, communication, and emotional intimacy can improve sex. Medications, condoms, and lubricants can delay orgasm and reduce stimulation. A variety of techniques can help men control when they orgasm, including techniques used for premature ejaculation and certain sexual positions. Give some of these a try and find out what works best for you.

Resources:

1. Urology Care Foundation. Premature Ejaculation.

2. The Journal of Sexual Medicine. Original Research—Ejaculation Disorders: A Multinational Population Survey of Intravaginal Ejaculation Latency Time.

3. International Society for Sexual Medicine. Women’s Orgasm Takes Longer During Partnered Sex.

4. Mayo Clinic. Kegel Exercises for Men: Understand the Benefits.

5. Journal of Social and Personal Relationships. The Associations of Intimacy and Sexuality in Daily Life.

6. The Journal of Sex Research. Couples’ Sexual Communication and Dimensions of Sexual Function: A Meta-Analysis.

7. Cleveland Clinic. Premature Ejaculation.

8. International Journal of Impotence Research. Sildenafil Does Not Improve Sexual Function in Men Without Erectile Dysfunction but Does Reduce the Postorgasmic Refractory Time.

9. Nature Reviews Urology. Sildenafil Improves Sexual Function in Men Without Erectile Dysfunction.

10. Mayo Clinic. Erectile Dysfunction: Viagra and Other Oral Medications.

11. Circulation. Drug Interactions With Phosphodiesterase-5 Inhibitors Used for the Treatment of Erectile Dysfunction or Pulmonary Hypertension.

12. Journal of Sex & Marital Therapy. The Coital Alignment Technique (CAT): An Overview of Studies.

 

How to Perform the Master Your Orgasms Exercise (from The Ultimate Guide To Male Enhancement)

The following is taken from Chapter 14: Ways to Treat Premature Ejaculation from The Ultimate Guide To Male Enhancement.

Edited for content

How to Perform the Master Your Orgasms Exercise

Many men never experience the full potential of pleasure they can receive from their sexual encounters. This little–known mental/sexual exercise will take you to levels of pleasure and control you never thought possible.

Step 1:
First, you must find a time and a place in which you will be COMPLETELY undisturbed for 20–30 minutes.

Step 2:
Lie back naked on your bed (or another comfortable surface) and encircle your penis with your thumb, index, and middle finger. Place your middle finger on the sensitive spot directly behind your penis head (glans.) Rub your penis or visualize until it becomes erect.

Step 3:
While maintaining the pressure behind the glans with your middle finger, close your eyes and concentrate as deeply as possible on visualizing yourself performing with the utmost confidence and completely stress free, and in feeling a slight bit of pressure behind the sensitive spot behind the glans. It’s the EMOTIONAL feel of performing in this manner you’ll want to be able to duplicate in real live sexual scenarios.

Mastering Your Orgasms Takes Time

At first, it will probably be difficult to concentrate deeply without a break in concentration for any length of time.  This is where the mantra “practice makes perfect” comes into play. It will probably take a dozen sessions or more of 20–30 minutes before you are able to achieve the very deep level of concentration necessary for this exercise to work.

After you master the technique, your ability to concentrate and focus will become so strong, you will be able to bring yourself to orgasm merely by keeping pressure behind the glans with your middle finger and
concentrating on the feel of the movement! Some very light rubbing is acceptable.  Some men have even reported multiple orgasms from following this technique!

Once you have mastered this technique, you will then be able to fully appreciate the pleasures of sex!

NOTE: Keep in mind some men will not be able to achieve orgasm without movement. If this describes your situation, once you come as close to climaxing as mere pressure and concentration will allow, you can jiggle your penis just enough to push you over the edge into climax.

The Ultimate Guide to Male Enhancement

Dealing with Premature Ejaculation & Causes of Premature Ejaculation (from The Ultimate Guide To Male Enhancement)

Dealing with Premature Ejaculation & Causes of Premature Ejaculation

The following are two chapters taken from the book: The Ultimate Guide To Male Enhancement.

Edited for content

Chapter 12: Dealing with Premature Ejaculation

What is Premature Ejaculation?

The definition of what constitutes premature ejaculation may vary depending on the source, but it’s commonly accepted as a scenario where the length of time for sexual performance on the part of the male is unsatisfactory, by either the man or his partner. That being said, what constitutes premature ejaculation can be arbitrary. There is no set time that if you orgasm before it then you have premature ejaculation.

Consider this – the average time between arousal and ejaculation is typically three minutes for a man. Considering the
average time for a woman to orgasm is typically 13 minutes after arousal it can be seen how many men may think they have premature ejaculation, but really they are simply normal. With this in mind, you can see why foreplay is so important to satisfying a woman.

Phases of Ejaculation

There are two phases of ejaculation.

● The Emission Phase and
● The Ejaculatory Phase

Emission Phase:

Here are the physical processes which occur during the emission phase of ejaculation:

● The vas deferens begins to contract to move sperm from the testes toward the urethra and prostate gland.
● The seminal vesicles secrete fluids into the urethra
● Chemical messages activate the sympathetic nervous system and begin what’s known as the ‘point of no return’
(PONR). Ejaculation is inevitable at this point.

Ejaculatory Phase:

During the ejaculatory phase, the posterior portion of the urethra senses the sperm and secretions and sends a signal
to the spinal cord. This then sends messages to the muscles at the base of your penis. This causes said muscles to contract, which results in ejaculation.

Chapter 13: Causes of Premature Ejaculation

Premature ejaculation can be caused by any number of factors. These can be separated into two categories:

● Physical (which can include chemical side effects) and
● Mental (or psychological) causes.

It’s not uncommon for both some mental component to be present in physical cases of premature ejaculation. Worry
about the experience of premature ejaculation often compounds any physical components.

Physical Premature Ejaculation

The most common form of premature ejaculation is due to physical causes. The most common among these is negative conditioning. This is usually because most men masturbate in a hurried and furtive manner. Doing this repeatedly trains the body into ejaculating quickly, so it shouldn’t be surprising to understand how this can lead to issues.

If added stimuli like porn is used, it can further skew what you can expect from real sexual encounters. This then adds to anxiety, which further increases the possibility of premature ejaculation. The easiest way to correct this is to train in a manner contrary to negative conditioning. This will be discussed in detail further in the section.

Hormonal Issues

If you have low testosterone or abnormal levels of catabolic hormones this can have a drastic effect on your ability to maintain an erection. This can turn into premature ejaculation if you have to strive to get erect. It can be further compounded if your hormone imbalances induce negative emotions like anxiety. Diet and exercise is often recommended as a treatment for issues related to hormone imbalances; however, if do-it-yourself treatments aren’t effective, then a full blood work up is necessary to determine the cause of these imbalances.

Chronic and/or acute stress can lower levels of dopamine in the system. This can create a scenario where you can find it difficult just to get aroused even in the absence of anxiety. Stress management is key to helping treat this issue. The amino acid L-Tyrosine has been shown to be effective at helping to restore natural dopamine levels.

Infections

It’s been shown infections of the prostate and urethra may contribute to premature ejaculation. Infections usually require medical attention and antibiotics for treatment.

Pelvic Floor Issues

Pelvic floor spasms may contribute to premature ejaculation. If these symptoms are minor, rest and targeted stretching of the area should help to alleviate the issue. If the problem is more severe, this might require the services of a physical therapist for relief.

A strain in the pelvic floor may cause pain upon Kegeling and symptoms such as “hard flaccid”. Certain muscles like the ischiocavernosus can become perpetually strained. This leads to a difficult to resolve issue, as these muscles are involved in many different bodily functions. Due to this, it’s not easy to allow them to recover as you would if you immobilized an arm or even a leg. A strain may require targeted massage and heat. Specific yoga poses which specifically target the pelvic floor may help to speed healing as well.

A common cause of pelvic floor issues is due to abusing the Kegel. This includes the Reverse Kegel (contractile) exercise. It’s vital you start Kegeling by using only as much contractile force as is needed during any of the Kegel type movements. A limited number of reps should be performed as well and then slowly increased each session.

Prescription Medications

Some prescription drugs may cause premature ejaculation as one of their side effects. If this is the case, contact your physician or pharmacist to see if there are alternative medications.

Mental Premature Ejaculation

Premature ejaculation may be placed on the spectrum of erectile dysfunction, especially if the case is so severe that penetration becomes difficult or impossible. This is often the case if performance anxiety is involve. A common scenario will involve difficulty in obtaining an erection, with almost immediate ejaculation upon or even before penetration. This stage most commonly precedes impotence.

Anxiety, depression and stress are three of the leading mental causes of premature ejaculation. Sometimes, it’s a matter
of which came first though – the chicken or the egg – the premature ejaculation or the anxiety/depression/stress. It’s
not uncommon for men to suffer from these three common challenges without even realizing. It’s even more common for these challenges to surface, when there’s a concern about premature ejaculation.

The Ultimate Guide to Male Enhancement

To light a fire you need all elements of heat, oxygen and fuel

To light a fire you need all elements of heat, oxygen and fuel

Article courtesy of Anthony_gerio

Edited for content

Many have overcome the PreE by applying some of the techniques advised on various forums. However, there are many cases which say despite putting an effort for a long time, they have not been successful in developing stamina. Often when I look at the posts (the ones which give some information) I see missing links.

To light a fire you need to provide all the necessary elements and without one of them (triangle of heat, O2 and fuel) you cannot generate fire.

The same is for improving ejaculation time. As frustrating as it could be, during the years you have developed your body mechanism in a way that you are not able to prevent ejaculation and thus you have to address all those situations in parallel and if you fail at one, there is a chance that your efforts will not result in satisfactory output. The very main elements that need to be worked on all together are:

– PF elongation and expansion: you need to be able to release and keep your PF released during intercourse. The best way experienced by successful people is to trying RKs (Reverse Kegels) and keeping a very very light RK for as long as a period you can (hours). Now you have find what is a RK, maybe you have been doing it all along during these years. It is worth to mention as much as you progress into your routine, your requirement for RK hold decreases.

– Flexibility and openness of the core: you need to have an open core as they are all connected to your PF and in particular if you are in a dynamic position during sex, any tightness can trigger you PF to react badly and more PF needs space to expand and tight hip is a barrier for it. The core includes all the muscles and ligaments connected to your PF.

– Glutes (Maximus, medium and piriformis)
– hip flexors
– hip abductors
– hip adductors
– hamstring
– lower and upper abs
– Obliques
– lower back (lumbar spine)

– Power and activation of the core: a power core helps you to keep a neutral position and gives you stamina for your the movements in intercourse. Power full abs help to keep the PF down, power full glutes automatically increase the power of the PF and activated Multifidus helps glutes to do their jobs (preventing back PF to lock in) during the sex. Glute max power and activation is a must for PF development.

– Remember that PF is at the centre of your hip and imbalances between hip flexion, hip extension and hip adduction and hip abduction significantly disturb and gets it out of balance. Any weakness in these areas should be addressed by training the muscles responsible for them.

– Memory: you need to remember what you need to do during the sex. Some as soon as the first kiss (I was like this once) loose every thing and their anatomy gets back to the mixed up situation. You need to know:

– keep your PF relaxed and down at all times (keeping a light RK could help initially)
– you need to feel your Transverse abdominal layer within the sex and not letting your abs to be fully deactivated. It is your tool to play with your PF.
– you need to play with glutes as well and keep your back PF expanded.
– you need to remember to breath, not necessary belly breathing which needs a lot of concentration itself (as much as you hear, hey you need to make it your own default) and just breath relatively calm and do not keep your breath.
– you need to keep out all the bad sex memories from the past, it doesn’t matter, you have changed, you have trained and you have overcome the physical aspects which was not your fault. Be in the moment.

I hope this would be of help to some and guide them that in order to see improvement as fast as possible, you do not have the luxury of overlooking any of the above aspects. And remember it may take time to make all the transformations, maybe half a year or more. It is important to be consistent in training and development.

 

Original thread: To light a fire you need all elements of heat, oxygen and fuel

Premature Ejaculation

Premature Ejaculation

What Is It?

Published: February, 2020

This article is a repost which originally appeared on Harvard Health

Edited for content

Premature ejaculation occurs when a man reaches orgasm and ejaculates too quickly and without control. In other words, ejaculation occurs before a man wants it to happen. It may occur before or after beginning foreplay or intercourse. Some men experience a lot of personal distress because of this condition.

As many as one in five men experience difficulty with uncontrolled or early ejaculation at some point in life. When premature ejaculation happens so frequently that it interferes with the sexual pleasure of a man or his partner, it becomes a medical problem.

Several factors may contribute to premature ejaculation. Psychological problems such as stress, depression and other factors that affect mental and emotional health can aggravate this condition. However, there is growing evidence that biological factors can make some men more prone to experience premature ejaculation.

Rarely, premature ejaculation can be caused by a specific physical problem, such as inflammation of the prostate gland or a spinal cord problem.

Symptoms

The key symptoms of premature ejaculation include:

  • Ejaculation that routinely occurs with little sexual stimulation and with little control
  • Decreased sexual pleasure because of poor control over ejaculation
  • Feelings of guilt, embarrassment or frustration

Diagnosis

Premature ejaculation is diagnosed based on typical symptoms. To understand your problem, your doctor will need to discuss your sexual history with you. Be frank and open. The more your doctor knows, the better he or she can help you.

If your sexual history fails to reveal significant mental or emotional factors that may contribute to premature ejaculation, your doctor may want to examine you. Your doctor may examine your prostate or do neurological tests (tests of your nervous system) to determine if there is a physical problem that could be causing premature ejaculation.

Expected Duration

Sometimes, premature ejaculation goes away on its own over weeks or months. Working to relieve stress or other psychological issues may help the situation to improve.

Other men have lasting difficulties with premature ejaculation, and require professional help. Some men respond to treatment promptly, while others struggle with this problem over a prolonged period. Effective treatment is available.

Prevention

There is no known way to prevent premature ejaculation. However, you should consider the following advice:

  • Maintain a healthy attitude toward sex. If you experience feelings of anxiety, guilt or frustration about your sex life, consider seeking psychotherapy or sexual therapy.
  • Keep in mind that anyone can experience sexual problems. If you experience premature ejaculation, try not to blame yourself or feel inadequate. Try speaking openly with your partner to avoid miscommunication.

Treatment

Behavioral therapy is one possible approach for treating premature ejaculation. Most commonly, the “squeeze technique” is used. If a man senses that he is about to experience premature orgasm, he interrupts sexual relations. Then the man or his partner squeezes the shaft of his penis between a thumb and two fingers. The man or his partner applies light pressure just below the head of the penis for about 20 seconds, lets go, and then sexual relations can be resumed. The technique can be repeated as often as necessary. When this technique is successful, it enables the man to learn to delay ejaculation with the squeeze, and eventually, to gain control over ejaculation without the squeeze. Behavioral therapy helps 60% to 90% of men with premature ejaculation. However, it requires the cooperation of both partners. Also, premature ejaculation often returns, and additional behavioral therapy may be needed.

Another possible treatment is prescription medication that helps to delay ejaculation. Delayed orgasm is a common side effect of certain drugs, particularly those used to treat depression. This is true even for men who are not depressed. When this type of medication is given to men who experience premature ejaculation, it can help to postpone orgasm for up to several minutes. Drugs used for this type of treatment include selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), paroxetine (Paxil) or sertraline (Zoloft); and tricyclic antidepressants, such as clomipramine (Anafranil).

Some men with premature ejaculation may benefit from drugs called phosphodiesterase inhibitors, such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). A phosphodiesterase inhibitor can be used alone or in combination with an SSRI. One drug should be started at a time, preferably at a low dose.

Some men with premature ejaculation also benefit from reducing the stimulation they experience during sex. A number of creams are available that can partially anesthetize (numb) the penis and reduce the stimulation that leads to orgasm. Another option is to use one or more condoms. However, these techniques may interfere with the pleasure experienced during sex.

When To Call a Professional

Speak with your doctor if you consistently ejaculate before you want to. Remember, one instance of premature ejaculation does not mean that you have a condition that requires treatment. Your doctor may refer you to a sex therapist if premature ejaculation is causing major problems in your sex life or personal relationships or if you would like to consider behavioral therapy.

Prognosis

Many men experience a brief period of premature ejaculation, then improve on their own. Even for men who require medical treatment, the outlook is usually good.

Male Sexual Worries: Trends in the Post-Viagra Age

Male Sexual Worries: Trends in the Post-Viagra Age

TOPICS:Urology

By European Association of Urology July 18, 2020

This article is a repost which originally appeared on SciTechDaily

Edited for content

Trends in reasons for visiting a the San Raffaele sexual health clinic. Credit: This diagram appears with the permission of the authors and the International Journal of Impotence Research. The EAU thanks the authors, and the journal for their cooperation.

Scientists report a change in why men seek help for sexual problems, with fewer men complaining about impotence (erectile dysfunction) and premature ejaculation, and more men, especially younger men, complaining about low sexual desire and curvature of the penis (Peyronie’s disease).

Presenting the work at the European Association of Urology (virtual) Congress, after recent acceptance for publication, research leader Dr. Paolo Capogrosso (San Raffaele Hospital, Milan, Italy) said:

“Over a 10 year period we have seen a real change in what concerns men when they attend sexual health clinics. This is probably driven by greater openness, and men now accepting that many sexual problems can be treated, rather than being something they don’t want to talk about.”

The success of erectile dysfunction treatments such as Viagra and Cialis, and the availability of new treatments, means that men facing sexual problems have now have treatments for sexual problems which weren’t available a generation ago. Now researchers at San Raffaele Hospital in Milan have studied why men come to sexual health clinics, and how this has changed over a 10-year period.

In what is believed to be the first research of its kind, the scientists questioned 3244 male visitors to the San Raffaele Hospital Sexual Health Clinic in Milan over a 10 year period (2009 to 2019), and classified the main reason for the visit. They found that the number of patients visiting with erectile dysfunction problems increased from 2009 to 2013, then started to decrease.

There were comparatively few patients complaining of low sex drive or Peyronie’s disease in 2009, but complaints about both of these conditions grow from 2009 to the end of the study. In 2019 men were around 30% more likely to report Peyronie’s disease than in 2009, and around 32% more likely to report low sexual desire.

The amount of men complaining of premature ejaculation dropped by around 6% over the 10-year period. The average age of first attendance at the clinical also dropped, from a mean of 61 to 53 years.

“Erectile dysfunction is still the main reason for attending the clinic, but this number is dropping, whereas around 35% of men attending the clinic now complain of Peyronie’s disease, and that number has shown steady growth,” said Paolo Capogrosso. “Our patients are also getting younger, which may reflect a generational change in attitude to sexual problems.”

Dr. Capogrosso continued “We need to be clear about what these figures mean. They do not indicate any change in the prevalence of these conditions, what they show is why men came to the clinic. In other words, it shows what they are concerned about. The changes probably also reflect the availability of treatments; as treatments for sexual conditions have become available over the last few years, men are less likely to suffer in silence.”

These are results from a single centre, so they need to be confirmed by more inclusive studies. “Nevertheless there seems to be a growing awareness of conditions such as Peyronie’s disease, with articles appearing in the popular press*. In addition, we know that the awareness of this condition is increasing in the USA and elsewhere, so this may be a general trend,**” said Dr. Capogrosso.

Commenting, Dr Mikkel Fode (Associate Professor of Urology at University of Copenhagen), said:

“Although these data are somewhat preliminary as they stem from single institution they are interesting because they allow us to formulate several hypotheses. For example the drop in men presenting with erectile dysfunction may mean that family physicians are becoming more comfortable addressing this issue and that the patients are never referred to specialized centers. Likewise, the simultaneous drop in age at presentation and increase in Peyronie’s disease and low sex drive could indicate that both men and their partners are becoming more mindful to optimizing their sex lives. I will be very interesting to see if these trends are also present in other centers around the world.”

Dr. Fode was not involved in this work, this is an independent comment.

References:

* “Trends in reported male sexual dysfunction over the past decade: an evolving landscape” by Edoardo Pozzi, Paolo Capogrosso, Luca Boeri, Walter Cazzaniga, Rayan Matloob, Eugenio Ventimiglia, Davide Oreggia, Nicolò Schifano, Luigi Candela, Costantino Abbate, Francesco Montorsi and Andrea Salonia, 1 July 2020, International Journal of Impotence Research.

** “The Prevalence of Peyronie’s Disease in the United States: A Population-Based Study” by Mark Stuntz, Anna Perlaky, Franka des Vignes, Tassos Kyriakides and Dan Glass, 23 February 2016, PLOS ONE.
DOI: 10.1371/journal.pone.0150157
PMCID: PMC4764365

Premature Ejaculation, What Is It?

Premature Ejaculation

What Is It?

Published: February, 2020

This article is a repost which originally appeared on Harvard Health

Premature ejaculation occurs when a man reaches orgasm and ejaculates too quickly and without control. In other words, ejaculation occurs before a man wants it to happen. It may occur before or after beginning foreplay or intercourse. Some men experience a lot of personal distress because of this condition.

As many as one in five men experience difficulty with uncontrolled or early ejaculation at some point in life. When premature ejaculation happens so frequently that it interferes with the sexual pleasure of a man or his partner, it becomes a medical problem.

Several factors may contribute to premature ejaculation. Psychological problems such as stress, depression and other factors that affect mental and emotional health can aggravate this condition. However, there is growing evidence that biological factors can make some men more prone to experience premature ejaculation.

Rarely, premature ejaculation can be caused by a specific physical problem, such as inflammation of the prostate gland or a spinal cord problem.

Symptoms

The key symptoms of premature ejaculation include:

  • Ejaculation that routinely occurs with little sexual stimulation and with little control
  • Decreased sexual pleasure because of poor control over ejaculation
  • Feelings of guilt, embarrassment or frustration

Diagnosis

Premature ejaculation is diagnosed based on typical symptoms. To understand your problem, your doctor will need to discuss your sexual history with you. Be frank and open. The more your doctor knows, the better he or she can help you.

If your sexual history fails to reveal significant mental or emotional factors that may contribute to premature ejaculation, your doctor may want to examine you. Your doctor may examine your prostate or do neurological tests (tests of your nervous system) to determine if there is a physical problem that could be causing premature ejaculation.

Expected Duration

Sometimes, premature ejaculation goes away on its own over weeks or months. Working to relieve stress or other psychological issues may help the situation to improve.

Other men have lasting difficulties with premature ejaculation, and require professional help. Some men respond to treatment promptly, while others struggle with this problem over a prolonged period. Effective treatment is available.

Prevention

There is no known way to prevent premature ejaculation. However, you should consider the following advice:

  • Maintain a healthy attitude toward sex. If you experience feelings of anxiety, guilt or frustration about your sex life, consider seeking psychotherapy or sexual therapy.
  • Keep in mind that anyone can experience sexual problems. If you experience premature ejaculation, try not to blame yourself or feel inadequate. Try speaking openly with your partner to avoid miscommunication.

Treatment

Behavioral therapy is one possible approach for treating premature ejaculation. Most commonly, the “squeeze technique” is used. If a man senses that he is about to experience premature orgasm, he interrupts sexual relations. Then the man or his partner squeezes the shaft of his penis between a thumb and two fingers. The man or his partner applies light pressure just below the head of the penis for about 20 seconds, lets go, and then sexual relations can be resumed. The technique can be repeated as often as necessary. When this technique is successful, it enables the man to learn to delay ejaculation with the squeeze, and eventually, to gain control over ejaculation without the squeeze. Behavioral therapy helps 60% to 90% of men with premature ejaculation. However, it requires the cooperation of both partners. Also, premature ejaculation often returns, and additional behavioral therapy may be needed.

Another possible treatment is prescription medication that helps to delay ejaculation. Delayed orgasm is a common side effect of certain drugs, particularly those used to treat depression. This is true even for men who are not depressed. When this type of medication is given to men who experience premature ejaculation, it can help to postpone orgasm for up to several minutes. Drugs used for this type of treatment include selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), paroxetine (Paxil) or sertraline (Zoloft); and tricyclic antidepressants, such as clomipramine (Anafranil).

Some men with premature ejaculation may benefit from drugs called phosphodiesterase inhibitors, such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). A phosphodiesterase inhibitor can be used alone or in combination with an SSRI. One drug should be started at a time, preferably at a low dose.

Some men with premature ejaculation also benefit from reducing the stimulation they experience during sex. A number of creams are available that can partially anesthetize (numb) the penis and reduce the stimulation that leads to orgasm. Another option is to use one or more condoms. However, these techniques may interfere with the pleasure experienced during sex.

When To Call a Professional

Speak with your doctor if you consistently ejaculate before you want to. Remember, one instance of premature ejaculation does not mean that you have a condition that requires treatment. Your doctor may refer you to a sex therapist if premature ejaculation is causing major problems in your sex life or personal relationships or if you would like to consider behavioral therapy.

Prognosis

Many men experience a brief period of premature ejaculation, then improve on their own. Even for men who require medical treatment, the outlook is usually good.

Additional Info

American Society for Reproductive Medicine
https://www.reproductivefacts.org/