Improving communication

Improving communication is often one of the first steps in treating rapid ejaculation (RE). Forget about the shame and blame – they are barriers to attacking the problem openly and honestly. Remember to turn off that internal critic every time you hear it whispering in your head. If you have to, remind yourself that RE is a medical condition.

Secondly, talk to your partner. Better yet, listen. Don't forget, you are on the same team.

Communication and the "stop-start technique"

In terms of therapy, the best recommended treatment consists of the "stop-start technique." Basically, it's a form of physiotherapy/biofeedback, to identify and communicate your level of excitement or arousal with your partner, and to enjoy sexual arousal at low intensity.

  • When moderate sexual arousal is reached, STOP the stimulation for 1 minute. Then continue the stimulation.
  • Repeat 3 times (slowly).
  • After the third time, just relax and enjoy the experience and move on to ejaculation.

Start by practicing 3 times a week. Begin with self-stimulation, and graduate over time to exercises with your partner. Hold off on intercourse until you are sure you've mastered all the less stimulating techniques.

Start with dry stimulation, then progress to moist activity. Gradually, ejaculatory control will improve, but be patient. It requires about 30 minutes, 3 times a week, for 3 months to start to see some progress, so don't be discouraged.

Seeing a sex therapist

It is a good idea to see a sex therapist, a psychologist, or a family doctor who deals with sexual problems while you are on the program. If there are doubts, resistance, or communication barriers, seeing a therapist with your partner might be helpful. Don't be a martyr. These problems are readily solvable, and in the end, increased communication between partners can result in more intimacy.

The "squeeze technique"

The "squeeze technique" is similar to the "stop-start technique," but you are supposed to squeeze the penis firmly to stop ejaculation. This technique is generally not recommended anymore, as it can cause damage to the penis.

Additionally, with the "stop-start technique," the man and his partner are continuously monitoring and controlling the stimulation that is more naturally and effectively integrated into the practice of full lovemaking.

Other options

  • Your doctor may prescribe medication that can help delay ejaculation. However, it is not a cure, only a treatment, so the problem returns whenever the medication is not used.
  • Your health care provider may also recommend a local anesthetic applied to reduce sensation in the penis and delay ejaculation.

Future treatments for RE

Ejaculation involves a complicated and coordinated interaction between the nerves and muscles of the pelvic floor, the urethra, the vas deferens, as well as various adjacent glands, ducts, and vesicles. Researchers have also discovered some of the neurotransmitters which regulate ejaculation and how they work. New methods of studying the process in animal models are developing rapidly. Good medication treatments, and probably even better gene therapies are probably not more than a few years away.

 Barry Rich, MD 
with revisions by the MediResource clinical team