“Sorry I came” is one of the typical phrases used by a man who suffers from premature ejaculation. Premature ejaculation is the most common sexual problem along with erectile dysfunction in gay men.

When a patient in consultation complains of premature ejaculation it basically means that he ejaculates earlier than he would like or earlier than his partner would like if he has it. The man feels distressed, frustrated and disappointed about his sexuality, which can lead him to avoid having sex. Some of the phrases that I hear in consultation are: “I come becauseif I don’t solve it I will be alone all mylife” “the couples I’ve had haveleft me because of this problem” “I’m ashamed to have a sexual encounter”;, which speaks of the anguish they suffer.

Patients come for consultation with erroneous beliefs about the origin of their problem:

 “I must have some physical problem. “ The reality is that organic causes explain only 1% of cases, the rest are explained by “psychological”reasons”.

“I get too excited, my penis is hypersensitive“ The reality is that premature ejaculation is not due to overexcitement.

So, what is the cause of premature ejaculation?

1) The learned habits of masturbation. From childhood we are told that masturbation is wrong so we learn to do it hiding and as fast as possible for 2 or 3 minutes so we do not get caught, with this the body learns to masturbate quickly by not repairing the pre-orgasmic sensations (sensations that warn you that you are about to ejaculate). Here we begin to see the origin of the problem but also the solution.

2) Anxiety in sexual activity today. Anxiety that occurs when the problem is anticipated when something has already happened. Sex becomes a test in a competition against oneself. That causes you to be more attentive to how things are done, to calculate everything; to think “it’s going to happen to me again” “how this guy runs me is going to leave me” “what a shame he’s going to think about me”; increases nervousness and anxiety, as we see is not an excess of excitement but of nervousness.

Next to the two previous points there is an important factor to keep in mind that maintains the problem: the lack of communication in the couple. If you have this problem talk to your partner, in relationships there are no individual problems at the sexual level, your participation will be vital in the intervention. If you think that your partner has it, talk about it with tact, the greatest anxiety on the part of people who suffer this problem has its origin in the pressure they receive from their partners, affecting their sexual dissatisfaction.

   Once we know what premature ejaculation is and the origin of the problem, you may  ask yourself, can anything be done to solve it?

The objective of the treatment is to clearly perceive the sensations prior to orgasm, through a series of masturbatory techniques that are not complicated at all. This should be done in quiet conditions, first alone and then with the partner if you have one.

El tratamiento  tiene como objetivo percibir de forma clara las sensaciones previas al orgasmo, a través de realizar una serie de técnicas masturbatorias nada complicadas. Esto debe hacerse en condiciones de tranquilidad, primero solos y después con la pareja si se tiene.

Let’s see how to do them in detail:

Stage 1 (solitary masturbation). Create a relaxed context, in your bed, lying completely naked, disconnect mobile so as not to be interrupted, close your eyes and start masturbating, focus on the sensations you are having, continue masturbating, when you notice that you are close to ejaculate, stop.

Wait a minute, relax, let the desire to ejaculate calm down, massage the rest of your body, do not lose th  “erotic key” once the desire to ejaculate has disappeared, masturbate again; do it in the same way in a period of 3 times, the fourth time give permission to ejaculate. Try to do it at least 3 times a week, until you are more familiar with your pre-orgasmic sensations. Once this first stage is over, move on to the second, don’t be in a hurry to move from one stage to another

Stage 2 (with the masturbation partner). The same exercise is repeated but this time it will be your partner who masturbates you, explain that he has to stop when you tell him, there will be a sign that you both know and he mus tstop immediately. You must follow the same routine as in solitary, do it 3 times and masturbate until you ejaculate the fourth time. Once this stage is over, we move on to the third one.

Stage 3 (with partner penetration). Theposture must be "the precociousejaculator”; lying on his back and thecouple sitting on it, the penis remainsstill inside and it is the person on topwho makes the movements, the onelying only focuses on the sensations. Itrepeats the same as in the previousstages, when you have the preorgasmic sensations stop with thesignal you have decided and resumethe movements when the desire toejaculate have disappeared, in thosepauses is important to continue withthe games of the rest of the body not tolose "the erotic key”;, it is not amatter of losing the generalexcitement. The following phasesconsist of varying postures, rhythm, and that it is the "prematureejaculator”; who makes themovements. The objective is to learn todistinguish the pre orgasmic sensationswith ease that are possible to control, and not the phase of "expulsion”; that is a reflex, and once started cannot be stopped.

Once these stages have been overcome, we can begin to have sexual relations without carrying out this type of exercise, but it would be good to continue practicing at least once or twice a month. Take these exercises as what sex is a game in which the main objective is to enjoy, have fun and let yourself go. Besides helping you to solve this problem will serve you to have an intimate contact with yourselves know more and contact in a more intimate way with your partner.

To finish indicating that this article is not intended to replace the work of a sex therapist I advise you to visit a specialist if you have this problem, but at the same time I hope it has helped you to realize that if you have this problem has a solution.

Dr. Antonio Ortega López.

Psychologist, sex and couples therapist specializing in the LGTB community

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