Hello again and thanks for your clarifications.

Your husband's sexual problem, pre-mature ejaculation is a very common problem in males. Most of the times, the underlying subconscious anxiety / fears / doubts about inadequate sexual performance (called as "performance anxiety") or a hypersensitive response of the penis or improper sexual arousal are the underlying causes.

Treatment of this problem is using behavioural techniques as well as using medication, in some cases. Usually medication is kept only as the last resort as most of the problems will resolve with proper behavioural techniques.

I would suggest the following tips to overcome this problem:

1) Firstly he has to get rid of thoughts that he may be sexually inadequate or doubts that he may not be able to perform properly. Like I mentioned before, performance anxiety, feelings of sexual indequacy, self-doubts, guilt, past negative sexual experiences, poor communication / understanding with the partner, etc. can all affect sexual functioning and performance. So, removing the person's doubts and fears, and improving his self-confidence levels will definitely help in improving sexual performance.

Most importantly, performance anxiety soon becomes a "viscious cycle" That is, anxiety leads to poor performance and poor performance then leads to further anxiety and this keeps on increasing. So, the key is to break this cycle at some point of time and take control of oneself.

2) The second cause for pre-mature ejaculation is hypersensitivity of the penis to touch sensations. Now, there are certain specific sexual techniques which can reduce this hypersensitivity. The "stop-start technique" or "squeeze technique" have been proven to be successful in increasing the ejaculatory time.

In the stop-start technique, the penis is stimulated (by sexual intercourse or by masturbation) till a point when you feel close to orgasm. At that point, the stimulation is stopped for some time and after a small gap, it is continued. This process is repeated repeated a few times.

In the squeeze technique, the penis can be stimulated by hand (by masturbation or by your partner) till a point when you feel close to orgasm. At that point, the lower part of the head of the penis is squeezed tightly with the index finger and thumb around for a few seconds till the erection decreases. Then the stimulation is restarted and the process is repeated a few times.

Both these techniques, if practised regularly can increase the time taken to reach ejaculation.

3) The third problem responsible for early ejaculation is inadequate sexual arousal. When the person is not properly aroused, the blood flow to the penis is not maximal, and so, after a few strokes, the erection weakens and ejaculation happens prematurely. The way to tackle this is not to rush into intercourse quickly, but wait till he gets fully aroused. So, increase and spice-up your foreplay. Make sure that he initiates penetration only after both of you are fully turned on.

4) Improving sexual communication between partners - this means both verbal as well as non-verbal communication. Each person has his or her own ways of getting sexually aroused or feeling sexual pleasure. So, this verbal and non-verbal communication will let each of the partners understand each other's needs and thereby make sex both relaxing and enjoyable.

5) There are also certain medication like Dapoxetine (Prilyxet), which can help him with this specific problem of premature ejaculation. But like I mentioned before, medication should be kept only as a last resort after trying the behavioural methods and sexual techniques.

It is also important to eat a healthy & balanced diet, exercise regularly and try to stay positive and stress-free.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist & Sexologist

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