Ricky S's Premature Ejaculation (2)

Okay so we’ve established that 10 minutes of actual penetration makes you a marathon runner, not a sprinter...but Ricky said he was only lasting a couple of seconds before ejaculation. When he masturbated he could last longer, about 20 seconds. So how do you help someone who has premature/rapid ejaculation (PE)? The first step is to try to find out if the problem has a physical or psychological cause (aetiology). Most people think PE is a psychological problem and the most common treatments are to adjust the way men think and behave. It has also been suggested some men might have as yet poorly understood physical reasons (e.g. increased sensitivity of penile nerves) and their PE should be treated with drugs. We don’t really know much about physical causes or treatments, but we do know that both psychological and drug treatments can work. The dilemma is that I don’t ideally want to treat a psychological problem with drugs, and I certainly don’t want to treat a physical problem psychologically. I explain that a psychological treatment can give him the mental tools to ‘cure’ his PE but a drug treatment may be better and faster (but act like a ‘sticking plaster’ and not treat the root cause). If a man chooses the drug treatment route I always give him a psychological plan to follow too, as this helps enormously.          

Ricky’s sexual education had been very restricted (age 36 at first sexual contact) and I though he would benefit from us going through some things that happen to men and women when they get sexually excited. I’d asked him to invite his wife, Linda, to this appointment but he said he hadn’t been able to speak to her about his problem. I said that I thought honest and open dialogue between Linda and he was very important but he flat refused to do this. He was open to trying a psychological treatment plan and we’ll go through techniques for this next time.