It is impossible to come up with a universal definition of premature ejaculation because there is so much variation among individuals. I have met women who are perfectly satisfied with intercourse that lasts two or three minutes, while others are frustrated when their husbands cannot last more than fifteen or twenty. It comes down to individual judgment: do you and your partner feel that you reach orgasm too quickly? If so, there are many practical steps you can take to solve the problem.

The key to prolonging intercourse is to become so well tuned to your own body mechanisms that you can take action to hold off ejaculation before it is too late. Ejaculation is basically a two-step process. As arousal increases, you eventually reach the point of no return: ejaculatory inevitability. That is the moment when you feel that you are going to climax and there is nothing you can do about it. Physiologically speaking, you are correct; there is nothing you can do about it. Once that point is reached, the ejaculation reflex is set in motion, the muscles of the perineum forcefully contract, and the seminal fluid is already on its way out. In seconds, the expulsion stage is triggered. To delay ejaculation, you must be aware enough to do something before the point of inevitability sneaks up on you.

The first step is to pay close attention to physical sensations as you approach ejaculation. Just as you learned when to start braking your car as you approach a stop sign, you can learn to recognize when you are getting too close to the point of inevitability. That is the time to make adjustments. Some men try to distract themselves by thinking of anything besides what is going on: baseball, work, or anything nonsexual. Unfortunately, this is rarely effective. Even if it does slow down the process, it also separates you from the intimate connection of making love and ultimately detracts from your full enjoyment of the moment.

A more effective and far more enjoyable technique is to alter the way you are thrusting at that point: change the angle, speed, or depth of your thrusts, which will shift the sensations away from the head of your penis (the glans, which is the most sensitive part), thereby delaying ejaculation. Intercourse does not have to be limited to deep, rapid thrusts. You can make love slowly. You can move in a circular motion or enter only partway. The variations are limitless. The secret is to pay attention to the sensitivities of your own body and then make the appropriate adjustments to your sexual technique.

You can also stop thrusting entirely. Try suspending motion for a while and just lying together with your penis fully penetrated. It is a great way to reduce arousal and prolong intercourse. It can also be wonderfully romantic. When you feel you can resume thrusting without ejaculating immediately, resume your motion slowly.

Another variable is to withdraw entirely. This “start and stop” method is often used by sex therapists. When you feel yourself nearing inevitability, simply pull out and rest. If your relationship is a good one, your partner should understand the need for this and welcome the opportunity to do other erotic things. This is the time for using your hands, lips, tongue, and any other body part that gives you pleasure while at the same time giving your penis a break from direct stimulation. When you resume intercourse, it will be that much more intense and your total time of penetration will increase. Do not be afraid of losing your erection if you stop thrusting or pull out entirely. You might lose it, but so what? It will come back with the right stimulation.

It is important not to view early ejaculation as a personal failure. If it occasionally happens, it is probably due to a long lapse between orgasms or to nervousness: a new, passionate love affair might be so exciting that the threshold for orgasm is lowered considerably. Even if the problem is chronic, I can assure you that it is not a sign of permanent inadequacy or diminished manhood, but simply a matter of bad habits that can be changed with practice and patience. The good news is that no matter where you start from, you can vastly increase your ejaculatory control.


Dudley S. Danoff, MD, FACS is the attending urologic surgeon and founder/president of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, California. He is the author of Penis Power: The Ultimate Guide To Male Sexual Health (Del Monaco Press, 2011) and Superpotency (Warner Books).

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