What is premature ejaculation (PE)?

What is premature ejaculation (PE)? You might expect that this is an easy question to answer, but it depends on whom you ask. Masters and Johnson (1970), the founders of modern sex therapy, stated that a man has PE if he ejaculates before the woman reaches orgasm in 50 percent or more of their sexual encounters. PE is sometimes defined as a problem accomplishing a “normal” length of time between insertion and ejaculation. Studies have even defined PE by a specific amount of intercourse time: less than one minute, two, three, four, five, seven, or 10 minutes, each amount based on a different reason. Still others have proposed to define PE by the number of intravaginal thrusts: eight thrusts, 15 thrusts.

What underpins PE is a man's inability to hold back his climax. Sometimes that's down to sheer arousal - he's so excited he can only hold out for a short period of time. But with really serious PE, a man might have such a hair-trigger reaction that he comes before he even touches his partner.

What should he do?
One way forward is for him to climax before intercourse - the second time he's more likely to be able to hold back. He also needs to learn to spot his body's signals leading up to orgasm, so he can take action. The best way is through practice. For a few weeks, he should regularly masturbate nearly to climax, at which point he should stop - then start again - thus learning to control his orgasm.

If a man has too much control over his climax, he may not be able to orgasm at all.

If the problem's suddenly kicked in, it's more likely to be down to a single, physical, cause - so a GP check-up is necessary. But if your man has always had difficulty with climax, it may be that he is feeling anxious about sex and the relationship, and can't relax enough to climax during lovemaking. In this case, relationships counselling or sex therapy can help.

PE often happens with age - as men get older, they can take more time to come. Sometimes there's a physical basis for the problem, such as colostomy, spinal injury, multiple sclerosis or certain forms of medication. One of the main causes, though, is that a man is simply over-controlling his orgasm and can't let go.