Sidney McGill - HEALTHY SEX 101CARLTON, A well-dressed, 41-year-old businessman, entered the counselling room. His grimacing face showed signs of fighting one battle too many. He had eight children with eight different women. His wife, a no-nonsense, hardworking woman had recently announced that he could no longer sexually satisfy her and so she was looking for a better sex partner.
Carlton loved women but could not stay committed long enough to develop a meaningful, lasting relationship. His wife was adept at discovering his frequent philandering and accosted him and his girlfriends with the swiftness of a toad's tongue. Carlton's insecurity was evidenced by the onset of rapid ejaculation. He had resorted to wearing several condoms, applying desensitisation creams and ointments to his penis, repeatedly masturbating prior to intercourse, not allowing partners to stimulate him, or distracting himself by performing complex mathematical computations while making love to overcome his rapid ejaculation. These tactics, though creative, proved unsuccessful. He was now at the end of his tether (no pun intended).
By improving Carlton's family situation and self-esteem, and dealing with his intrapsychic conflicts and depression, the rapid ejaculation would soon disappear. For most complainants however, the problem has been lifelong. Here are two more treatment methods that will help behavioural therapy and anti-depressants.
Behavioural therapy: the most commonly-used method, the 'squeeze' method, in which gentle pressure is applied to the head of the penis with the index finger and thumb to prevent ejaculation, has a 98 per cent success rate. Improved ejaculatory control however is only long lasting if the man's anxiety is significantly reduced as well.
TO FIRE LATER RATHER THAN
SOONER INVOLVES LEARNING TWO SKILLS
1. focusing more fully on your own sensations of arousal and tension (especially at the head of the penis)
2. the ability to make changes in your behaviour to delay ejaculation.
The 'squeeze' technique involves masturbating or allowing your partner to masturbate you. As the penis is being stroked, be aware of the sensations you are experiencing from the penis and scrotum. Don't be distracted by the fear of coming quickly or wondering if your partner really wants to do the exercises! A few seconds before you reach the point of ejaculation, squeeze the head of the penis. (If ejaculate is noticed then you have squeezed too late).
Squeezing the head of the penis causes a little pain, which helps to reduce the heightened sensation. Wait for about 30 seconds, take deep breaths to help you to relax and repeat the exercise several times before allowing yourself to ejaculate. Practice the exercise three to five times per week, increasing the length of time for the exercise to a maximum of one hour. The exercise improves communication and encourages lengthy foreplay, which extends the range of sexual expression between the couple.
Anti-depressants: In recent years, a number of studies have revealed that anti-depressants can be fairly effective in postponing ejaculation when taken on a daily basis or when taken about five to 24 hours before anticipated sexual activity. A low dose of antidepressant can improve the man's sexual enjoyment and confidence if given after say three weeks of practising the 'squeeze' method.
Working with a sex therapist while trying the medication is beneficial since the additional guidance helps you to sort out things that relate to anxiety and in learning behavioural changes that will support your goal of lasting longer.
Dr. Sidney McGill is a Marriage and Family Therapist.
