Premature Ejaculation: What Can Lie Behind It

If you come sooner than you want to during sex, you are not alone. Tension and pressure usually speed up arousal, often without you noticing. That is where you can start: by perceiving your own arousal more closely, on your own and as a couple.

What “too early” actually means

Medically, premature ejaculation means that ejaculation almost always happens within about a minute of penetration, has done so for at least six months, and causes you distress. The technical term is ejaculatio praecox. For comparison: on average it takes about five to seven minutes from penetration to ejaculation. According to the German Federal Ministry of Health’s health portal, around four percent of men are regularly affected.

So many of the men who worry about it are nowhere near the medical definition. That doesn’t make their concern unimportant. What matters is whether it weighs on you, or on both of you. If you lie in bed with a stopwatch running in your head every time, you get little out of sex, however many minutes it lasts in the end.

Ejaculation and orgasm, by the way, are not the same thing. They usually happen together, but they can be told apart. For some men, that alone is new information about their own body.

Always, or only for a while

Some men have known it for as long as they have been having sex. Others had no difficulties for a long time, and at some point it began, for example in a new relationship, in a stressful phase, or after the erection was unreliable once. This difference matters for the medical check. If it is new, it is worth taking a closer look at possible physical causes.

Where it can come from

Research doesn’t know of a single cause. The sensitivity of the penis, physical factors and the mind all play into it. What I see almost every time in my practice: pressure doesn’t make it better.

The cycle of pressure and tension

If you are afraid of coming too early, you tense up. Belly, buttocks, pelvic floor and thighs go tight, and your breathing becomes shallow or stops. Often the pace picks up too, because you want to “make it” in time. That is exactly what drives arousal up. Anyone who tenses strongly and is stimulated fast and uniformly will usually come sooner. And once you have come too early, you go into the next time even more tense.

That is how one experience turns into a pattern. Some men start avoiding sex. Some turn away as soon as it is over, because they feel ashamed. To the other person, that often looks like a lack of interest.

Coming early can also have something behind it that is hard to put into words. Doubts about whether you are enough. Being torn between wanting closeness and fearing it. Questions like these can have a place in our conversations, without having to play a part in everyone’s ejaculation.

When the erection is unreliable too

Sometimes both come together: the erection feels unreliable, and to avoid losing it, you hurry. Then it makes sense to have a doctor clarify which came first.

Have physical causes checked by a doctor

If coming early is new, or it comes with pain, inflammation or erection problems, please see a GP (Hausarzt) or a urologist. They can check whether a physical cause is involved.

Sprays, creams and pills are sold online. Whether a medication is right for you is a question for a doctor. I don’t recommend any products. And even if you take medication, you can still be curious about how your arousal works.

Perceiving instead of controlling

The most common attempt is control: pulling yourself together, thinking about something else, holding your breath. The trouble is that this makes it hard to feel your arousal at all. And what you can’t feel, you can’t influence.

In Sexocorporel, a body-oriented approach from clinical sexology, the first step is therefore perception. The approach assumes that arousal can be influenced through breathing, muscle tension and movement. In this view, breathing more deeply, keeping your muscles looser and moving your pelvis spreads arousal through the body. Tensing up and keeping still concentrates it in the penis.

Getting to know your own arousal curve

Masturbation is a good place to observe. With no one else there and nothing expected, you can notice how your arousal rises. Where in your body do you feel it? When does it get so strong that ejaculation can no longer be held back? This moment is called the point of no return.

With the start-stop technique, you pause stimulation shortly before this point, wait until arousal drops a little, and then carry on. What you notice along the way matters more than the technique: What happens to your breathing and your muscles just before it tips over? What changes when you slow down instead of stopping?

What distraction, condoms and willpower do

Many of the men who come to me have already tried quite a lot. Thinking about the tax return. Two condoms on top of each other. Masturbating beforehand so it lasts longer the second time. Some of this buys a few seconds in the short term. But it leads away from feeling, and it turns sex into a project in which you mainly keep an eye on yourself. That is rarely good for desire, neither your own nor the other person’s.

Dealing with it together

When you both stop counting the minutes, the pressure changes. Sex is more than penetration. If you experience pleasure together, with hands, mouths and touch, you don’t depend on penetration lasting a long time. For many couples, that takes a lot of weight off.

Talk about it, outside the bedroom and without blame. For the person who comes early, a sentence like this can help: “I’m ashamed of it, and that’s why I often pull away. It has nothing to do with you.” For the partner: “I don’t care how long it lasts. I care that you’re there.” How to deal with the shame while you do this, you can read under talking about sex.

Your partner doesn’t have to take the issue on. It doesn’t help anyone if one person is constantly watching out, slowing down or comforting. Each person is responsible for their own arousal. Together, though, you can find a way of having sex in which both of you have less to prove.

What happens in sex therapy

In sex therapy we look closely at how your arousal unfolds. How do you breathe when it gets exciting? Where do you tense up? What goes through your mind? We work in a body-oriented way, with breathing, movement and perception. In sex therapy I don’t touch you, and your clothes stay on. If you like exercises, you get some to take home. You can read more about working with the body under body-oriented therapy.

Then there are questions that go beyond the body: What does coming “too early” mean to you? What images of masculinity and of good sex do you carry around? How are you doing in your relationship? You can come on your own or as a couple. You will find more about the sessions under sex therapy for premature ejaculation.

The next step

I work in Neukölln, in Prenzlauer Berg and online. If the topic is easier for you in English, we speak English. As a rule, you pay the fees yourself. Write me two or three sentences. That is enough to begin with.