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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5220
Experience:  Dr. Mark is a PhD in psychology in private practice
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is there a way to last longer durind sex

Customer Question

is there a way to last longer durind sex
Submitted: 4 years ago.
Category: Mental Health
Expert:  Dr. Mark replied 4 years ago.

Hi! I believe I can help with this issue.

There are a number of good solutions to help you.

First of all, you need to know there are a number of medical "solutions" available today. Low dosages of antidepressants have been found to slow down ejaculation. You would need to discuss this with your doctor and see if he is familiar with this or if he needs to refer you to a psychiatrist who will be able to prescribe and monitor the drugs.

PDE-5 inhibitors are a class of drugs that help maintain erections. The most popular drug today is Viagra. They are the first thing most men try as they are easy to use. Though doctors don’t often tell you: best results are had when you take them on an empty stomach.

A penile pump and ring may be helpful as well. There's a lot of history with a vacuum pump and penile ring. Here's some information:

http://www.medicinenet.com/penis_prosthesis/article.htm

If you've tried one of the PDE-5 inhibitors and it didn't work well, there are two medical options. The way most patients choose between them is they decide which application method they're most comfortable with. Intracavernosal penile injections (IPE) have been shown in research to be the most effective medical ED treatment option. But intraurethral alpostradil (called MUSE commercially for Medicated Urethral System for Erection) is a close second. They both involve applying something to the penis under the skin. But the word injection gets some people nervous, whereas the MUSE uses an applicator that's inserted into the tip of the penis. Even though many people are queasy about injecting their penis, once they are used to it, there is very little complaint. The first application of either medication requires it to be done in a supervised fashion. That's important. So make sure your doctor doesn't just describe the procedure. No embarrassment allowed here.


The other determining factor is side effect. The most common for IPE is pain. For MUSE it's a burning sensation. Now when I say common, I mean reported, not that everyone gets these side effects. But the success with either of these methods has been well documented without any problems for most men who try them.



Another approach is to do some looking into your emotional self as much as your sexual self. To do this, you may want to seek an experienced sex therapist. By that I mean a psychologist or psychotherapist who is certified by either the AASECT (http://www.aasect.org/) or the American Board of Sexology (http://www.americanboardofsexology.com/). This is a more demanding solution for you but it is the most comprehensive with the greatest chance of success for the long term in getting this problem solved if it is a manifestation of your emotional difficulties and not a physical problem. Most men with PE find that it is a psychological problem more than a physical one.

But there are also some self-help techniques that you most likely want to try first. So, I'm going to give you to try first a quick technique that the great psychiatrist Viktor Frankl came up with for this problem in his practice: it is called paradoxical intention. You can learn a little about it here:

http://www.psychologicalselfhelp.org/Chapter14/chap14_72.html

The way it works is: when you need to sexually perform, that is, from when you first know that you are going to have sex that day/night, you tell yourself: "Okay penis, I dare you to come quicker than you have ever come before!!!! Go ahead, you are going to be lightening fast!!! You're going to come even before you get inside her (him)!!!"

Do you get the idea? It seems kind of silly, but you will be surprised how many people this simple technique has helped!! The idea is that you have to challenge your premature ejaculation. You have to be bold and dare it. You have to make fun of it and you have to trash talk to it. Serious! Read the chapter on it in the link I gave you above for a bit more detailed explanation.

Okay, that's one simple technique that has helped many. Next, here are books that you should read and see if you connect with:

1. She Comes First: the Thinking Man's Guide to Pleasuring a Woman by Ian Kerner. This is a classic and I've seen many men helped by it.


2. How to Overcome Premature Ejaculation by Helen Singer Kaplan. Those who connect with this book find it SO helpful!


3. This third book is good for the many areas it explores for how to treat this yourself: Coping with Premature Ejaculation by Michael Metz.


Okay, I've given you a number of approaches here to explore: 1) Antidepressants, Viagra, and penile pump, 2) penile injections, 3) counseling, the long-term approach. 4) Paradoxical intention, a quick self-help technique. 5) Self-help books.

I wish you the very best!

Please remember to click the green accept button because: even though you have made a deposit, I do not get paid for my time unless you press ACCEPT. Feel free to continue the discussion as my goal is to get you the best answer possible. You can continue the discussion even after pressing ACCEPT. Bonuses are always appreciated! If I can be of further help with any issue, just put "for Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, Dr. Mark

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