Chronicles of Premature Ejaculation

The English jazz singer and raconteur George Melly was once asked what he liked most about growing old. Losing your libido, he said; it was like getting unchained from a lunatic.

I know what he meant. Now that I'm in my late 30s, things have calmed down, but as a pubescent teen my libido was bouncing off the walls of his padded cell, talking in tongues, mad as a March hare. Pretty much anything would arouse me—the particular way a bus engine vibrated at a stop light; the synthetic fibers in boxer shorts. The list was endless.

At some point, this cauldron of over-heated desire ran into an actual live female, with predictably disastrous results. I was 15, the girl's name was Lisa, and to this day she has no idea of the part she played in my earliest sexual misadventure. That's because the party, as they say, was in my pants. That's right: I'm one of those preposterous guys who has literally jizzed himself in public.

It happened while waiting to go into class. I'd had my eye on Lisa for a while, and one day, I tried flirting with her. She must've reluctantly decided I was the best option in our class of fairly gormless-looking teenage boys, because Lisa responded positively to my lame chat-up line. We started shoving each other around (how kids in my school tended to communicate sexual interest) and one way or another, I found myself behind her with my arms draped over her shoulders.

I could feel her breasts pressed against my forearms. Just a slight adjustment, I thought, and I could have them in my hands. The corridor was filling up with other kids. I could feel their eyes on us. What was I doing! But Lisa seemed to coax me to go further.

"You're too tall," she said in a soft, comely voice, bumping her butt against me.

I tried to play it cool. "Yeah well you're too sma…"

SPLUFF!

I've told that story several times in my life, not always climaxing with the word "spluff," but always as an amusing anecdote. It seems natural to make a joke out of it, but at the time, it was anything but funny. Especially since my experience in the school hallway ended up predicting my sex life for the next ten years.

Premature ejaculation, or PE as it's casually abbreviated in medical shorthand, is the most common male sexual dysfunction, far more prevalent than impotence. The International Society for Sexual Medicine defines PE as a condition "characterized by ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration." Experts estimate about 30 percent of the male population suffer with it at some point in their lives. For some it's a passing phase; but for many others it's not.

"One of the myths is that PE is a young man's problem and that once he learns how to have sex and be more aware of his arousal the problem will go away," says sex therapist and author Dr. Ian Kerner, who has written at length about his own struggles with PE. "But in truth most men who suffer from PE suffer from it chronically for the course of a lifespan."

These men can end up feeling like "sexual cripples," says Dr. Kerner, yet the common cultural response is still to laugh at it. Think of the classic scene in American Pie when Jim jizzes himself twice in front of the sexy exchange student, or the Lonely Island skit that got everyone singing about jizzing in their pants.

Dr. Kerner says this tendency to ridicule makes it harder to have a serious dialogue about premature ejaculation. "Think of all the sex issues that get talked about in the media day in day and out—erectile dysfunction, low female desire, sex addiction, porn addiction—yet you rarely hear about PE."

We make jokes about those other problems too, but we're also prepared to take them seriously. A Hollywood actor's sex addiction might make him an object of derision but the fact that he can publicly admit to it says a lot. No star admits to being a chronic premature ejaculator.

The taboo surrounding PE means that most who suffer with it do so in silence. It was that way for me. The only people who knew were the girls I shared my bed with—and sometimes not even them, since when you have a problem with PE, you become adept at hiding it.

Ed*, a 23-year-old finance worker from Texas, admits to being "kind of intense" about covering up his PE and has a whole protocol worked out for first sexual encounters to ensure his date doesn't find out.

"Before beginning, I make sure we're in a house or somewhere with a bathroom I can escape to," says Ed. "So we start making out and I start stimulating her with my hands. Then I move my mouth around and work into cunnilingus.

"If she tries to touch my dick before that, I literally move her hand away and keep making it about her. After her orgasm I'm ready to bust, so I say I'm going to go rinse and run to the bathroom, where I rinse and jerk off."

Ed blames PE for ruining at least two relationships. At his age, I had the same fail rate.

A couple of years after Lisa, I met a girl called Vicky, who became my first girlfriend. I was totally in love with Vicky, though our abortive attempts at sex were usually over before they began. Just having our naked bits in the vicinity of one another was enough to set me off. I was so devastated when she dumped me that—in a gesture high in romantic cant but low in environmental friendliness—I took a crappy plastic bracelet she had given me and solemnly buried it at the bottom of the garden.

Like Ed, I became convinced Vicky had finished me because of my PE. I tried to tell myself I'd do better next time, but whenever next time came along, the old trouble returned. My relationship to sex became characterized by evasion, bailing out on dates when things got too passionate, changing the subject when friends shared stories about their sex lives and wanted to hear mine.

In my early 20s I met a girl who I dated for a year. With her, at least I was able to talk about the issue and we both agreed I should try and get help. I told my doctor, who referred me to an urologist. He was a somber northern Englishman, cold and unempathic. After listening to my mumbled explanations he told me about a few behavioral techniques I could try out with my girlfriend, the main one being "the squeeze," which sounds like a dance craze from the Jazz Age but actually involves getting your partner to squeeze the tip of your cock when you feel yourself approaching bursting point.

The squeeze was developed in the 60s by the inventors of sex therapy, William Masters and Virginia Johnson. Before Masters and Johnson, treatment for PE was considered unnecessary, since up until fairly recently, the world was entirely run by men who didn't give a shit about women's sexual pleasure and so saw no need in prolonging sex for mutual satisfaction. Even the famous sexologist Dr. Alfred Kinsey, who shone a light on what a bunch of perverts we all are with his sex surveys back in the 50s, saw nothing abnormal in his discovery that 75 percent of men reported ejaculating within two minutes at least half of the time.

When psychoanalysts did begin to take PE seriously as a problem, their main contribution seems to have been to stigmatize men with the condition. Take this psychoanalytic quarterly from 1933 that states in a chapter titled Amphimixis of Erotisms in the Ejaculatory Act: "Patients who suffer from premature ejaculation manifest the same attitude of indifference towards their semen as they would towards their urine, that is to say, as a valueless excretion of the organism." (In stark contrast, I suppose, to the rest of the male population at the time who were presumably treating their semen as the elixir of life it surely is, perhaps keeping a vial of their most memorable excretions in the trophy cabinet.)

The squeeze technique didn't work for me. My girlfriend found it too weird and after a few attempts, we stopped. I tried delay sprays and wearing a condom to numb sensitivity, but that didn't help either and within a few months she had ended things, telling me our lives were going in "different directions," though I of course knew the truth.

By this point I'd given up hope of ever having a normal sex life. The only consolation was that I was at least able to make girls come. Oral sex is the ace up the sleeve of premature ejaculators: Ed calls it his "best friend," and Dr. Kerner has authored a best-selling book about it, called She Comes First, in which he outlines "a methodology for consistently leading women to orgasm" through cunnilingus.

I too became something of an oral genius, but remained unsatisfied. Why couldn't I share that pleasure with someone through sex? The trouble was that the more I obsessed about my limitations, the more my symptoms grew—a kind of self-fulfilling prophecy. Dr. Madeleine M. Castellanos, a New York-based psychiatrist specializing in sex therapy, says that this is not uncommon in PE sufferers.

"One of my main goals with all men who suffer with PE is improving the quality of their thoughts rather than the focus of their thoughts," says Dr. Castellanos. "I have found that when men are having positive thoughts full of eroticism and free of anxiety, they have much greater success overcoming PE than those who are primarily interpreting every thought and sensation with negativity and self-criticism."

How much PE is a psychological problem versus a physiological one is a vexed issue in the sexual therapy community. Dr. Kerner, who is firmly in the second camp, cites the latest research suggesting it's a neurobiological issue linked to the balance of dopamine and serotonin. "It's probably inheritable and might also have to do with nerve sensitivity in the penis."

Dr. Kerner backs medical treatments including, as a last resort, the SSRI class of anti-depressants, which have proved useful in treating PE since one of their side effects is diminished desire. He's also taking part in a research study with the company that produces Promescent, a lidocaine-based spray that works as a numbing agent.

At the other end of the spectrum, Dr. Leonore Tiefer, a clinical associate professor in the psychiatry department at the New York University School of Medicine, is against the whole idea of medicalizing PE. "Medicalizing means viewing something as a medical condition. It's a mistake because nothing is broken—rapid ejaculation, average ejaculation, slow ejaculation are points on a continuum of variation," she told me. "Some cultures, some partners, some circumstances prefer fast, slow, or average. There's no normal."

Dr. Tiefer thinks that the public's current understanding of PE is being clouded by the pharmaceutical industry abetted by doctors too quick to diagnose and prescribe. There are ways, she says, to teach men to orgasm more slowly but "the individuals involved have to be interested, cooperative, and willing to practice the techniques and exercises."

Ed, who says he tried Promescent and found it ineffective, doesn't know how much of his PE is in his head, but he says there's a limit to the amount of behavioral therapy he's prepared to do. "I'm not going to engage in hours of tantric practice to manage it so I do what I can with controlling my environment and breathing slowly," he says.

When I was 25, I went for a summer to Tuscanny where I worked as a tour guide. While there I met a dark-eyed Italian called Daniela who inadvertently "cured" my PE when she introduced me to the blissful pleasures of stoned lovemaking. I don't know if the marijuana's effect on me could be said to be primarily physical or mental but at the time, of course, I didn't care. I was finally able to fuck for long periods, get girls off through penetration and bust out all those sex positions I'd been fantasizing about half my life. It was amazing.

After Italy, weed became a necessary ingredient to my sex life and, for a while, if I didn't have any around I'd get nervous. I don't smoke pot anymore, and though in the course of my current relationship we've used it in our lovemaking and the sex has been amazing, it also has been amazing without it. And sometimes I've made a mess of the bed sheets—but I'm coming to terms with that.

Dr. Kerner believes PE can't be cured, only managed. He might be right but I wonder how much the distinction really matters. I put a lot more stock by Dr. Tiefer's observation that there's no normal. And while I don't deny that there's something innately funny about jizzing in your pants, it's also true that what you're laughing at really is an over-sensitivity which, if brought under even a modicum of control, can produce the kind of super sensitive lover that many women are crying out for.

Ed recently had a one-night stand where, for the first time in his adult life, his PE felt like a non-issue. He had three ejaculations, each one further apart from the last, the final one coming after over an hour of sex. What helped make this experience so different?

"I think the girl was what made it unique because she was so mellow," he said. "I was 100 percent upfront about my problem and she didn't feel weird. She had multiple orgasms and hasn't stopped texting me all week."

*Some names have been changed

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