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Is premature ejaculation permanent? I don’t think so

No, but it can certainly feel like it. I explain the reasons why and how you can get unstuck.

Video transcript

If you regularly reach orgasm and ejaculation too quickly, are you stuck with this situation?

The short answer: no, you’re not. But you may need to brush up on some fundamental skills.

In medical terms, premature ejaculation is categorised as either:

  • Acquired PE: sex was fine before and then the problem began.
  • Lifelong PE: it’s always been a guy’s experience, for as long as he’s been sexually active.

Note that there are nuances here. Some guys consistently last for the average 5.2 minutes or longer, but worry that it’s not long enough. Their PE problem might be more perceptual, but it still causes them distress.

Lifelong PE is most certainly a thing and countless men experience it, but allow me to firm up this definition too.

Lifelong means that you have ejaculated sooner than desired, typically within 0-2 minutes during partnered sex, consistently since you became sexually active.

But lifelong PE is not a prognosis. You may be naturally wired to ejaculate sooner than the average guy, for reasons I’ll summarise here. But for the vast majority of men in this situation, it need not be inevitable or permanent.

PE is frustrating, no doubt about it. And the more it occurs, the more stress it generates. Men can spiral into hopelessness and depression.

Why do men feel so stuck in this rut, and how can they climb out of it?

Every man is different, with his own combination of factors underlying his PE difficulties. It’s a bio-psycho-social condition, and I’ll explain why this is so relevant.

Biological factors

Research has identified differences in men who struggle to last and men who don’t. This includes (often subtle) variations in brain structure, serotonin receptors, hormone balance and skin sensitivity.

Some of these factors may be genetic. And they may well be permanent too, unless medicated or altered by a significant medical intervention.

These days, SSRI pills are the most commonly used medication for premature ejaculation. They are taken as a daily dose, or the on-demand version dapoxetine (also known as Priligy) is available in many countries.

SSRI medication can be effective. After taking dapoxetine, guys can typically expect to last two or three times longer than usual. If guys opt for a daily dose of paroxetine (Paxil) or fluoxetine (Prozac), they may benefit even more.

But SSRIs come with side-effects. And this approach doesn’t cure anything. As soon as guys stop taking it, they ejaculate just as quickly as before.

Various surgeries have been attempted too, including circumcision, cutting of the frenulum band of tissue, injections into the glans of the penis to permanently disrupt sensitivity and using pulsed radio frequency to affect the penile nerves. These are experimental treatments and so far, they have had limited long-term effect.

To help remedy skin sensitivity, numbing creams and condoms are widely used. But again, they only have a temporary effect and require a fiddly pre-sex ritual of application and washing off.

So does this mean guys are fundamentally stuck with PE? No. They might need to work on their bodily awareness. They probably need to adjust the way they have intercourse.

Men can’t manually change the gears of their arousal, but they can drive differently. And this requires skill development.

What gets in the way of building skills? The overwhelm of anxiety and stress around sexual performance. That’s not fun for anyone, and inevitably leads to avoidance.

Which brings us neatly to the psychological aspect of PE.

Psychological factors

Confusion from early experiences of sex, feeling less of a man, desperation to satisfy, fear of losing a partner. Men with sexual difficulties experience conflicted feelings; they feel the excitement and natural urge to have sex with their partners, but some level of dread too.

Resourceful men go online and look for advice, and there’s no shortage of guides and techniques out there. But remembering and applying techniques goes out of the window when they find themselves in bed with their partners.

That’s anxiety shutting down their resourcefulness. They are having sex in panic mode, with the brain fog and increased tension that compromises erections or accelerates ejaculation.

Anxiety around sex can be addressed, through therapy and relaxation skills rehearsed outside of the bedroom first.

Breathing, pelvic relaxation and relaxed movement can make a big difference in the body and the brain takes notice. Arousal awareness helps us to implement these techniques in a timely manner. This sets up a positive feedback loop of body and mind cooperation.

A little real-world sex education goes a long way too. Reframing intercourse as not the be all and end all of sex takes the pressure off. Porn isn’t a particularly good educator on this front.

Social factors

All of this impacts our relationships, of course. This brings us to the social side of things.

Men can make significant progress by working on skills and techniques as a solo project. Due to feelings of embarrassment, that’s their understandable preference of course. Men are solo problem-solvers by nature.

But for men in relationships, I advocate open communication with their partners and tackling PE as a joint effort. When guys are stuck in a PE rut, sex becomes a tense ritual for both partners. The grim prospect of dead bedroom looms.

One guy I worked with lived this scenario throughout 25 years of marriage. He’d tried various creams and tricks over the years, but never opened up. When he and his wife finally started to understand each other’s needs and struggles, they progressed past their years of wrestling with PE and dissatisfaction.

Realistic personal development

Another common sticking point in overcoming PE is unrealistic expectations. Porn perpetuates the narrative that good sex means remaining rock-hard for 20 minutes and pounding through a multitude of advanced sex positions.

But the male self-help industry cultivates this expectation too, with promises of ‘ultimate stamina tonight’ and ‘orgasm on demand’.

Even if guys see through the entertaining fakery of porn, they believe the assurances of lasting-longer gurus and marketing blurb.

Remember that the average duration of sexual intercourse is 5.2 minutes, and this is perfectly adequate for many couples.

If you or your partner desire more, then by all means communicate and enjoy working on your game together. But if you worry about PE because you don’t last 20 minutes or don’t have complete control over when you ejaculate, your expectations could be holding you back.

Conclusion: skills are the permanent treatment for PE

So, yes – your body might be predisposed to PE. But your potential for shared sexual pleasure doesn’t end there.

With some investment in your skills and your connection, you may well turn out to be a more exciting partner than a lot of guys who take duration for granted.

Essential as it is, this isn’t all about your sexual satisfaction. These skills transfer to all aspects of life; living with more awareness, calm and openness. What’s not to like?

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