By Dr. Stephanie Buehler
Premature ejaculation is a source of frustration and embarrassment for many men. In my sex therapy offices in Orange County and Riverside, California, I get calls from men asking for help with this perplexing sexual problem. There are multiple causes of premature ejaculation, but the one that probably gets most discounted are emotions.
But before talking about the role of feelings, here is a bit of general information about premature ejaculation (also known as rapid ejaculation). Often the first question I ask is, "How long do you actually last?" When a man answers three or four minutes, I tell him that he's doing fine, because on average men last from three to 10 minutes. However, the caller is often unhappy with this answer. Generally, the partner is disappointed because she cannot have orgasm within the time that the couple has intercourse, or he once enjoyed better control but has noticed a change. Some men have control for a minute or two, if that, which leads to the most frustration.
What to do? It depends on the cause as well as perspective. Some people, including many medical doctors, see premature ejaculation as a physical problem. The thinking goes that a man's penis and his mental responses to stimulation are overly sensitive, causing ejaculation before the man and his partner want it to occur. When the medical model is used to explain and treat the symptom, then a medical treatment is used, such as a numbing cream or an antidepressant. (Antidepressants can have the side effect of delaying ejaculation.)
However, premature ejaculation can also be a psychological problem. Anxiety and stress are common culprits. When a man is anxious about how long he will last, whether or not he will please his partner, or about some other aspect of sex, then his brain is primed to react quickly to stimuli. Stress does the same thing by causing the body and mind to be "keyed up" in high alert, making it difficult to stay focused and manage all the sensations going to the brain.
But feelings can also contribute to premature ejaculation. If a man is feeling sad, for example, about his relationship, he may find it difficult to last as long as he'd like while being intimate with his partner. Men often contact me about this problem after the breakup of a relationship. The problem starts seemingly for "no reason," but upon reflection, the relationship was actually on shaky ground for quite some time. Fears about one's ability to please a woman not just sexually, but emotionally, can be subtle but still create an effect in the bedroom.
Anger can also disrupt a man's sexual performance, as can feeling exploited or used by his partner. He may not feel like being close to his partner under such circumstances, even though he mostly wants to please her. He also may be too distracted by his negative feelings, unable to push them aside. Though it may be a stereotype, men do tend to pride themselves on their ability to put aside feelings in favor of thought. But try as a man might, if his negative feelings are strong enough, or if he is under stress or tired, they will make themselves known through various symptoms, including premature ejaculation.
When feelings are absent, there can also be problems. If a man is with a sexual partner with whom he has little emotional connection, he doesn't have an incentive to last a long time. He also may not want to have a long period of intercourse because he doesn't want to seem or become interested or involved with his partner. Though there are some men who want to appear as "studs," able to last a long time under any circumstance, the truth is that feelings do play a role in sex for most men. After all, men are simply human; they shouldn't dismiss the important information that their feelings hold for them, including when it comes to sex.
Want to learn more about marriage and sexuality? Dr. Stephanie Buehler is an internationally recognized psychologist and sex therapist, author, and speaker. She is also the Director of The Buehler Institute in Orange County, CA. If you visit Sex Therapy Orange County today, you can sign up and instantly download her e-book, Sexual Discoveries: 25 Secrets for Incredible Sex.
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