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Where the problem of premature ejaculation exists, it can be a great source of frustration to the couple involved. There are some men who get so nervous or excited that they ejaculate before they can get the penis into the vagina. There are others who can penetrate but ejaculate before the woman has had an orgasm. The question arises: whose fault is premature ejaculation? The man's - or his partner's slow response? Or is it their mutually clumsy and inept lovemaking? Is there a need for development of more sensate focus?
But good sex is anything that is sexually satisfactory to man and woman. A man does not have to "hold out" for a certain number of minutes before he can qualify as a virile lover. Experienced lovers can manipulate one another to accommodate almost any chosen time schedule. A woman can respond orgasmically 30 seconds after penetration if she has been stimulated to be "wildly ready." There's no doubt that lots of men think they are premature ejaculators and inadequate lovers when nothing is wrong except that they aren't in rhythm with their partners.
Misconceptions excepted, however, there are premature ejaculators, and there are men who, with their partners, would like to spend a longer time thrusting than they are able to do. One definition is that a man has a premature ejaculation problem if he's unable to satisfy his partner (bring her to orgasm) at least 50 percent of the time - providing, that is, the female partner is capable of being satisfied. They also say the premature ejaculation often reflects socio-cultural orientation. Research confirms that men of lesser education, lesser income, and lesser socioeconomic groups are less likely to care about whether their female partners are orgasmic. This includes all sexual partners.
As far as one's future sex life is concerned most advanced forms of adolescent sex play are unhelpful. Experts believe the female is over-stimulated, often without relief. And the male is moved to hasty ejaculation. Such patterns have a way of persisting later in life when they are no longer necessary or desirable, if indeed they ever were. Another common sexual practice in which partners shortchange each other is one of the oldest forms of birth control - withdrawal immediately prior to ejaculation. If withdrawal is skillfully practiced, both the male and the female may obtain sexual satisfaction. But the method does not teach the man to control his ejaculation schedule or to be considerate of his partner's orgasmic response. He pulls out in a hurry when he gets the unmistakable physiological signal that he is about to ejaculate.
This practice not only unhappily "trains" men to develop premature ejaculation and therefore poor lovers but is also an inadequate system of birth control as a few drops of seminal fluid loaded with sperm can escape before the warning signal is felt. Contrary to popular belief, masturbation does not cause a man to be a premature ejaculator. Masturbation has been blamed for everything from insanity to poor grades but it has no known effect on a man's future as an efficient lover. Prematurely ejaculating men fail to satisfy their women, who may never have orgasms - and who suffer for it. Many women suffer without knowing what they are suffering from. Their ill temper is blamed on everything from menstrual periods to their mothers-in-law. Those who do come for consultation about premature ejaculation may be with men who can't be touched on the penis without quickly ejaculating, men who ejaculate within moments while engaging in love play, or men who can't last long after penetration.
The majority who seek help, ejaculate within the first few thrusts of the penis into the vagina - before the woman has a chance to arrive at orgasm. Such a man brings with him a partner who is often attractive, intelligent, informed, and has read most of the sex manuals. She knows her man has a problem but it hasn't yet occurred to her that as a partner she has one, too. Unfortunately, many couples with this problem don't get around to seeking treatment for quite a long time. It may be five years after they get together in marriage or relationship. Or it may be 20 years. In the interim they don't understand why there is so much quarreling, distraction, and exhaustion. They are diverted by the man's upward climb in profession or business, the woman's energetic devotion to childrearing, the adventure of establishing a home - until the woman reaches the point where she is ready to leave. She may go to a therapist. Yet studies show that psychotherapeutic support for the partner of a premature ejaculator rarely does much good. Technically it's called "palliative" which means something in the nature of a Band-Aid. Or she may take a lover.
But the woman who gets involved with other men - be it the milkman or her partner's best friend - is likely to find herself unresponsive with other male partners also. This may be due to guilt (adultery is still socially disapproved and penalized) or perhaps because the other man's sexual efficiency downgrades her own self-confidence. ("Why couldn't I attract a man as good as that in the first place?").
Some women caught in this bind seek other women for sexual partners. What happens more often, however, is a period of years of struggle, during which both partners are bewildered and unhappy. The woman knows she's not getting sexual satisfaction. Her man doesn't know why she is such a bitch. They have no sensate focus. In this period, the woman verbalizes and acts out her sexual discontent. Every time she does it, she makes things worse. If you keep telling a person he is no good and he has it demonstrated to him every day, he begins to believe it.
Pretty soon the man begins to act like a second-rate person even if he wasn't one before. Now the married sexual pattern changes. The man accepts his identity as a sexual schlemiel (a vivid Yiddish word that means a worthless do-nothing). The woman goes to visit her mother or her older sister and stays longer than she planned. He goes on lengthy fishing trips. Maybe they tell each other it will be better next time. The tragic error is that they have acted to reduce the sensate input rather than enhance it. Some men respond by increasing the frequency of sexual attempts, others by withdrawal from all attempts, and still others by finding a sexual partner other than his partner.
Clinical records show that premature ejaculators, faced with repeated failures, often retrogress sexually and become impotent. The transition is clearly marked and alarming. The man may ejaculate when he has half an erection and, later, may ejaculate with no visible erection. He may just "seep" seminal fluid and ejaculate with no pressure. Rapid ejaculators remain that way all their lives unless they go out of their way to learn calculated methods of control.
But premature ejaculation can be successfully treated with a simple technique. To hundreds of thousands of couples who suffer because the man comes too fast or the woman too slow this simple physiological device can mean a great deal. How can you describe it? The learned "slow-down" for the man? The learned "speed-up" for the woman?
Couples complaining of premature ejaculation have long been told that at the very instant the ejaculatory experience begins the woman should temporarily retard it by applying the "squeeze technique." This was first brought to public attention by Masters and Johnson, but they didn't invent this method. They credited it to Dr. James H. Semans, who first described it in "Premature Ejaculation: A New Approach" (Southern Medical Journal, 49: 353-357, 1956).
Dr. Masters and Mrs. Johnson would tell a woman to begin at once and touch her man's genitals. She was supposed to fondle him to an erection, with or without oil or lotion. Then they assumed a position called "training position for ejaculatory control." In this position the female partner sits up straight, her back braced by the head of the bed, and possibly supported by pillows. She spreads her legs. Her man lies opposite her on his back, his head in the direction of the end of the love play. When he again feels the warning onset of ejaculation, he asks her to squeeze again. There are some women who just can't bring themselves to squeeze the penis hard enough to make the squeeze play work. One woman said, "I squeezed, just as I'd been instructed, but I asked my man, 'Doesn't it hurt?' He said, 'No, I think you're supposed to squeeze harder.' So I did. But I was still afraid that he was just being brave."
For such hesitants, Masters and Johnson directed that the man placed his fingers over his partner's and show her just how much pressure he could bear. What happened next was described by Masters and Johnson as "non-demanding intromission." That was their delicate and dignified way of describing a posture for intercourse in which the woman is in command and yet makes no demands on her man.
Seemingly its advantage is that it is the sexual position least stimulating for the male. The "female superior coital position" -- or woman on top sex position - was advocated by Masters and Johnson, like the squeeze play on the penis, as a temporary technique to cure rapid ejaculation. (If, afterwards, it proves pleasant and useful, that's a matter of personal choice.) It is combined with the squeeze play, and here is how it goes: Over three or four days a couple learns to do the squeeze. No penetration of the penis into the vagina has yet occurred in that time. But now they have the green light. The man lies supine - that is spine down on the mattress - with his head toward the headboard of the bed. His legs are slightly spread apart. His woman crouches astride him with her bent knees approximately opposite his nipples. She uses all the techniques she has been taught in the past few days - including use of oil or massage lotion - to encourage him to have an erection. She may apply the squeeze technique several times as her man's erection and impulse to ejaculate builds and goes away.
Then she leans gently forward so that her breasts are dangling over his chest. With her hand she gently guides her man's penis so that it slips effortlessly into her vagina. His hands support her hips. The woman should always guide the penis into the vagina. Once the penis is inserted the woman does not move. She doesn't rock back and forth. She must not "sit down" strongly on her man's hips but remains in the leaning forward position. Her hands may be on his shoulders or on the mattress beside his shoulders. Neither is asking anything of the other at that time except the quiet pleasure of vaginal containment. If the man tells his partner he feels the onset of an ejaculation she arches her back, permitting the penis to slide out, and firmly performs the squeeze therapy. Then she reinserts the penis as before. Pelvic thrusting on his or her part is still forbidden. The man is cautiously given permission to move his penis in and out of her vagina just enough to retain his erection. The woman is under orders to remain motionless. The female "superior" sex position is at a 40-degree angle and the sole of his foot is resting on the mattress.
The woman lengthens out her right leg. Her right leg is now between her man's legs. Her weight is now leaning on her remaining bent knee -- her left knee. The couple then move into the lateral position.
Next: She lowers and extends her body so that it is even more parallel - almost chest to chest, although her left leg is still bent and her weight is balanced on that knee.
Next: The man puts his left hand across her shoulders in the middle of her neck and his right hand on her buttocks and uses the strength of his arms to hold them firmly together.
Next: Now they roll - he to the left, she to the right. The penis remains in the vagina.
Next: They complete the roll. The male is turned on his right flank: The woman is largely lying on her stomach, tipped to her left off her man's torso. Each may need to be propped in that position by pillows. Her right thigh rests its weight on his left thigh.
Next: The woman puts her right arm and the man puts his left arm around each other's necks. Their other two arms are left free for fondling and love play.
Next: The woman bends her right leg upward a bit so that her knee is braced against the bed. Her left leg is thrown over her man's right hip so her knee is resting on the bed. With these slightly bent knees and her weight thrown to her left, she has leverage for bearing down on the penis at her and his will. Masters and Johnson admitted there may be some difficulty in converting from the female-mounted "superior" sex position to the lateral sex position. In their textbook they do not say who signals when it's time to move. Presumably the idea is mutual or it comes from one partner and is willingly acceded to by the other. When a couple with a problem of premature ejaculation has learned to use this position, the squeeze technique is not supposed to be a part of their future sex life but should be used, when needed, for the next few months. They are encouraged to have frequent and regular sex. In-between times they are urged to be spontaneous - to do what comes naturally.
Hopefully, they will leave their stopwatches and anxieties behind them. The sense of putting on a performance will also have disappeared. Women are told that in the early days of their menstrual period, when most couples do not care to have intercourse, they can use their time manually stimulating their man and then using the squeeze technique. Masters and Johnson consistently emphasized the role of the woman in pre-ejaculatory problems. To the woman who asked, "Why can't he turn himself off?" they said something like, "He can learn to turn himself off, but it doesn't help to reeducate him alone. When he goes back to you, he would have just as much trouble as ever. However, if you can help to reeducate him, together you can work out this problem."
Masters' and Johnson's reported success rate - based on cures lasting five years or more - in this most common male sexual dysfunction was 97.8 percent. But they said repeatedly that it couldn't be done without a cooperative, involved sex partner. They seemed to feel that as men and women assumed a joint and equal responsibility for one another's sexual joy, the anxiety-ridden rapid ejaculation symptoms would disappear.
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