Teaching males to control their minds and bodies so that they can overcome a premature ejaculation problem during sex does not appear to be backed by reliable evidence, researchers revealed in a Review published in The Cochrane Collaboration. Two authors, however, added that so-called behavioral therapy should not be discounted yet, before further studies are done.

Stanley Althof, executive director of the Center for Marital and Sexual Health of South Florida, said:

“We need to do more to
prove it works.”

Experts define premature ejaculation as ejaculation that occurs within a minute of placing the penis inside the vagina. Nobody is sure what percentage of men experience premature ejaculation, and how often.

Althof says that approximately between 2% to 5% of men suffer from premature ejaculation if the one-minute definition is used strictly. He added that more men probably think they are too quick, even if their ejaculation occurs after one minute.

Althof said:

“If you ask men themselves if they have premature ejaculation, you’re likely to get 20 to 30 percent who say they have it.”

Nobody is sure what causes premature ejaculation; experts believe it is probably linked to:

  • A malfunctioning ejaculation reflex
  • Anxiety
  • Brain chemical problems
  • Possibly also genetics
  • Prostate disease

Antideppressants, such as Zoloft or Paxil are sometimes prescribed for premature ejaculation.

Lead review author Tamara Melnik, professor of internal medicine and evidence-based medicine at the Universidade Federal de São Paulo, Brazil, said:

“These medications are a simple treatment and cost effective
if not used for a lifetime.”

Although delayed orgasm may be one of the desirable side effects of antidepressants for some men, they also come with some other side effects which are not so nice, Melnik said.

Dr. Ege Serefoglu, a urologist at Kiziltepe State Hospital, in Turkey said that lidocaine or some similar topical anesthetic may also help. Some patients do not like having to apply it 15 minutes before sex and then having to put on a condom.

Behavioral therapy is commonly offered for men with premature ejaculation, either on its own or in combination with medications. The therapy tells men not to try to distract themselves by thinking about other things during sex, such as prices, the stock market or baseball.

Althof said:

“It’s like looking at a speedometer. We teach men to hover in the midrange of excitement and learn to slow down or speed up when they notice where they are.”

The review authors set out to determine how effective behavioral therapy is. They gathered data from four studies involving 253 individuals.

One study appeared to show good results by teaching the man to change positions during sex, control his movements better, to focus better, and use a start-stop approach.

Another study showed better results with Celexa, an antidepressant, compare to just behavioral therapy.

Another study showed better results among the men who took Thorazine (schizophrenia drug) combined with therapy, compared to those who were just on the Thorazine.

There was not enough data in the fourth study to make any conclusions.

According to their review, the authors believe that studies have not been able to confirm in a compelling way that behavioral therapy works. There are too few studies they added, and their techniques are all similar.

They added that men who are distressed by premature ejaculation should undergo a medical examination.

Written by Christian Nordqvist