Our expert says:
Hi Andrew, apologies for the delay in responding. No you are not suffering from a disease necessarily. The mostly likely reason for this is that you have not yet learned to delay your ejaculation. There is no need to do this when masturbating and so your response is likely to be well trained to go with the excitement and not focus on slowing down stimulation in order to reduce arousal. There are options as some of the other respondents have pointed out - creams or sprays that slightly anaesthetise the penis - but be aware that this could also impact on your partner unless you are using a condom (incidentally this could also help - using a condom - as it slightly reduces sensation). you could also request from a doctor a medication called Priligy which helps as long as you use it (i.e. once you stop, the effect stops). The best solution is to learn to delay your ejaculation.
You will need to learn recognise your physical signs of excitement (e.g. heightening sensation, a sensation in your testicles, heart rate) and at which point you need to ease off before it's too late (i.e. when the 'twitching' begins, it's probably too late). One way to help with this would be to try scoring your excitement on a scale of 0-10, with 8 being the point at which there's no turning back. When you get to about 5 or 6/10 you need to start using delaying strategies. For example: slowing or changing the rhythm of the friction, trying to take some deep and slow breaths, and try tensing your pelvic floor muscles as if you are trying to stop the flow of urine. Once your arousal has reduced somewhat (e.g. to about 3 or 4/10), you can resume stimulation and repeat this process several times before allowing ejaculation to take place. Since anxiety plays another important part in premature ejaculation, it would be really helpful for you to learn to do this by yourself to develop your confidence in your ability to do this.
Once you have had some success, perhaps your partner could stimulate you, but she must slow down as and when you says to do so. Once you've gained confidence like this, you could move onto trying this intravaginally. This is likely to be much more difficult because of the sensations (warmth, moist) of the vagina so you should maybe slow your arousal down earlier than 5 or 6/10 to begin with. The best position to learn this would be with your partner on top so that you can focus all of your attention on your sensations, but you must remember to direct your partner to slow, stop, or start again as you need.
It's really important that these are 'exercises' though, and not 'sexual acts' as normal, otherwise you will feel more pressure to perform and your partner may feel frustrated - neither of these will help you with this learning process.
Good luck and enjoy!
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