There are many reasons why a man might not last as long in bed as he would like. At some point or another, most men experience this feeling. This results from performance anxiety, stress, premature ejaculation and erectile dysfunction (losing erection during sex). There are a variety of behavioral changes and prescription treatments which can help a man last longer in bed.
WHAT IS PERFORMANCE ANXIETY?
If you find yourself worrying about how long you’ll last in bed, then you could be suffering from performance anxiety – ‘nerves’, essentially. Practically every man will have experienced some form of performance anxiety. Normally it is nothing to worry about. However, sometimes anxiety can develop into premature ejaculation or erectile dysfunction.
WHAT IS PREMATURE EJACULATION?
Premature ejaculation is a very common problem and one which affects most men at some point. Usually, premature ejaculation involves sex lasting less than two minutes before the man ejaculates. However, if both parties are happy and fulfilled then there is nothing to worry about. On average, men are more likely than women to define an orgasm as ‘premature’.
Primary premature ejaculation is often psychological and starts when the man first becomes sexually active. It can then remain a lifelong issue. Secondary premature ejaculation occurs later in life and can be caused by both psychological and physical factors. Stress, anxiety, depression are all possible causes.
WHAT IS ERECTILE DYSFUNCTION?
Premature ejaculation isn’t the only condition that can affect a man’s sexual duration. Erectile dysfunction is when you can’t achieve or maintain an erection sufficient for sex, and this can include losing your erection during sex. Erectile Dysfunction is a common condition and, like premature ejaculation, most men will experience it at some point. Sometimes erectile dysfunction is psychological but often it is a symptom of an underlying physical cause, such as high blood pressure. As such, it is always best to have a health check to rule out the possibility of your erectile dysfunction being related to a more serious underlying health condition.
WAYS TO LAST LONGER IN BED
Whether you experience premature ejaculation, erectile dysfunction, or whether you just want to hold out longer than you already do, here are some tips on how to last longer in bed:
Foreplay: Sex is more than simply penetration. Foreplay can greatly increase the sexual experience in terms of both time and pleasure.
Behavioral Techniques: Try the ‘squeeze technique’. Squeeze the penis tip near climax to prevent ejaculation, and the stop-start technique reducing simulation when nearing climax.
Mental Distraction: An old classic. During sex focus on your attention on something deeply unerotic such as multiplication tables. This can reduce the enjoyment of the act itself but is often effective in delaying ejaculation.
Slow Down: Generally, the faster the man has sex, the quicker he ejaculates. Rapid, hard thrusts result in a faster climax. A slower, more measured technique means the penis tip is less stimulated and ejaculation delayed. It also allows for greater control over ejaculation.
Masturbate: Masturbation is perfectly healthy and natural. Masturbating regularly can help build up your stamina and thus enable you to last longer during sex. You can also practice behavioral techniques while masturbating so you are more comfortable using them during sex.
Condoms: Condoms decrease sensitivity and therefore usually increase the time taken to ejaculate. They also have the added bonus of preventing sexually transmitted disease and unwanted pregnancies.
Communication: Make sure you let your partner know what works for you and what doesn’t. An open attitude towards sex should also relax you more and lessen the nerves that cause a swift ejaculation.
Men who regularly experience premature ejaculation or erectile dysfunction may find treatment is the best option. There are a number of easy, effective treatments for both conditions. Counseling is another option, highly effective for those whose condition is psychological.
Treatment for Premature Ejaculation
Common treatment options for premature ejaculation include behavioral techniques, topical anesthetics, medications and counseling. Keep in mind that it might take time to find the treatment or combination of treatments that will work for you. Behavioral treatment plus drug therapy might be the most effective course.
In some cases, therapy for premature ejaculation might involve taking simple steps, such as masturbating an hour or two before intercourse so that you’re able to delay ejaculation during sex. Your doctor also might recommend avoiding intercourse for a period of time and focusing on other types of sexual play so that pressure is removed from your sexual encounters.
Pelvic floor exercises: Male pelvic floor muscles
Weak pelvic floor muscles might impair your ability to delay ejaculation. Pelvic floor exercises (Kegel exercises) can help strengthen these muscles.
To perform these exercises:
Find the right muscles. To identify your pelvic floor muscles, stop urination in midstream or tighten the muscles that keep you from passing gas. These maneuvers use your pelvic floor muscles. Once you’ve identified your pelvic floor muscles, you can do the exercises in any position, although you might find it easier to do them lying down at first.
Perfect your technique. Tighten your pelvic floor muscles, hold the contraction for three seconds, and then relax for three seconds. Try it a few times in a row. When your muscles get stronger, try doing Kegel exercises while sitting, standing or walking.
Maintain your focus. For best results, focus on tightening only your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely during the exercises.
Repeat 3 times a day. Aim for at least three sets of 10 repetitions a day
Topical anesthetics: Anesthetic creams and sprays that contain a numbing agent, such as benzocaine, lidocaine or prilocaine, are sometimes used to treat premature ejaculation. These products are applied to the penis 10 to 15 minutes before sex to reduce sensation and help delay ejaculation. A lidocaine-prilocaine cream for premature ejaculation (EMLA) and Priligy are available by prescription.
Although topical anesthetic agents are effective and well-tolerated, they have potential side effects. For example, some men report a temporary loss of sensitivity and decreased sexual pleasure. Sometimes, female partners also have reported these effects.
Also, anesthetic condoms which contain local anesthetic cream to numb the sensitive penis tips without requiring manual application are also effective.
Many medications might delay orgasm. Although none of these drugs are specifically approved by the Food and Drug Administration to treat premature ejaculation, some are used for this purpose, including antidepressants, analgesics and phosphodiesterase-5 inhibitors. These medications might be prescribed for either on-demand or daily use, and might be prescribed alone or in combination with other treatments.
Antidepressants. A side effect of certain antidepressants is delayed orgasm.
Analgesics: Tramadol (Ultram) is a medication commonly used to treat pain. It also has side effects that delay ejaculation. Unwanted side effects might include nausea, headache, sleepiness and dizziness.
Phosphodiesterase-5 inhibitors: Some medications used to treat erectile dysfunction, such as sildenafil (Viagra, Revatio), tadalafil (Cialis, Adcirca) orvardenafil (Levitra, Staxyn), also might help premature ejaculation. Unwanted side effects might include headache, facial flushing and indigestion.
TREATMENT FOR ERECTILE DYSFUNCTION
A number of prescription treatments are available for erectile dysfunction such as Viagra, as well as Cialis, Spedra, Levitra and Sildenafil. Essentially they all help you gain and maintain an erection by increasing blood flow to your penis; helping you last longer in bed.
Depending on the cause and severity of your erectile dysfunction and any underlying health conditions, you might have various treatment options.
Before taking any medication for erectile dysfunction, including over-the-counter supplements and herbal remedies, you should get your doctor’s OK. Medications for erectile dysfunction do not work in all men and might be less effective in certain conditions, such as after prostate surgery or if you have diabetes. Some medications might also be dangerous if you take nitrate drugs, have heart disease or heart failure and have very low blood pressure.
Other medications for erectile dysfunction include Alprostadil self-injection, Alprostadil urethral suppository (which involves placing a tiny alprostadil suppository inside your penis in the penile urethra. The erection usually starts within 10 minutes and, when effective, lasts between 30 and 60 minutes. Side effects can include pain, minor bleeding in the urethra and formation of fibrous tissue inside your penis) and Testosterone replacement. Some men have erectile dysfunction that might be complicated by low levels of the hormone testosterone. In this case, testosterone replacement therapy might be recommended as the first step or given in combination with other therapies.
Penis pumps, surgery and implants
If medications aren’t effective or appropriate in your case, your doctor might recommend penis pumps or Penile implants (this treatment involves surgically placing devices into both sides of the penis. These implants consist of either inflatable or malleable (bendable) rods. Inflatable devices allow you to control when and how long you have an erection. The malleable rods keep your penis firm but bendable)
Recent studies have found that exercise, especially moderate to vigorous aerobic activity, can improve erectile dysfunction. However, benefits might be less in some men, including those with established heart disease or other significant medical conditions.
Even less strenuous, regular exercise might reduce the risk of erectile dysfunction. Increasing your level of activity might also further reduce your risk.
Premature ejaculation and erectile dysfunction are often psychological. Counseling allows you to address the underlying issue. The counseling can be combined with a medical regime that addresses the problem in the short-term. Once the counseling has resolved the issue, medical treatment can be ceased.