Treatment for more severe cases

If PE is causing you significant problems, it is best to consult an expert for treatment.
The Masters-Johnson methodThis method cures the vast majority of men, provided that both partners are keen to co-operate (which isn't always the case). It is based on a special 'penis grip' developed by the American therapists Masters and Johnson.The finger-grip abolishes the desire to climax, so if, under careful instruction, the couple use it over a period of weeks, they can usually re-train the man so he can last much longer.
What does it involve?
Your partner places her hand so that her thumb is on one side of the man's erect penis (the nearer side to her when she is facing him).
Her index and middle fingers are on the other side.
The index finger is just above the ridge of the glans (the 'head'), while the middle finger is just below the ridge.
When the man feels that he's near to a climax, he tells his partner.
She then squeezes his shaft firmly between her thumb and the other two fingers. (Don't worry: it's painless!)
The programme and the grip can work for male couples as well as for heterosexual ones.
Does it work? We have seen many men with PE who couldn't last for 30 seconds, who were able to last as long as half an hour after careful training over a period of months. But unless this is done as part of an organised programme, it probably won't work.The Masters and Johnson grip really needs to be demonstrated to you personally by an expert. Most couples who try to learn it from the Internet or a book get it wrong.Our advice: see a professional. In the UK, try one of the organisations listed at the end of this article.


Cognitive behaviour treatment (stop-start technique)In December 2006, we attended a conference on sexual medicine in Vienna. One of the speakers, Dr Mehmet Sungur, talked of the cognitive behaviour (CBT) method of treatment for PE.The CBT method focuses on addressing the kind of thinking that has proved unhelpful.For example, a man may believe that ‘real men’ must thrust endlessly to give a woman pleasure. Such thinking is not only damaging to the man, but wrong. Most women want penetration but also derive great pleasure from love play – often preferring fondling and oral sex to intercourse.The CBT method also aims to alter the man’s behaviour: he is encouraged to masturbate using the stop-start technique to gain more control over his responses and his urge to ejaculate quickly.
The stop-start technique
1. The man is encouraged to masturbate alone.
2. He is asked to set time aside to be private and to masturbate with dry hands.
3. The man is encouraged to masturbate almost to the point of ejaculation and then stop.
4. He should do this three times.
5. On the fourth time, he is permitted to ejaculate.
After he has achieved this measure of control, he can try masturbating with a wet hand, which will feel more like the inside of a vagina. He is encouraged to do the stop-start technique as before.Obviously, this technique could be adopted by a man who does not seek treatment from a therapist.But because there are often psychological difficulties as well as behavioural and mechanical ones, most men will benefit more from seeking treatment rather than using the stop-start technique on their own.