ejaculation means that a man doesn’t last as long as he wants to, regardless of the time or number of strokes. The standard medical treatment was proposed by Masters and Johnson: stimulate the penis, stop when he feels excited, squeeze the penis and wait until the excitement lessens, and then alternate stimulation and squeeze\rest until a man can’t delay ejaculating any longer. This technique does not delay ejaculation significantly, although it can cause a great deal of discomfort. Anaesthetic ointments that are supposed to be inserted into the urinary tube prior to intercourse are effective only some of the time (1)

Anafranil, Paxil, Prozac and Zoloft are drugs that are used to treat depression. Unfortunately for most men who take them, they reduce sexual desire and prolong sexual intercourse so long that men who take them often fall asleep before they climax. However, when given to men who climax prematurely, they delay climax to normal. Fifty mg of clomipramine, brand name Anafranil, can extend time to climax in premature ejaculators to more than 8 minutes (2,3). Perhaps, the authors chose clomipramine because it has been reported to cause painful ejaculation (4), which would make anybody want to delay ejaculation . Prozac and Zoloft also can delay climax (5). Another study shows that 20 mg of paroxitine, brand name Paxil, at bedtime stops premature ejaculation temporarily. When the drug is stopped, premature ejaculation returns (6)

Premature ejaculation should not be a problem for a considerate lover. A man is usually satisfied after he reaches a climax. If he reaches it before she does and doesn’t help her to reach one also, he’s inconsiderate whether he climaxes in 2 seconds or 5 hours. Most women take more than 20 minutes to climax with conventional penile-vaginal contact and only four minutes when they stimulate themselves because women know more about women than men do. Most women require clitoral stimulation to climax. A premature ejaculator should always ask his lover to tell him what he should do to help her climax. After he has climaxed, she may request stimulation with a vibrator or that he just hold and kiss her while she stimulates herself. Since most men lose interest in lovemaking immediately after climaxing, she may prefer to climax first and let him climax as quickly as he can afterward. As long as he is considerate of her feelings, it shouldn’t make any difference to her how quickly he climaxes.

By Gabe Mirkin, M.D., for CBS Radio News Checked 11/18/11