Neurologic System PE Treatment

The premature ejaculation type assessment I took recently indicated that I have neurologic system and psycho-sexual skills PE, the same result I got a year ago. I am reviewing the chapters in Coping with Premature Ejaculation that deal with each of these types.

The treatment plan for neurologic system PE is easy.  For this type of PE, the authors first suggest that you try the psycho-sexual skills chapter to try to compensate a quick and efficient neurological system.  This is easy for me because that is the other type the assessment indicates that I have.  Because I did have success earlier, I don’t think I need to try the drug or device suggestions they provide in the book.

Now I can focus on the psycho-sexual skills chapter.

 

PE Self Re-Assessment

One of the most helpful chapters of Coping with Premature Ejaculation (see the Resources page) is chapter 4, “Assessing Your PE”.  In this chapter they give series of exercises where you evaluate the type and severity of your premature ejaculation.  Based on your answers, they provide suggestions for treatment plans and advice on approaching a solution to the problem.

I went though the exercises last year when I first got the book.  I found it incredibly helpful and encouraging to see a list of types of PE and an organized approach to each.  Since I am having a relapse, I thought it would be helpful to review my results.  Since I am not sure what the cause of the relapse is, I thought it would be a good idea to do the self assessment again.  I wanted to make sure that I hadn’t missed something.  I wanted to make sure that i was addressing the root problem.

I thought I had written about this, but I can’t find the post, so I’ll summarize the assessment again.  The authors identify nine types of PE:

1. Neurologic system PE
2. Psychological system PE
3. Psycho-sexual skills deficit PE
4. Physical illness PE
5. Physical injury PE
6. Drug side-effect PE
7. Psychological distress PE
8. Relationship distress PE
9. PE with another sexual dysfunction (mixed PE)

I cannot possibly properly describe each of these types in this post.  If you would like more information, please get a copy of the book.  The authors divide these nine into two groups: those that are lifelong and those that are acquired.  The first three in the list above are in the first group, and the remaining are in the latter.  The assessment of the type of PE consists of answering several Yes / No questions and tallying the number of answers.

The next exercise in the book is designed to evaluate the severity of you PE.  You answer ten questions where you rate the question on a scale from 0 to 10, then you add the results.  They call this sum the PE Severity Index (PESI).  The higher the PESI, the more severe your case of PE.

When I took the test last year, got a positive result from the first three types: neurologic system, psychological system, and psycho-sexual skills deficit.  None of the rest applied because they are all acquired, and I have had PE my entire life.  As I read more about the psychological system PE, I found that it didn’t fully apply in my case.  So I was left with neurologic system and psycho-sexual skills deficit.

Last year when I completed the severity exercise, I had my wife complete it also.  She came up with a PESI of 64, and I came up with a 74. Both of these scores put me in the “High severity” category.  (We answered most of the questions with almost the same answer.  Most of the difference was in one question:  “If you can have intercourse, how long is it before you typically ejaculate?”  I answered “15 seconds”, which is how long it would take if I took any reasonable thrusts.  She answered “4 minutes”, which is how long I could last if i was barely moving.)

So that is where I left it last year.  With the relapse, I decided to take the PE type evaluation again.  When I took it this time, i got the same result:  neurologic system and psycho-sexual skills deficit.

That result confirmed my plan of action.  The good news is that I don’t have to start a new treatment plan.  The bad news is that I need to work harder on my current treatment plan.

Off to review the treatment chapters in the book.

 

Morality of Self-Pleasuring Exercises

I recently received a comment on a previous post that I thought would make a good post.  The post was about reading Coping with Premature Ejaculation and the comment went like this:

Curious, I am dealing with PE myself, and have bought this book as well.  I am struggling being a Christian and following the program in the book particularly when it comes to the self exercises on finding the peak levels.  I made an oath to my wife that she alone is my outlet for sexuality.  Is your wife fine with you doing the self exercise?

Here is an expanded version of my answer:

I understand his concern.  I, like him, am sensitive to the promise that I made to my wife.  She is to be my sexual outlet and I shouldn’t use anything else.  If I am doing something else to receive that pleasure, or I cannot give her the pleasure she wants when she wants it, then I am being unfaithful to her.  So I know where he is coming from.

My starting point in this is that the Bible does not prohibit masturbation.  It specifically prohibits sexual contact many different people, and Jesus summarizes it by saying basically “You are only to have sexual relations with your wife.”  But masturbation is never mentioned.  I could expand this and it could be a blog post by itself, so I’ll save it.

I think my early posts record the negative impact my premature ejaculation was having on me and our marriage.  I was spiraling downward to where it was really bad and there was a lot of tension between my wife and me, especially when it came to sex.  It got to the point that I needed to do something, rather than continue to wait and just hope things would get better.  At that time, however, my wife was not on board with helping me to overcome PE or interested in working on our sex life at all.  So I decided that the problem was bad enough and that I was distraught enough that I was going to work through as much of the book as possible on my own, without my wife’s help.  So basically, I never asked her if it was OK for me to do the self-pleasuring exercises.  I just started doing them on my own.  My thought was that if I took the lead and started to make a difference, she would eventually follow.

Having said that, however, I do not consider these exercises a sexual outlet.  I did not do them because I felt I needed a release.  To me they are exercises that I am using to improve my sex life.  I am learning new skills and learning about myself in a way that I never had on my own before, and didn’t in the several years of our marriage.  They are truly exercises and they are work if you want to get it right.  My focus was always on improving my ability to please my wife.  I knew she was not pleased with our sex life, and I believe that it was not what the Lord wanted either.  I knew that this was a necessary thing to do.

Also, I actually don’t do the exercises that McCarthy and Metz describe in CWPE.  I do them the way the Taoist masters like Mantak Chia describe.  To control ejaculation, they teach you to circulate your sexual energy and the goal is to NOT ejaculate at all.  So ejaculation was never my goal and if I did ejaculate, I considered that session a failure.  As it turned out, I learned to relax and circulate my energy quickly, and now I can avoid ejaculation during the exercises.

The times I did ejaculate never prevented me from being intimate with my wife.  Doing the exercises never diminished my desire for my wife, and in fact, it enhanced it.  While I am doing the exercises, my focus is (and should be) on my sensation and relaxation, and occasionally on my wife.  I don’t think about other women. It is more about learning the sensations of my body than it is about something sexual.

The improvement in our sex life and my mental outlook has been dramatic.  I think the Lord is pleased with what I have done.  I did not do anything that i consider impure or inappropriate.  My focus is on becoming the husband and lover that I think God created me to be.  Along the way, I have had to learn some new skills.  But my wife and I are now reaping the benefits.  I have no regrets and I don’t believe I have done anything immoral or unfaithful.

Of course, if you are still uncomfortable doing the exercises alone, invite her to cuddle with you and watch, or to participate.  You can still do it that way, you just need very good communication so that you can stay in control and relax.

I pray that the Lord would guide you and increase the pleasure and intimacy of your marriage!

 

 

No More Sex Therapist

The last time I went to see the sex therapist was more than a month ago, and I don’t think I am going to go back.  I think we have gotten everything we can from her, and I don’t think she can provide the help that we currently need..

As we talked with her, I realized that we really have enough resources to address my premature ejaculation.  There is nothing that we talked about with her that indicated that my diagnosis of my PE is incorrect.  I probably have neurologic system PE and sexual skill deficit PE (both of those are from Coping with Premature Ejaculation.  See the resources page.)  I don’t have relationship PE, that is PE caused by a problem in my relationship.  I think the sex therapist might have been more helpful in that situation, but with my basic skill deficit, I am not sure how helpful she will be.  I have also found good information with the Tantric and sexual energy articles and books, neither of which she would probably be able to help with.  So I think we are better off working our way through exercises ourselves.

I want to make it clear, however, that she was immensely helpful for us overall.  She was the one who introduced me to No More Mr. Nice Guy, which shook me out of complacency and got me moving again.  I still cannot believe how helpful and insightful that book has been.  From the book I saw things about myself that I hadn’t before, and I am able to start addressing them now.  These are all problems long-standing problems and as I recognize them and start to take action, my life and relationships will improve immensely.

The sex therapist also helped my wife and I start to talk more honestly and openly about sex.  We uncovered a lot of problems and frustrations in a very short period of time.  It brought parts of our relationship and pasts that had been hiding out into the open, and allowed to start talking about it and understanding each other.  The process of going to a sex therapist and talking with a third party got us past a hump that we had been stuck on through the previous years of our marriage.  Just that push has put us in motion, moving in the right direction together.  It has opened up better communication about sex specifically, and our relationship in general.

My wife and I still have more work to do to get our marriage to where we want it to be.  The discussions have surfaced some frustrations and resentments that we both have built up over the years that have never been addressed directly.  They are things that we have overlooked but bother us and ultimately drive us apart.  We also still have big problems in empathy and conflict resolution that have remained almost unchanged since we got married.  We need to work on these and finally get past them.  I think involving a counselor will facilitate and speed the process of growth and healing, but I would prefer to go to a good, Biblically based counselor for this.  Reading parts of No More Mr. Nice Guy reminded me that counsel not based on the Bible can be contrary to it and, therefore, detrimental and destructive to our marriage.  I have a friend who is going to what sounds like an excellent, biblically sound counselor, so I am going to get in touch with him and start there.

I appreciate everything that the sex therapist did for us and how she helped to move us along, but I think she did her job, and now it is time to move on.  The work isn’t done, but we need to use different tools.

Thanks, Dr. S.

 

Deep Relaxation

I have had good success with feeing in control when I can relax during sex.  This should not be surprising to me, because it is what every author says about sex.  From Mantak Chia in The Multi-Orgasmic Man to McCarthy and Metz in Coping with Premature Ejaculation, they all say that both men and women need to relax during sex to reach higher levels of arousal and pleasure.  I should have known this several years ago when I first started to look into sex techniques.

Actually, I did know this.  What I didn’t know was how much tension I typically carry around in my body and particularly in my pelvic region.  It has actually taken me several years to learn how to relax enough to be able to maintain the relaxation during sex and to see a difference in my arousal rate.  When I read the descriptions of what I should feel, I never understood because I was so far from being able to do it.  I have really had to concentrate and practice and focus to be able to make the progress that I have.

In fact, it was very difficult at the start.  I started to relax in the shower since I didn’t know what would happen when I started to relax so much.  It took me a long time to identify the correct muscles and separate those that control the bodily functions from those that control sex and ejaculation.  Once I was comfortable in the shower, I started to try relaxing in the car on the way to work.  Then I worked up to sitting at my desk and during meetings.  Now I am working on relaxation while I am walking and doing other activities.

Now that I can really relax, the way I think I am supposed to, I can feel the energy moving through my body.  When I am sitting still and I fully relax, I can feel the energy being generated in my testicles.  It moves from there through my perineum, back past my anus and up my back.  Just in the the last week I can now feel it moving through my head, down my chest and into my belly.  Very cool!  Exactly what is described by authors talking about moving energy through the microcosmic orbit.

The sensation feels like a tingling or vibrating as it moves through my body.  The most interesting part is the effect it has on my attitude and outlook.  When I am relaxed and the energy is moving, I feel calm, energetic, and  upbeat.  It completely changes the way I feel.  I have struggled in my life with depression and I wonder if the excessive tension in my pelvic area is responsible, at least in part, for the physical causes of my depression.  I relax on my way home from work and by the time I get home I have forgotten about work and I am filled will love for my wife and kids and with energy for interacting with them.  I would never have believed it if I hadn’t experienced it.  I think I am on the right path.

I am going to keep at this.  It is exciting it be in the middle of this.  It looks like I can improve my outlook and my sexual performance at the time time.  That is awesome!

 

Recent Observations About My PE

I’ve already mentioned that we did a great job sticking to the schedule this month.  That gave us some structured time to work on my premature ejaculation in a more controlled way than if we just had sex when the urge struck us.  It was beneficial to me to be able to take it slowly and to focus on what I was feeling and experiencing without having to focus on her.  With the focus on me, I am also able to practice self entrancement arousal, since she isn’t necessarily distracting my focus with her reactions.

Part of overcoming PE is becoming more aware of what is going on in my body.  Here are a couple of things that I have noticed and that I wanted to record.

• One night we focused just on pleasuring me.  The idea was to take things slowly and to have her stimulate me with her hands.  Hands are much less stimulating, and easier to control than other parts of the body, so it allows me and her to control the stimulation and rate of arousal much more easily.  It was a good session, but it didn’t end up quite the way I’d planned.  She started out with her hands, but then her clitoris got involved, then her labia, and finally her vagina.  I worked fine, however, since she controlled her motion and went slowly.  She was also not that aroused, and I notice a big difference in how good she feels depending on how turned on she is.  The interesting observation I made had to do with where I feel the sensation on my penis.  I thought that I felt the most sensation on the underside of my penis, right below the head (I don’t know the technical names for the parts).  I am also very sensitive on the top, right below the head.  But as she was moving on me slowly, I felt the most sensation on the sides, at the widest point of my penis.  I didn’t expect that, and the sensation was really intense, making my sex muscles contract sharply when the friction got more intense.  I mentioned this to my wife afterwards and she suggested that if we try the Promescent again, but only on these two areas.  This is a good possibility and worth trying at some point.
• The last time we had sex, it went really well, from a control perspective.  I felt really relaxed and I felt like I was able to feel the pleasure throughout my body better.  I had really been practicing deep pelvic muscle relaxation all day and I was able to maintain it while we were having sex.  When I can do that, I feel the pleasure of penis in vagina, but I don’t feel the urge to ejaculate.  I was able to thrust comfortably and more deeply than usual.  It was fun.  I felt relaxed and able to enjoy the sensations and be present with my wife.
• I’ve notice a peculiar problem that I have sometimes that is related to PE.  Sometimes if the stimulation on my penis changes quickly, I can feel my ejaculation reflex starting.  I am somehow relaxed enough for the contractions to be small and I don’t actually shoot out any semen.  It is not really pleasurable, but it is enough of a contraction that it acts like an ejaculation and I start to slowly lose my erection.  Interestingly, I still feel aroused as my penis is going down.  Although I haven’t felt like I’ve had an orgasm, I suffer the same result.  When this happens, I can’t regain my erection.  It will come back more quickly than if I had a complete ejaculation, but for the current situation, I am done.  It’s a little bit frustrating, but I think that with more consistent relaxation I can keep this from happening.

In summary, it was a good month.  We had some good sex and I learned some important things about myself.  I am hoping that in the coming months we can build on this and keep the progress going.

 

Reading CWPE Again

I am frustrated with my lack of progress on premature ejaculation and how slow things are moving.  I am also shocked at how quickly I forgot what I read in Coping with Premature Ejaculation by Michael Metz and Barry McCarthy.  (see the Resources page for a link).  I relayed the discussion my wife and I had about what they said in the book about using anesthetic creams for PE.  I had to go back and search the information out and read it again, because I forgot it.  As I read through the book, I got encouraged again.

I forgot what was in it. I like their approach.  If you go back to the earliest posts, it was this book that gave me the courage to go and find help.  In fact, the professional help was originally intended to be a supplement to the book, to help me stay focused and to understand the techniques if I got confused or lost.  The sex therapist has been helpful in several ways, including getting me to see the areas of sin, pride, and fear (“emotional issues”) that I still have.  She has also helped to open up some communication with my wife about sex. So it has been good, but it has distracted from the primary goal of addressing the PE.  The relationship issues need to be addressed, but I do not have relationship-caused PE, so fixing the relationship will not help my PE.  (Actually, where it is helpful is getting my wife and I to engage in it together, so that is good)

So I need to focus more on the goal – addressing PE. As a result, I am going to read through the book again.  And I’ll do it again and again and again as long as I takes for me to get it and have it work.  Not that I don’t have enough to read now, but that is my goal.  I’ll add insights as I go.

I’m excited to read it again. I decided to get friendly.  Inn the title I called is “CWPE” for “Coping with Premature Ejaculation”.  We are on a nickname basis now. Time to stamp out PE!

 

Success with the Schedule

The first month of our schedule ended today and we followed it successfully.  We followed it almost exactly, although there were some changes because of other things we had scheduled.  For the most part it was good.

My wife commented today that it was painful, like trying to get pregnant.  It turns something that should be fun into work.  That is true to some extent.  Sex becomes somewhat mechanical and forced, not spontaneous and emotional like we think it should be.  But I have premature ejaculation, so it is never as relaxed and free as it should be anyway.  In addition, we are trying to improve our sex life and address the PE problem.  In order to make progress, we need to be on a schedule, as least for a short period of time.  It is going to be work until it gets better.

I hope that we don’t have to do this forever, but it helps me now.  I know that we have set aside a specific time to work on techniques to address the PE.  It is a systematic approach to the problem.  I feel like we are making progress when I can say we have a definite time to work on it.  Before we had a schedule, we weren’t making any progress.  My hope is that the short term inconvenience of having sex on a schedule outweighs the tedium. In the long run we will benefit.

So congratulations to us!   We did it!

 

Penis Anesthetic Advice

The other night after our unsuccessful attempt to use Promescent, my wife and I were talking about the effectiveness of using creams and sprays to numb the penis in attempt to address premature ejaculation.  At some point, she asked what the authors of Coping with Premature Ejaculation thought about it and why I had decided to buy it.  I told her I bought it because the urologist suggested it, but I couldn’t remember what McCarthy and Metz said, either good or bad, so I looked it up. Here is what they have to say about the use of anaesthetic creams:

We understand some men feel desperate to slow ejaculation and believe that they need to use anaesthetics.  We believe this is unnecessary and an ill-advised quick fix that does not really solve the issues of PE and cooperative lovemaking.  To deaden the pleasure in your penis is contrary to our approach, which is designed to increase you pleasure, enhance intimacy with your partner, and teach you to saturate your body with pleasure while you maintain ejaculatory control.

From my experience, it is true that numbing my penis doesn’t work.  I would also agree that one of my problems is that I don’t saturate my body with pleasure during sex.  In an earlier post I talked about the discussion my wife and I had where I had cum but told her I didn’t feel turned on.  She didn’t understand, but that is my common experience.  There have been times when I have felt more in control and in those times I have also felt more pleasure throughout my body.  So I think McCarthy and Metz are correct and that a numbing spray is not the answer.  I may still try it again, but it is not a good long-term solution.

 

Promescent First Use

As I wrote earlier, the Promescent arrived a couple of weeks ago.  Last night we finally decided to try it out.  Here’s how it went.

The night started off nicely.  We both got into to shower to rinse off.  The warm water, the familiar smells of soap and shampoo, and wet, slippery skin made for a very sensuous introduction to the following events.  We made out a little bit and at this point I started to get an erection.  We stopped, finished washing up, and got out of the shower.  So the stage was set for a good night.

The directions on the Promescent bottle say to apply it 10 minutes before intercourse.  The dosage is three to ten sprays and they suggest that you start with five sprays.  It doesn’t say how long numbing effect lasts and I didn’t want to apply in bed, so I decided to apply it as soon as I dried off.  I pulled the bottle out of the package and the first thing I notice was that it was an ordinary small spray bottle, like something that might be used for a breath spray.  I had expected something better, since the web site said it would administer exact doses.  The first spray was partial, and so was the third, so I applied another half spray after the fifth.  Not as exact as I had expected.

The next thing I noticed was the smell.  It smells very medicinal, like Listerine or something else that your mother used on you.  I suppose that it’s good that they don’t add a much of unnecessary ingredients, but I didn’t like the smell.  I rubbed it in as much as I could, and then washed my hands.  I could still smell it on my hands even after I washed them.  Not so good.

The directions say to rub it all in, so I rubbed for at least a minute.  I think that started to warm up my penis, but I also noticed a slight tingling sensation on my skin.  If it was worse, I would have described it as burning, but it was very light.  As soon as we started to make out, I forgot about it or it disappeared.

When my wife first started to stroke my penis, it was hard to tell if something was different.  It felt slightly numb, but I did notice my ejaculation reflex kicking in anyway.  So it was not much help at this point.  My penis eventually got very numb.  As she continued to rub it, I could tell something was going on, but I couldn’t feel my normal sensations.  I made me feel disconnected from my body, like my penis wasn’t there.  I didn’t really like it.  Kind of like trying to talk after having a cavity filled.

As it turns out, my wife was on fire last night, but unfortunately, I was not.  We did all kinds of things to turn her on and give her pleasure.  It was the most aroused she has been in a while and she had several orgasms (we didn’t count).  What we were doing and her response should have been a big turn-on for me, but I wasn’t responding.   She was stroking my penis but I wasn’t getting hard.  I don’t know what the problem was, the Promescent or my mind.  It was very frustrating to not respond to such passion.

After we slowed down, we focused on me, and with effort, I got an erection.  I was only slightly turned on at this point.  As I slid into her, I could feel that there was less sensation, but it didn’t really change my ejaculation reflex or threshold.  I couldn’t take the strokes that I wanted to, and our movement started to put my on the edge as it usually does.  I didn’t have control, and I exploded after a very short period of time.

So I would classify the first Promescent trail as a failure.  I didn’t like the smell or the numb feeling and it didn’t extend my intercourse time.  It may have even interfered with my arousal.  It’s not looking like a good solution so far.
I purchased three bottles, so I should have at least 5 applications left.  We’ll try it again.  I think I will use only 4 sprays next time and see what happens.

[Here is a follow-up on what McCarthy and Metz have to say about penis numbing]