A Guy's Guide To Premature Ejaculation: The 4 Different Subtypes of PE And How To Approach Them
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A Guy's Guide To Premature Ejaculation: The 4 Different Subtypes of PE And How To Approach Them

Updated: Nov 10, 2023


A Guy's Guide To Premature Ejaculation: The 4 Different Subtypes of PE And How To Approach Them by bdestyle

What's up guys? Today we're going to talk about a subject that not a lot of us like discussing. HOWEVER, it should be discussed more often. Premature Ejaculation (“PE” for short) is a common sexual dysfunction that can lead to feelings of anxiety, shame, and frustration. It's important to note that roughly 30% of men experience premature ejaculation.


PE occurs when a man reaches orgasm and ejaculates too quickly during sexual activity. Although, there are varying definitions of what it actually is…There are also 4 different types of PE with different causes that could either be physical, psychological or a combination of both. It’s important to know which type you have, so you can address it appropriately.


From understanding the way your erections work to self-reflecting on the moments you do experience PE, there are ways to help men overcome this issue, so that you can resume a quality and satisfying sex life.


In this guide, we'll cover everything you need to know about premature ejaculation, including the different types, causes, treatment options, and how to last longer in bed. We'll also explore the difference between PE and erectile dysfunction, and much more.


 

Disclaimer....


We, at BDEStyle.com have tried many different male enhancement devices, sex aids, men's technology, and penis enlargement products. As we grow we will review more products and help others out with information based on the experience and science we research. Additional Disclaimer: BDEStyle.com is a professional review site that receives compensation from the companies whose products we review. We test each product thoroughly and provide educational information that shouldn't be misconstrued as medical advice. We are independently owned and the opinions expressed here are our own. Read more about our policies and disclosures here.

 


Before dive in, Let's start with a poll!

how long should good sex last by bdestyle.com illustrating a man trying to last long for sex but is having a hard time delaying it


I'll explain the poll in a future post and relate it to what research has to say on it!


The First Studies On Premature Ejaculation

Did you know that the earlier definitions on premature ejaculation were criticized for being too vague? That’s because researchers used to view PE as “only” a psychological disorder. They didn’t have a universal definition to encompass the complexities of this dysfunction -- and many of the ideas and theories behind it had limitations that lacked evidence to classify what PE is and what PE isn’t.


Let’s take a look at some of these older definitions:


The first “acceptable” definition proposed by Masters and Johnson in 1970 was that premature ejaculation is “the inability of a man to delay ejaculation long enough for his partner to reach orgasm on 50% of intercourse attempts”.


This first brought awareness dating back to the first studies on PE in 1887. But the limitations of this definition was that it depended on the female orgasm, which studies have shown take longer to achieve than the male orgasm.

PE was then defined by The American Urology Association as “ejaculation occurring sooner than desired causing distress to one or both partners”. But this definition didn’t have scientific evidence to support this idea nor did they have a criteria to classify the “timing” component for ejaculation.


Time wasn’t a factor until The International Statistical Classification of Disease 10th edition (ISCD-10) proposed “15 seconds'' as a part of the definition. But, the evidence to support their “cut off” time was unclear, too “exclusive” and inconclusive.


As research improved over the past few decades, premature ejaculation is now understood as a complex issue, including physical etiologies as well.


It wasn’t until…


The International Society for Sexual Medicine (ISSM) Redefined Premature Ejaculation:


“A male sexual dysfunction characterized by ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration (lifelong PE), or, a clinically significant and bothersome reduction in latency time, often to about 3 minutes or less (acquired PE), and; inability to delay ejaculation on all or nearly all vaginal penetrations; and negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy”

sexual response cycle for men experiencing premature ejaculation by bdestyle

As you can see, ISSM’s definition breaks down premature ejaculation into categories and this new perspective sheds light for new research and analysis of men with 4 different types of premature ejaculation.


The Criteria For International Society For Sexual Medicine’s (ISSM) Definition of Premature Ejaculation

To get more technical, there are 3 factors when determining premature ejaculation in men. This includes intravaginal ejaculation latency time (IELT), lack of ejaculatory control and negative personal consequences associated with PE.


reiteration of ISSM's definition and criteria for premature ejaculation

  1. Ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration from the first sexual experience (lifelong), or, a clinically significant reduction in latency time, often to about 3 min or less (acquired).

  2. The inability to delay ejaculation on all or nearly all vaginal penetrations.

  3. Negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy

I’ll be referring to IELT and the different types of premature ejaculation shortly. In the meantime, let’s discuss how ejaculation happens.


From Erection To Ejaculation: How It Happens

Before we explain the imbalances that cause premature ejaculation, we first need to understand how our bodies work when it comes to erections and ejaculation. In our recent guide on The Erection Process, we talked about the nervous systems involved to produce an erection. There is a brain and penis connection involving numerous body systems, and intricate neurophysiology (including social and emotional influences) for an erection to happen.


erections and ejaculations are a brain to penis connection by bdestyle

Just like erections, ejaculation is similar in the aspect that there are multiple things going on that lead up to it. Research also suggests that ejaculation is thought to be a sympathetic effect (sympathetic response) whereas erections are a parasympathetic response. I’ve talked about this in the past and how we tend to function on a spectrum between both parasympathetic and sympathetic nervous systems.


For instance, erections are triggered when your parasympathetic nervous system activates in response to a sexual encounter. Ideally, you want to be in a calm and relaxed state to become aroused (parasympathetic reaction). Once enough pleasure and stimulation is achieved and you are well on your journey through the sexual response cycle and its stages (plateau phase → orgasm phase) the sympathetic receptors soon trigger the ejaculation process.


Ejaculation Has Its Processes, Too

Based on medical studies, ejaculation is believed to be a spinal reflex involving a few other coordinated processes. There are two phases of ejaculation: emission and expulsion (aka ejection…which tends to lead to orgasm for men)

medical illustration of Rich from bdestyle explaining the ejaculation process

During emission, sperm and seminal fluid are secreted into the prostatic urethra. Followed by this, expulsion occurs (when you “unload” or “bust” a nut). This is where we experience rhythmic contractions of the bulbospongiosus and ischiocavernosus muscles as well as pelvic striated muscles, which lead to the movement of sperm through our urethra and out the urethral meatus (out your “pee” hole).


Some people call the expulsion period the “point of no return”. I’m sure many of you guys have noticed the reactions mentioned above during your own “points of no return” and the contractions that come with it.


Now that you have a better understanding of it, let’s talk about the causes of premature ejaculation (PE).


What Are The Causes Of Premature Ejaculation?

Based on the research we have so far and from ISSM’s definition of what classifies premature ejaculation, it is believed by some researchers that serotonin, also known as 5 Hydroxytryptamine-5HT and its receptor subtypes are involved in the “control of ejaculation” ---anything from prolonging latency time to rapid ejaculation.


bdestyle reposts waldinger's theory of pathophysiology of PE in men

Some researchers like Waldinger theorize that PE is caused by low serotonergic levels. Specifically, low levels of 5HT/hyposensitivity of 5HT2c receptor or hyper sensitivity of 5HT1A receptor as one of the main culprits of PE in certain men who have always had this issue (classified as “lifelong premature ejaculation”…which we’ll explain shortly).


But it’s not just an imbalance of specific receptor subtypes of serotonin. PE can also be triggered by:


  • Psychological impulses like conditioning

  • Poor social learning environments and upbringing

  • A traumatic sexual experience.

  • Prostate issues

  • Hormonal imbalances

  • Health diseases like diabetes, hypertension or use of recreational drugs.

  • Psychological distress and issues like depression, stress, or anxiety about sexual performance.

  • And even poor sleep quality. Studies on poor quality of sleep show that it can lead to low serotonin levels.

Point is, you can’t have a “simplistic” view of what causes premature ejaculation. Otherwise it’s going to be harder for you to figure out which type you have and how to appropriately address it.

And failure to accurately categorize your type of premature ejaculation may lead to further psychological distress, anxiety, embarrassment and depression, erectile dysfunction, reduced libido (desire to want sex), poor communication in a relationship and difficulty relaxing and being present during sex (both mentally and physically)


Understanding YOUR Type of Premature Ejaculation

To get started, lets first quickly discuss the types of PE. There are FOUR main types of premature ejaculation:


  1. Lifelong (primary) premature ejaculation

  2. Acquired (secondary) premature ejaculation.

  3. The third type of PE is subjective premature ejaculation which has only been identified in recent years.

  4. The fourth type is called “natural/variable” premature ejaculation, one that not a lot of people discuss often, but should.


4 different types of PE illustrated by bdestyle

Lifelong (Primary) Premature Ejaculation

According to the ISSM definition, lifelong PE is defined as “a male sexual dysfunction characterized by ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration and the inability to delay ejaculation on all or nearly all vaginal penetrations, which results in negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy”


Symptoms Of Lifelong PE Include:


  • Again, the main component here is the intravaginal ejaculation latency time (IELT). For men with lifelong PE, ejaculation usually happens within 1 minute or less of penetration.

  • You’ve always had this happened since the start of being sexually active

  • If you fit this category you might also have little to no ejaculation control (trouble delaying it)

  • You might also feel inadequate or have frustration in the relationship causing further distress


What Research has to say about Lifelong PE:


Lifelong premature ejaculation typically occurs from the very first sexual encounter a guy has and persists throughout the man’s life. In these cases, premature ejaculation often has a stronger neurobiological origin and can become a chronic issue if a man delays treatment intervention.


In addition to this, a substantial number of men with this category of premature ejaculation not only have PE, but may also have issues with premature erection and penile detumescence (almost immediate loss of erection after ejaculation).


bdestyle explains how PE is more than just a serotonin issue

It has been theorized that these issues are a part of a larger problem when engaged in an erotic situation or when making love. Researcher Waldinger suggests that this is result of an acute hypertonic or hypererotic “state” and that PE is not just a serotonin issue. It’s more than this. It’s actually a very complex interplay of central and peripheral serotonergic, dopaminergic, oxytocinergic, endocrinological, genetic and probably also epigenetic factors.


Acquired (Secondary) Premature Ejaculation

According to ISSM’s definition, “acquired PE” is defined as “a male sexual dysfunction characterized by a the development of a clinically significant and bothersome reduction in ejaculation latency time in men with previous normal ejaculatory experiences, often to about 3 minutes or less, the inability to delay ejaculation on all or nearly all vaginal penetrations, and the presence of negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy.”


Symptoms of men with acquired PE include:


  • IELT gradually decreases to 3 minutes or less as time goes on

  • You’ve never experienced this in previous relationships, but all of sudden you do because of certain “developed” health issues are now in the mix

  • Premature ejaculation can co-exist with issues like prostatitis, diabetes, certain thyroid conditions and other health issues affecting your nervous systems and urologic and endocrine systems


the physical causes of acquired PE explained by bdestyle

What Research has to say about acquired PE:


Unlike “Lifelong” PE, which is more neurobiological, “acquired” PE is more related to an underlying medical issue. Acquired premature ejaculation occurs when a man who has previously had satisfactory sexual experiences suddenly begins experiencing PE. In these cases, it's often secondary to a physical or psychological issue.


Some physical causes of acquired PE can include hormonal imbalances (prolactin or neurotransmitter irregularities), inflammation, infection, or prostate problems. It may also be related to medications, drug or alcohol abuse, or can coexist with conditions like erectile dysfunction.


Psychological reasons such as depression, anxiety, guilt, or relationship issues are also known to contribute to acquired PE, as well as previous sexual experiences that introduce performance anxiety. However, research suggests there is limited research on sexually performance anxiety being a main cause for acquired PE (but it’s considered a ‘partial’ cause instead).


Subjective Premature Ejaculation

The third type of premature ejaculation is known as subjective premature ejaculation. This is when a man believes he’s experiencing PE, even though he may not be at all, and is actually experiencing perfectly normal ejaculations.


Symptoms of subjective PE may include:


  • You become obsessed or unusually preoccupied with ejaculatory function or loss of control, but your IELT is normal

  • You tend to perceive your ejaculation time as “rapid”

  • Subjective PE is characterized by a higher variation of sexual performance, including ejaculation latency times that are normal or longer in duration


What research has to say about ‘subjective’ PE


I often see and hear this among guys who think they have a physical cause for premature ejaculation, but it’s really a cultural, psychological or relationship problem that causes this perceptual issue. For instance, these guys may have a normal ejaculation time, which is considered between 3 to 6 minutes or even longer durations from 5 to 25 minutes. These guys may or may not have “ejaculation control”, which is the ability to delay it. But in the end, these guys are still not satisfied with the length of intercourse, regardless if they fall within normal ejaculation times.



Rich from bdestyle frustrated because he has subjective PE and doesn't know what a good ejaculation time is considered

These guys also tend to have an unrealistic expectation about sexual performance, or negative beliefs around sex in general that can lead to feelings of inadequacy. We can speculate that this is because we tend to internalize what we see and hear online about sex through online spaces like social media, pornography, or Hollywood movies on how long a guy should last in bed.


For instance, pornographic videos tend to be longer in duration than the average duration for normal “real life” sex.


Although men in this category tend to have a normal ejaculation time, It's important to note that subjective premature ejaculation is still classified as a form of PE and many of the same treatments are applicable for dealing with this issue.


Natural “Variable” Premature Ejaculation

Another category of PE that SHOULD NOT be considered a disorder is “variable” or natural premature ejaculation. This type of premature ejaculation is more situational or coincidental. Men tend to have variability when it comes to ejaculation times. However, they usually have normal ejaculation functions and times.


Symptoms of natural premature ejaculation include:


  • Early ejaculations are inconsistent or they occur irregularly (think of a dry spell and not having any sexual activity for a long time and then boom you ejaculate super quick when you get back in the game. But after that, you ejaculate within normal time frames as time goes on.)


Unlike subjective premature ejaculation, which is influenced by sociocultural, psychological and relationship issues…natural variable premature ejaculation does have a similar component of the guy overly criticizing their ejaculation time.


Although I like to think of natural variable premature ejaculation as more of a “random occurrence” or a once in a blue moon type of thing, some guys might take it personally and think that something is wrong with them, when they should be reassured that it was just a random occurrence and maybe they were overly excited or the mood and sexual environment was overly enticing. All completely normal occurrences.

 

Can premature ejaculation be controlled?


Understanding which type of PE is affecting oneself, as well as the underlying causes, will help formulate the most effective approach to managing it. With that being said, let's talk more about treating each type and how to deal with it emotionally as this can be very frustrating for men trying to figure out the underlying cause for their PE.


 

As a reminder...


Disclaimer: We, at BDEStyle.com have tried many different male enhancement devices, sex aids, men's technology, and penis enlargement products. As we grow we will review more products and help others out with information based on the experience and science we research. Additional Disclaimer: BDEStyle.com is a professional review site that receives compensation from the companies whose products we review. We test each product thoroughly and provide educational information that shouldn't be misconstrued as medical advice. We are independently owned and the opinions expressed here are our own. Read more about our policies and disclosures here.

 

Treating Premature Ejaculation: The Approach


the approach to treating PE starts by going to the doctor for men's issues by bdestyle.com

When discussing PE with your doctor, it’s important to hone in on your specific type of premature ejaculation. You can’t have a “simplistic” view like we mentioned earlier. It’s important to consider the definition ISSM has classified for true PE (lifelong and acquired PE):


  • The time it takes for you to ejaculate (ejaculation latency)

  • Ability to control/delay ejaculation

  • And the psychological impact or distress it’s causing in your relationship and quality of life


Your approach to treating PE should be individualized rather than claiming you have it when you didn’t meet the criteria or classifications.


Approaching Lifelong PE: Treatments


***Remember this is highly dependent on whether or not you meet the criteria for a rapid ejaculation time. If you ejaculate within 1 minute or less, have lack of ejaculation control, negative impact on quality of life/relationship, and have ALWAYS had this issue since your first sexual encounters, then that’s considered the threshold for Lifelong PE. Treatments may include:

  • SSRI/Pharmacological Therapy to upregulate serotonin

  • Behavioral/Psychotherapy

  • A combination of the above treatments

  • If secondary to ED (meaning…if you have ED as well), treat this as well (PED5i’s, Li-ESWT, Injections, etc)

Approaching Acquired PE: Treatments


***Remember, this is “secondary” and usually developed because of an underlying medical condition. Treatments may include:

  • Treating the underlying medical issue that caused PE in the first place

  • If secondary to ED, treat this as well

  • Pharmacological intervention (Explore certain/some SSRI treatment with the guidance of a doctor and with the least amount of side effects)

  • Behavioral/psychotherapy

Approaching Subjective PE: Treatments

***Remember, this is more of a perceptual issue and view on what ejaculation time is considered normal for the average guy. If you ejaculate within 3-6 minutes or within 5-25 minutes, this is viewed as normal based on medical literature. Treatment for this type of “perceived” premature like ejaculatory occurrence may include:


  • Sex education and reassurance (debunk cultural and psychological myths around sex, and male performance to improve mindset around sex and ejaculation times)

  • Psychotherapy

  • Behavioral techniques (if a guy wants to practice ejaculation control)

  • A combination of the above treatments

Approaching Natural Variable PE: Treatments

***Remember, ejaculation times can vary for most men. If you experienced a coincidental or situational occurrence where you ejaculated early, it doesn’t mean you have PE. If all other times you have or had normal ejaculation times or you last even longer on other occasions, then this is just normal variation and natural for most men. Sometimes you may bust a nut in 5 minutes whereas others it’s 10 minutes because you added in a few different sex positions that added on time to the actual sex part. Again, these are normal times.


Treatment may include:

  • Reassurance and sex education (just like subjective PE)

  • Psychotherapy

  • Behavioral Therapy and Techniques

  • A combination of the above

Unpleasant “Feelings” Around Premature ejaculation

Research into psychotherapy and counseling on premature ejaculation show that men feel “diminished” by their PE.


For instance, some men might blame their partners while others worry they might cheat on them because of the issue. Some guys will also try to overachieve in other areas like oral sex, only to be rejected because their minds are preoccupied with their own performance rather than being attentive to their partners.


On the other hand, partners have shown to be distressed because the guy experiencing premature ejaculation has been unable or unwilling to try to fix the problem. As a result, partners will gradually resent the guy with PE due to his preoccupation with his own performance and neglect of wanting to communicate or treat the issue…


Usually, when guys ejaculate early or have PE, they tend to feel ashamed or embarrassed. Overtime, they tend to isolate or shut their partners out leading to communication deterioration and poor emotional intimacy. It’s almost like a snowball effect that sends couples into a sexual drought.

  • “I am a complete failure because I come quickly”

  • “If I fail tonight my girlfriend will dump me”

  • “I’m embarrassed, I’m going to close myself off from my partner

  • “I’m going to avoid sex because I’m afraid it’ll happen again”


Again it’s important to be able to recognize and address which type of premature ejaculation you have. It’s natural for a guy with Lifelong PE to be more accommodating or “used” to their ejaculatory process being abnormal and short whereas a guy who has acquired PE might have more intense and anxious feelings about it because it came on suddenly.


The same can be said for both subjective and natural variable PE archetypes because these guys might be misinformed about ejaculate times or might be influenced by their relationships or sociocultural expectations that guys need to last a long time or that they’re supposed to.


Is There A Way For A Man To Last Longer In Bed?


If you are a guy who has Lifelong PE or Acquired PE, then the techniques I’m going to mention below might make small improvements or they might not make much of a difference for you at all.


You should always approach PE treatment based on your type. So, if you meet ISSM’s criteria for those two types of PE, then you have to exhaust all options including medical intervention with medication therapy, psychotherapy and sex education.


For everyone else (normal and subjective types of premature ejaculation), these behavioral techniques and therapies may help stretch time out, so you can last a little longer in bed.


What are behavioral techniques for Premature Ejaculation?


Behavioral techniques are non-invasive methods that can help improve ejaculatory control. For behavior techniques, we would like to start off by talking a bit about Pav Lows' theory. In this experiment, they found how conditioning can greatly affect behaviors.


Ivan Pavlov's iconic experiment demonstrated that, when a stimulus (e.g. the ringing of a bell) was regularly presented prior to feeding his dogs, they soon began to associate the sound with food and would consequently begin salivating upon hearing it, even if no food was present! This kind of learning is today referred to as "Pavlovian conditioning."

pavlov theory of the salvating dog concept

This same concept can apply to guys wanting to last longer in bed or wanting to recondition poor masturbation habits. It's possible that men can condition themselves to cum quickly through poor masturbation techniques without even realizing it. Or condition themselves to a death grip like masturbation technique (death grip syndrome).


HOWEVER, with the same idea, it can be used as a behavioral treatment for PE. A perfect example of this is by using the Fleshlight Stamina Training Unit. Besides being a novelty toy, it was also designed specifically to help you last longer in bed!


If you want to learn more about that or read a full review of the Fleshlight, we did one not too long ago and it's worth a read!


Pelvic Floor Exercises And Reverse Kegels For Premature Ejaculation


Reverse Kegel exercises/Pelvic floor exercises: These exercises involve “relaxing” the pelvic floor muscles in order to improve ejaculatory control.


Although, I highly suggest you consult with a medical professional such as a pelvic floor therapist specializing in male pelvic floor dysfunction, as they can help you perform these specific types of kegels the right way! ***Don’t go at it on your own or follow these YouTubers as you need a PT to help evaluate you


men's pelvic floor illustrated by bdestyle

Besides the reverse kegels and pelvic floor exercises you’ll learn from a physiotherapist, most of the other "behavioral" stuff you can do at home can be done with a fleshlight…


Some other common behavioral techniques for treating PE include:

  • The squeeze technique: This involves squeezing the base of the penis to reduce arousal during sexual activity.

  • The stop-start technique: This involves stopping sexual activity once arousal becomes too high, and then resuming activity once arousal decreases.

  • Edging: A technique where you bring yourself near to ejaculating and stop right before you reach climax. In doing so, the time it takes to climax is increased and allows you to practice control.

As some of you might feel like sex toys are taboo, they can actually “indirectly” help you with these men’s sexual health issues mentioned earlier.


fleshlight for men with premature ejaculation by bdestyle

For instance, if you’re a single guy dealing with the perception that you cum too early, when really, you’re fine…or you are looking to find ways on how to last longer in bed with a new partner, then using a fleshlight will come in handy…no pun intended.


Fleshlight has a variety of accessories, like the shower mount or other “hands free” tools to help you maintain stamina for the time in between sexual partners (example: months without a sexual partner) to practice more control.


Point is…It’s better than using your hand and it helps you for when you do get back out there.

Other Tips On How To Last Longer in Bed


Based on what we know so far, some, if not most men have this perception that they need to last a long time in bed. Some might view their lack of ejaculation control or a perceived “short” ejaculation time as detrimental for the sex part of a relationship.


As research suggests that the average women can take up to 14 minutes to orgasm with a partner, this might indirectly put pressure on men who feel like they need to last just as long to help their partner get to orgasm.


You see where I’m going with this?


The problem with these perceptions are that Hollywood movies, social media and pornography tend to paint a picture that PIV is the pinnacle of sex. Both men and women are being exposed to these misconceptions about how long sex should last or what can guarantee pleasure, etc.


Having An Honest Conversation About The Quality Of Sex With Your Partner


Some, if not most men, preoccupy themselves with the concept of PIV being the main event for sex, but everything else, not as important. This is why couples should communicate their expectations and clear up any misinformation they might have learned from poor social learning environments. This includes women, too, as some might think that men are supposed to last an hour in bed or that they are “supposed” to always show up with an automatic erection at the start of sex (not true).

OMGYES can help men relearn that sex isn't about lasting a long time but rather focus on the quality of sex

This is why I’m an advocate for sex education. It helps clear up doubts so that guys with premature ejaculation can learn to relax and understand that sex is more than just PIV.


Sure, you can do things mentioned above to help delay ejaculation a little or to treat it, but it's also about diversifying your sexual repertoire such as oral sex, techniques with your hands or technical thrusting involving the angle you thrust your penis or broadening your thrusting style to make the overall experience better.


I recently partnered with OMGYES for this reason. It’s a platform to demystify female pleasure and they did a whole season on internal pleasure (PIV), which goes into the nitty gritty on how to thrust with your penis in ways that pleasures your partner and reduces that “in and out” motion that might contribute to a faster ejaculation time.


Less "in and out" thrusting and more variation can delay ejaculation!


Exploring different sexual techniques, such as different positions or not focusing solely on intercourse, can help reduce pressure and improve ejaculatory control. Again, we normally see in pornography a piston movement where the guy goes “in and out” while thrusting. As most men find this friction to be very pleasurable, this can eventually lead to ejaculation sooner than expected.


pornography often shows piston movements of men thrusting in and out whereas in real life sexual encounter men should be dynamic with their hips and be able to tilt their pelvic accordingly as explained by bdestyle

You also don’t want to limit yourself to these piston movements. Being dynamic with your hips and knowing how to pelvic roll or pelvic tilt may help you stretch the time out longer as well as make sex more enjoyable for your partner to reach their orgasm.


Remember, it is important to practice patience and persistence when exploring how to last longer in bed. Solutions that work for one person may not work for another, so it is important to identify what personally works best through trial and error.


FAQ On Premature Ejaculation And The Different Types


1. Is Premature Ejaculation And Erectile Dysfunction The Same Thing?

Although premature ejaculation and erectile dysfunction (ED) are both sexual dysfunctions that can impact a man's sexual performance and satisfaction, they are SEPARATE conditions.

Premature ejaculation involves ejaculating too quickly during sexual activity, while men with ED have difficulty achieving or maintaining an erection during sexual activity.


However, there is some overlap between the two conditions, as psychological and physical factors can contribute to both. Additionally, men with premature ejaculation may experience erectile difficulties as a result of worrying about the situation, or avoiding sexual activity or there could be a hormonal imbalance resulting in ED like symptoms as we mentioned this earlier from Waldinger’s research on hypertonic and hypererotic “state” that results in rapid erection loss after ejaculation.


It's important to determine the underlying factors contributing to either or both conditions and to receive appropriate treatment(s).


2. I Feel Like I Don’t Last Long In Bed And I Usually Cum Within 5-10 minutes. Is this normal?

Research doesn’t have a concrete answer on the average ejaculation time, but 3-5 minutes is considered normal or the average time in the medical literature we have to date on how long penetration usually lasts. Some will say it’s 5-7 minutes wile some informal studies on how long should good sex last for would be around the 5-10 minutes range.


But as we explained earlier, sometimes, men can ejaculate in between 3-6 minutes (if we are talking about subjective PE archetypes). And, if you fall within this range, you are FINE.


In fact, sex, or intercourse for that matter, is more tan just penetration. There is a wide variation in the way individuals enjoy sex--And the more sexual activities included in the session, the greater impact it will have on women's pleasure, encouraging their orgasm.


The lesson here is you don’t need to be having sex longer; you need to be having sex better. So, be versatile and not just hyper focus on ways to last loner, but to become better at sex in ALL areas!


3. What about premature ejaculation and masturbation? Is masturbation a cause?


Masturbation is not a cause for premature ejaculation. Some recommend it to help with PE and to last longer. However, it’s suggested to practice healthier masturbation techniques like using a fleshlight.


4. Can I Get To Round 2 If I Have Premature Ejaculation?

Yes. Some guys are quick to shy away after ejaculating early because of fear of rejection or judgment. But sex DOESN'T HAVE TO END after your orgasm. You can still spend time pleasuring your partner in other ways that I’m sure, once you start doing these things, you might queue yourself to get back in the mood---and before you know it, you’re erect and ready to go again.


Of course, if you are an acquired or lifelong type, make sure you speak with your doctor on other medical treatments and interventions as you guys are mostly likely the type to ejaculate in under 3 minutes versus the other types as well as face some erection issues because of health conditions.


Subjective and normal “variable” types, shouldn’t stress over this and should focus on the eroticism of the moment and focus on your erection triggers to get back into round two as well as being an attentive partner and considering their needs.


5. Should I Kegel to help with premature ejaculation?

A: First and foremost, people get confused with kegels because there is more than one type and the people suggesting you do kegels don’t understand the functions involved for erections to ejaculation. At the same time, I wouldn’t suggest following a YouTuber who is telling you to kegel and they’re lacking explanation on how to do it and for whom.


You NEED to seek a physiotherapist who is 1) knowledgeable in men’s sexual issues and 2) can evaluate you for male pelvic floor dysfunctions. You can’t diagnose yourself or do kegels on your own because you can strain your pelvic floor or make things worse!


You can easily perform a Google search by typing in “pelvic floor specialist for men in my area” or similar variations using the words “PT” or “physiotherapist” in the sentence. Once a list pops up, CLICK on their website to see if they have “men’s sexual issues” or “male sexual dysfunction” listed in their services. It’s not going to automatically say in the top 10 list on Google if they offer men’s services.


That’s for you to CLICK into their website to find out because NOT all physiotherapists are created equal. You have to LOOK.


Recap On Premature Ejaculation And Final Thoughts


ISSM helped with redefining PE and shedding light for new research and analysis of men with 4 different types of premature ejaculation. But the limitations are that these categories have mainly been researched among men who have sexual relations with women as opposed to other individuals and sexualities (although there are few out there).


In addition to this, there aren't studies on other subtypes, including masturbation, as some think this could be a part of conditional learning or fear of being caught that leads to early ejaculation. Although we can only speculate that those practicing masturbation are influenced heavily by sociocultural and psychological factors, including upbringing and religion, who may or may not frown upon sex and self pleasure--leading to masturbation in secret. We still don’t have enough concrete data, except for speculation.


Rich holding a sign of encouragement for people reading this that they can find a solution for premature ejaculation

It is also important to remember to be patient and persistent when exploring different solutions and to find what works personally through trial and error. Additionally, it is important to distinguish between premature ejaculation and erectile dysfunction (ED) as they are two separate conditions, but can coexist.


Overall, with proper analysis of one's own unique situation along with dedication towards developing effective strategies tailored specifically for oneself, premature ejaculation does not have to be left untreated or uncontrolled, but instead an opportunity for growth and improvement in one’s sex life.


I hope this helps some of you. I’ll be doing another deep dive into pharmacological treatment in the future as the Lifelong PE/Acquired sufferers need the most treatment as opposed to the other types.


Much Love,

-Rich






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