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Male Superior Position

Yet another reason for emphasizing the female-superior and the more effective lateral coital positioning is that the most popular position in our culture, the male-superior positioning, presents the greatest difficulties with ejaculatory control.

If the coital connection is to be brief with both partners obviously wishing rapid pelvic thrusting to release of their high levels of sexual tension, coital positioning does not matter. But if there is desire to prolong the connection either for mutual pleasure or because the female partner needs more opportunity to feel and think sexually, the male superior position, which places the greatest strain on ejaculatory control, should be avoided when possible.

On every occasion, before female-superior coital position is established and then possibly converted to a lateral mounting arrangement, a comfortable period of precoital sex play is encouraged. The wife should employ the squeeze technique at least two or three times before penetration is attempted.

It takes a significant period of time to alter an early imprinting of the pattern of rapid ejaculation.

However, in the two-week treatment program, sufficient competence in ejaculatory control can be developed to alleviate mutual fears of performance, obviate the spectator role, and provide all the opportunity necessary for continued improvement in control subsequent to release from the acute stage of therapy.

Before the couple leaves the clinic, the cotherapists emphasize the fact that problems of ejaculatory control continue to a minor degree for at least the subsequent year. Several techniques to encourage continuing success in ejaculatory control are described for marital-partner benefit. The unit is reminded that after returning to the demands of their everyday world, regularity of sexual exposure is of primary concern.

For the first six months the squeeze technique should be employed on at least a once-a-week basis prior to coital opportunity; the remainder of the unit's sexual opportunities during the week are encouraged to develop in a natural, unconstrained fashion. This approach provides the man with the necessary means for transition from a controlled sexual experience to a completely extemporaneous opportunity.

It is also suggested that the couple take advantage of the wife's menstrual period each month to provide at least one session of 15 to 20 minutes devoted specifically to male sexual stimulation with manual manipulation and repetitive application of the squeeze technique for control of the ejaculatory process.

Ejaculatory Control Techniques

Usually are indicated for a minimum of six to twelve months after termination of the acute phase of therapy. During the routine follow up discussions after termination of the unit's acute phase of treatment decision to terminate use of the squeeze technique is made by professional evaluation of the degree of control during the unit's spontaneous matings.

It also is important to emphasize that if circumstances lead to separation of marital members for a matter of several weeks, coital exposure after the couple is physically reunited may find the male returning to his role as a premature ejaculator. Obviously, the procedure in this situation is to reemploy the squeeze technique for several consecutive coital exposures.

If constituted with warmth and understanding ejaculatory control will return rapidly.

With adequate warning of the possibility of these complications, a more relaxed concept of freedom of sexual approach is possible for couples contending with severe premature ejaculation.

nnumerable approaches to the treatment of premature ejaculation have been described, discarded, or conducted with varying levels of professional acceptance. Hypnotic suggestion, both in natural and drug-induced states of receptivity, has been a popular approach to the problem.

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