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There has been widespread acceptance of anesthetic creams and jellies prescribed for application to the erect penis theoretically to reduce neurogenic end-organ sensitivity to the stimuli of manipulation or vaginal containment. Specific drug preparations, tranquilizers, barbituates, etc., have been prescribed in an effort to dull male sensitivity to stimuli in general and to stimuli of sexual content in particular.

Many men have tried with varying degrees of success to lower their natural sexual tension levels by ingestion of sizable quantities of alcohol before anticipated sexual encounter.

Frantic men consume a never ending list of potions, nostrums, and poisons, all designed to reduce rapidity of ejaculatory response, all curiously directed to a male's sexual functioning alone without regard for his partner's involvement. Any form of sexual inadequacy is a problem of mutual involvement for partners in a marriage.

With a wife's full cooperation, her willingness to learn and to apply the basic principles of ejaculatory control, and the warmth of her personal involvement expressed openly to her mate, reversal of this crippling marital distress is essentially assured. As further support of this argument for the necessity of involvement of the wife in the resolution of a well established premature ejaculatory pattern, it should be pointed out that the squeeze technique is not effective if done by the male attempting to teach himself control.

If a man manipulates his penis to erection and then applies the squeeze technique to control an imminent ejaculatory response, he usually can halt the natural progression of sex tension increment and successfully depress his ejaculatory urge.

However, once this man returns to the stimulation of a heterosexual relationship, it is as if he had made no prior solitary attempts at control. What is obviated by solitary attempts to learn ejaculatory control is the fact that with a female partner the individual male cannot entirely set the pace of sexual functioning, nor can he entirely, deny the sexual stimuli absorbed from the obvious psycho sexual involvement of his marital partner.

In the 11 years:

186 men have been treated for premature ejaculation. There have been 4 failures to learn adequate control during the acute phase of therapy. Adequate control is defined as sufficient to provide orgasmic opportunity for the sexual partner during approximately 50 percent of the coital opportunities. The failure rate is 2.2 percent.

Three of the failures were with couples; and one was with a man previously divorced because of his premature ejaculatory pattern, who brought a replacement partner to the treatment program.

In two of the four instances there was no real motivation on the part of the male partner to learn ejaculation control. These men had accompanied their non orgasmic wives as a cooperative venture, but when they learned that they were in fact contributing to their wives' sexual dysfunction they refused further cooperation. They simply could not accept a reversal of their deeply ingrained double standard of sexual function.

There is no specific explanation for the two remaining failures to control the premature ejaculatory tendencies of the men involved. Both units were fully cooperative but the techniques simply did not work. One of these men, 64 years old, was the only failure among 19 men 50 years or older treated for premature ejaculation.

A brief note of clinical warning is in order. After learning to control a premature ejaculatory tendency, 23 of the couples treated by clinic personnel were confronted by a brief period of secondary impotence just before or shortly after termination of the acute phase of therapy.

Sexual function improvement

Most couples, delighted with the significant improvement in sexual functioning, enter a period of marked frequency of coital connection as compared with their sexual exposure rate just before visiting the clinic.

Sometimes the male partner simply cannot meet the suddenly elevated frequency demand and encounters an episode of erective failure. He only has to have one such experience before all his fears of performance flood his consciousness. What new form of dysfunction is this? Has the treatment caused it? His initial anxiety reaction is of serious proportion.

The thought that he was sexually satiated for the moment never occurs either to the concerned husband or his sexually enthusiastic wife. Care must be taken by authority to warn couples of the possibility of a transitory experience with impotence, as they are adjusting their overwhelming pleasure with their newfound sexual function to the practicality of the male's level of sexual responsivity.

With prior warning the couples take an episode of impotence in stride, even laughing at the concrete evidence of their sexual greediness. Without adequate warning, a persistence of symptoms of secondary impotence is possible, for the fears of performance and spectator roles return to their dominant position before adequate explanation of the distressful event is available,

In brief, the problem of premature ejaculation is uniquely one that can be resolved effectively and permanently. For successful resolution of the problem, a man needs some understanding of the origin of distress, a knowledge of techniques to establish control, and, above all else, a cooperative, involved sexual partner.

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