Ep. 24 - When Fast & Furious Is a Bad Thing
Dr. Sex Fairy Podcast
Host: Dr. Kanwal Bawa | Runtime: 16:35 | Published: May 23, 2022
[00:12] Introduction: Premature Ejaculation
Dr. Bawa: Welcome to another episode of Dr. Sex Fairy. I am Dr. Kanwal Bawa, and I am here to transform your life. In fact, I am taking my message to millions of people all over the world. My TikTok account has gone viral and has tens of millions of views. Make sure you follow me on TikTok, @DrSexFairy. And don't forget to follow me on Instagram so that you never miss a message. Do support this podcast by leaving me a five-star review. We discuss all aspects of human sexuality and intimate wellness on this podcast.
Premature ejaculation is an important topic that must be addressed. It is by far one of the most common sexual disorders affecting men. It happens when a man ejaculates sooner during sex than he or his partner would like. It is something that can literally traumatize not only men, but also their partners.
It is a complex issue, and I know that you have many questions about it. I am going to discuss premature ejaculation one question at a time. Let's get started.
[01:19] Question 1: How Does the Male Orgasm Work?
Dr. Bawa: Let's first talk about the biggest subject: the male orgasm and ejaculation. How does the male orgasm work? An article about human sexual response, published in The Journal of Sex Research in 1970, outlined the four phases of the male orgasm.
Number one, the arousal phase. This phase leads to the release of nitric oxide into the arteries of the penis, which causes them to expand and quickly fill with blood. This leads to an erection.
Then comes the plateau phase. Immediately before a man has an orgasm is what is called the plateau. This stage usually lasts between 30 seconds and two minutes. During this phase, several things happen all at once. Heart rate increases to about 150 to 175 beats per minute. Blood pressure and body temperature go up. The testicles become firm and elevated, and body movements become involuntary. Seminal fluid may leak from the urethra, and this changes the pH of the urethra so that sperm have a better chance of survival.
[02:36] Emission, Ejaculation and Orgasm
Dr. Bawa: Then comes the mighty orgasm. The orgasm phase is divided into two parts, known as emission and ejaculation. During emission, semen moves into the urethra, close to the tip of the penis. At this point, ejaculation is inevitable.
During ejaculation, strong contractions of the penile muscles and pelvic-floor muscles help propel the semen from the body. At this point, the brain releases very large amounts of oxytocin and endorphins. Oxytocin promotes feelings of connection and bonding with a partner after orgasm. Dopamine is a feel-good neurotransmitter connected to the reward center of the brain.
[03:20] Resolution and the Refractory Period
Dr. Bawa: Now comes the resolution and refractory phase. Resolution is when the penis starts to go soft. The man often feels relaxation or drowsiness at this point. The refractory period is when a man is unable to achieve another erection, even with sexual stimulation.
[04:04] Question 2: How Common Is Premature Ejaculation?
Dr. Bawa: Depending on which study you look at, a very large percentage of men from all over the world suffer from premature ejaculation. Even if you go with just 40%, that is a large number of men who are unhappy and lost in the bedroom. For some, it is a chronic issue that bothers them every single time they have sex, and for others it is sporadic.
[04:22] Question 3: How Quick Is Too Quick?
Dr. Bawa: Next, how quick is too quick? A study titled A Multinational Population Survey of Intravaginal Ejaculation Latency Time was published in The Journal of Sexual Medicine in 2005. The study had 500 couples from five countries: the Netherlands, the United Kingdom, Spain, Turkey and the United States.
The study participants were men aged 18 years or older who had been in a stable heterosexual relationship for at least six months and had regular sexual activity. The couples used a stopwatch to time intravaginal ejaculation latency during a four-week period. Their age, sexual status and condom use were recorded as well.
The researchers found that the average duration was 5.4 minutes. Houston, we have a problem. Women want their men to last 25 minutes and 51 seconds, but the average man lasts only 5.4 minutes. Women take a lot longer than men to orgasm, so this becomes a really big deal. Women need at least 20 minutes to get there. Things are looking pretty dire for the average man.
When premature ejaculation happens, things become catastrophic. True premature ejaculation is when a man is unable to last one minute once he is inside the vagina. For the most part, premature ejaculation is when a man goes from penetration to ejaculation in under three minutes.
[05:50] Question 4: What Are the Types of Premature Ejaculation?
Dr. Bawa: The first is lifelong, or primary, premature ejaculation. This describes a man who ejaculates too soon 100%, or almost 100%, of the time, beginning with his first sexual encounter.
The second kind is acquired, or secondary, premature ejaculation. This develops after a man has had previous sexual experiences without ejaculation problems.
[06:20] Question 5: What Causes Premature Ejaculation?
Dr. Bawa: According to my alma mater, the Cleveland Clinic, physical, chemical, emotional and psychological factors can cause premature ejaculation.
Physical and chemical problems include an underlying erectile dysfunction and hormonal problems involving oxytocin, luteinizing hormone, prolactin and thyroid-stimulating hormone. And let's not forget the mighty testosterone. Low serotonin levels involve chemicals in the brain that are connected with sexual desire and excitement. Of course, the penis may also be highly sensitive to stimulation.
Emotional and psychological causes can include performance anxiety. This could be due to being with a new partner, having sex again after a long period of abstinence, lack of confidence, guilt, or being overly excited or stimulated. Other causes include stress, relationship problems and depression.
Then there are men who come from cultures that view sex very negatively and may consider sexual activity itself sinful. These men are especially at risk of premature ejaculation. Poor body image can also contribute.
[07:39] Genetics, Serotonin and Premature Ejaculation
Dr. Bawa: Premature ejaculation may be genetic in nature. Who would have thought? A study tested 89 men who had experienced premature ejaculation since their first sexual encounter. These men had serotonin levels that were far lower than those of 92 men who were not suffering from it.
The areas of the brain that lack sufficient levels of serotonin are the same areas that control ejaculation. A 2011 study published in The Journal of Sexual Medicine studied the effects of serotonin and receptor activation and found similar results. This has actually led researchers to believe that premature ejaculation may well have a genetic basis.
[08:32] Question 6: Do You Need Blood Tests?
Dr. Bawa: Do you require blood tests to diagnose premature ejaculation? You do not really need blood tests to diagnose premature ejaculation directly, but you can find abnormalities that may be leading to it, such as thyroid and testosterone issues, by simply checking your blood levels.
[08:55] Question 7: Can You Treat Premature Ejaculation?
Dr. Bawa: This is an important one. Can you treat premature ejaculation? The cause of premature ejaculation determines the treatment for it. For the most part, it is unclear what exactly causes a man's premature ejaculation.
So far, the two main categories of treatment include behavioral therapy and counseling, and medications. Behavioral therapy and counseling are usually the best place to start in treating this condition. Let's talk about behavioral therapy first.
[09:30] Distraction and the Start-Stop Method
Dr. Bawa: Behavioral therapy is all about learning to control your body and emotions in order to delay orgasm. Methods include distraction. The idea is to think about ordinary, nonsexual things when you are being sexually stimulated. Think about mundane things like traffic or bills. I say it doesn't sound sexy, but it will help you train your body to last longer.
Next is the start-stop method. With this technique, you stop when you are close to orgasm. You take a break for 30 seconds, until you are in control of your sexual response. This start-stop technique is repeated three or four times before you let yourself orgasm. Continue practicing this method until you have gained better control.
[10:10] The Squeeze Technique
Dr. Bawa: Next, let's talk about the squeeze technique. With this technique, you get to the point where you are close to orgasm, and then you gently squeeze the head of the penis for about 30 seconds so that you begin to lose your erection. You repeat this technique a few times before letting yourself orgasm.
The issue with this is that you have to come out of the vagina, and you have to have a partner who is supportive of this. You have to penetrate, take it out, squeeze, put it back, and then take it out again and repeat. It is really not very convenient or practical, but if all else fails, why not try it?
[10:52] Pelvic-Floor Exercises
Dr. Bawa: Then let's talk about pelvic-floor exercises, also known as Kegels. These can, in theory, strengthen the muscles in men with a weak pelvic floor. Weak muscles can make it harder to delay ejaculation.
You have to do these exercises correctly for them to be effective at all. To begin with, you have to identify the pelvic floor. You can do this by stopping urination midstream. The muscles you clench are the ones you need to be exercising.
To do a pelvic-floor exercise correctly, you should squeeze your pelvic muscles and hold that tight squeeze for three seconds. Do this several times in a row, at least a few times a day. Try to do at least three sets of 10 in a day.
[11:35] Condoms and Reduced Sensation
Dr. Bawa: Then there are condoms. They are not popular, I know, but they can help premature ejaculation. They do this by, of course, reducing sensation. You can even buy what are called climax-control condoms, which have a little numbing agent in them.
[11:55] Counseling
Dr. Bawa: Next, let's take an approach to premature ejaculation with counseling. Whether the problem of premature ejaculation is causing you emotional anguish, or psychological issues are causing you to have premature ejaculation, counseling is a very important step toward improvement.
However, according to a 2019 study titled Premature Ejaculation: Etiology and Treatment Strategies, behavioral or psychological therapy alone is usually not adequate to entirely manage and treat premature ejaculation. Despite showing a high short-term success rate of up to 65%, long-term success seems to be relatively difficult. When it comes to counseling alone, only about 25% of people are benefiting from it long term.
This is a perfect transition into medications.
[12:45] Oral Medications
Dr. Bawa: Several types of medications may be tried. Oral medications include antidepressants, especially SSRIs, or selective serotonin reuptake inhibitors. They can be immensely helpful to people suffering from this. SSRIs like Celexa, Prozac and Zoloft have been found to help premature ejaculation.
This is an off-label use because medications like these are not approved by the FDA for premature ejaculation. Erectile-dysfunction medications such as Viagra and Cialis are also being used to treat premature ejaculation to some extent. They may help men who suffer from underlying erectile dysfunction.
These medications, however, come with so many side effects and complications that they are not necessarily a good solution. I often hear my patients telling me that these medications cause headache, congestion, flushing and a drop in blood pressure, and they are right.
[13:35] Topical Numbing Medications
Dr. Bawa: Next comes the topic of topical medications. Over-the-counter numbing creams and sprays applied to the head and shaft of the penis are another way to delay ejaculation. The medication is applied to the penis ahead of time, about 10 to 15 minutes, so that the penis is less sensitive.
You must remember to wash the penis before sex to avoid accidentally numbing your partner's vagina, or numbing your partner during oral interaction. That would not be a good thing.
In fact, I have my very own Dr. Sex Fairy brand Delay Spray that can really help you. If you would like to know how to get it, email me at askme@drsexfairy.com.
[14:20] Acoustic Wave Therapy and the P-Shot
Dr. Bawa: And last, but certainly not least, let's talk about my favorite treatment modalities. In addition to my Dr. Sex Fairy brand Delay Spray, I am seeing incredible results with acoustic wave therapy and the P-Shot at my Boca Raton, Florida medical practice, Bawa Medical.
Erectile dysfunction, at its simplest, involves decreased inflow and increased outflow as a result of plaque and blockages in the heart and pelvic area. We use acoustic wave, or shockwave, therapy to safely break down these blockages and improve blood flow. This is leading to better erections and immediate improvement in cases of premature ejaculation in my practice.
I am also a strong believer in the P-Shot. This is when we take your blood, like when you are getting a blood draw, and spin it in a special centrifuge. This produces platelet-rich plasma, which has growth factors that can stimulate stem cells. We take it a step further at my practice and convert it into platelet-rich fibrin, which is far more concentrated and rejuvenates tissue so much more.
Acoustic wave or shockwave therapy and the P-Shot have a synergistic effect. If you go to my YouTube channel, Bawa Medical Boca Raton, you can see videos where I talk to patients whose lives have been transformed by my treatment protocols.
If you want to know more about these transformative treatments for both men and women, shoot me an email at askme@drsexfairy.com. I hope that you are now better informed about premature ejaculation and that you now have many tools that can help you overcome it. Until next time.
[15:58] Recorded Outro
Dr. Bawa: I hope you enjoyed the Dr. Sex Fairy Podcast today. I would love to continue this conversation with you. If you would like my top three secrets for amazing sex, send me an email at askme@drsexfairy.com and I will share them with you. Don't fo
