Full transcript of “Scientifically Proven Ways to Last Longer in Bed | Premature Ejaculation”. Click a timestamp to open the video at that moment. Need another video? Use the YouTube transcript generator.
0:00 do you want to know how to last longer in bed well i'm dr rena malek urologist and pelvic vision and today i'm going to answer exactly that question [Music] i want to thank promes at your one-stop shop for sexual wellness for sponsoring this video so before i get started i want to explain how long do people normally last in bed what's average so if you've watched my last video on the average duration of sex you know that the average time that someone takes from the beginning of vaginal penetration to the end is about 5.7 minutes so that's average so if you're doing that and you're comfortable with it that's totally fine however when you look at surveys where they ask people how long they want sex to last it's
0:46 anywhere between 7 to 13 minutes today we're going to talk about how to deal with something called premature ejaculation which will essentially help you last longer in bed however before you go down the rabbit hole or even watch the rest of this video make sure that's something that you and your partner both want if you are both completely satisfied with how long sex lasts for you you do not need to do anything or change anything you're doing and also talk to your partner about what kind of stimulation they want maybe it's not just penetrative sex maybe they want oral or manual or to bring some sex tools into bed with you so make sure you talk to them and find out other ways that may be equally pleasurable or more pleasurable than having longer penetrative intercourse so when should you consider using the tools in this video to help you well in medicine when ejaculation happens sooner than you or
1:33 your partner want we call that premature ejaculation when you look at studies you see that about 30 percent of men struggle from premature ejaculation however only nine percent actually go see their doctor about it so how do we define premature ejaculation well there's three major components to it one is having ejaculation within one to two minutes of penetrative intercourse number two the inability to delay ejaculation in nearly all sexual encounters and number three that this should cause some negative personal consequences like bother stress anxiety things like that that are actually causing you distress that's considered primary premature ejaculation meaning you've had that problem your entire life sometimes people can get what's called
2:20 secondary or acquired premature ejaculation and that's when you've previously had normal ejaculatory function meaning you've had a normal duration of sex and all of a sudden you start developing a shortened time to ejaculation usually less than three minutes after vaginal penetration and this is something that may be consistently seen after a certain time period that's causing you bother and is very different from the way you used to ejaculate previously well there's evidence to suggest that it's due to abnormal transmission of a chemical messenger in the brain called serotonin when people have premature ejaculation they have receptors that respond to serotonin that happen to inhibit ejaculation or stop ejaculation from happening and these receptors don't work
3:05 as well also it's important to understand how ejaculation happens ejaculation is a reflex meaning that your body automatically ejaculates in response to certain things and in this case it's usually friction as well as how your brain is perceiving that friction to feel i.e pleasurable this reflex is organized by an area called the spinal ejaculation center which is located in the spinal cord so when you have these stimulations it sends signals to the spinal ejaculatory center which takes that plus other information from the brain as to what you're thinking about the situation and it triggers the ejaculatory reflex also if you want to learn how semen is made and how it actually gets forced out of the body make sure you check out my video on how semen is made ultimately premature ejaculation is a super stressful problem
3:52 and when you look at data on this you see that men have tried at least five or more things before seeing their doctor about premature ejaculation but when you see your doctor are there certain tests that they're going to do there's actually no diagnostic testing that's necessary in order to diagnose premature ejaculation it's what we call a clinical diagnosis meaning we'll talk to you exactly about what's changed in your ejaculation or how it's always been and kind of understand a little bit about what's going on and if it does fit in the definition of occurring earlier than usual and causing you bother or distress then that's a reason to go ahead with treatment so what treatment options are available well number one is either psychotherapy or sex therapy the reason for this is things like depression
4:38 stress anxiety guilt can really impact the time to ejaculation so it's important to take into consideration how your mind is perceiving sexual activity with your partner fixing these issues with the help of a psychotherapist or sex therapist can be extremely helpful as always i'll link down a website which can help you find a sex therapist near you people who do end up seeing a psychotherapist or sex therapist in addition to the next treatment option have a eight times increase in their time to ejaculation a next treatment option is called the stop start method and what this is is when you're getting close to ejaculation your partner squeezes your penis until the erection partially goes away you do this about three times until you finally
5:23 allow yourself to ejaculate do this continuously three times a week until you see that you've increased the time to ejaculation sometimes seeing a pelvic floor physical therapist in addition to doing these treatments at home with your partner can be even more helpful because they can help you identify the muscles that can potentially control ejaculation as far as medical therapies the first line therapy is topical anesthetics and what these do they're numbing agents that you put on the penis and what they do is they actually diminish the sensitivity of the gland's penis so you're getting less sensory information from the penis to the spinal ejaculatory center hence inhibiting that reflex from going the first option for topical anesthetics is delay sprays these are
6:08 great because you can get them over the counter without a prescription and my favorite product is promescent it's the only delay spray in the united states available over the counter that's been clinically studied and you can buy it without a prescription their study was led by dr kristin mark and the study protocol was approved by the institutional review board at the university of kentucky in their study they recruited 195 men through their extensive network of people seeking to have longer lasting intimacy 91 of those men were sent a sample of the product and asked to use it every other time they had sex they also asked them to fill out a daily electronic survey before they started the study they had to answer a bunch of questions about how long it usually took them to ejaculate as well as several validated questionnaires or questionnaires that we use in research to assess if someone has
6:54 premature ejaculation the question they ask is how much time passes between the start of penetration with your partner to ejaculation at the beginning of the study participants reported their average time was about 6.5 minutes after the study their time went up to about 11.5 minutes so clearly a longer time after using the product interestingly they also asked about the rate of orgasm when using this product and what they found was that the rate of orgasm of both partners went from 44 to 66 after using the product it's super easy to use it uses a specialized metered dough spray and what that means is that you get the same dose with each and every spray you start off with three sprays for the glass of the penis at least five minutes before sex and you can titrate
7:41 that dose from anywhere from one to ten sprays per session until you get the right duration of sex they use a proprietary target zone formula now what does that mean exactly well they have a eutectic spray and what that is essentially is two different substances that are mixed together to make an oily substance on their own they don't need any other solution or what we call solvent to dissolve the substance in which means that you get a higher concentration per spray and it works faster that's why you can use it as quickly as five minutes before sex and you don't need to wash it off because it starts getting absorbed so rapidly of course if you are gonna use it for oral sex make sure you wash it off before your partner begins oral and the best part is it has very little risk of transferring to your partner so your
8:27 partner won't get any numbness after you've used it promescent patented this technology making them one if not the best available options on the market today if you're interested in trying it out check out promescent at www.promescent.com rena for 15 off your entire purchase you can get a whole host of sexual wellness products here not only for you but your partner as well condoms lubricants and so much more you get free shipping over ten dollars in the united states and it arrives in discreet packaging so no one needs to know what you're getting especially if you've got those snoopy neighbors your purchase is covered with a 60-day money-back guarantee if you use it and don't love it they'll give you your money back there are also other topical anesthetics available particularly by prescription in the united states you can get emla cream in
9:14 europe you can get fortacin emla is an off-label cream so it's not approved technically for premature ejaculation also has two anesthetic or numbing medications in it you apply it about 20 minutes before sex and you do need to wash it off before use side effects for this medication include some penile numbness and sometimes a little bit of irritation for our european viewers fortassen is actually approved by the european medical association for premature ejaculation it also includes two numbing agents that is made into a again eutectic spray for use for premature ejaculation because of that it's also fast acting and can be used within five minutes of sex but again this does require a prescription from a doctor to obtain moving on to our next treatment option is antidepressant
10:01 medications and you may be wondering why exactly antidepressant medications but it's because they all work on serotonin or preventing the uptake of serotonin so more of it's around to then work on those receptors that are maybe not responding as well so you can get more of a delay before ejaculation certain antidepressants called selective serotonin reuptake inhibitors or ssris are prescribed daily these are often fluoxetine peroxide or sertraline these are prescribed by your doctor off label because they're not actually meant for premature ejaculation but they have the side effect of delaying ejaculation typically if you take it daily you will need about five to ten days after starting the treatment before you notice the difference and that may continue to improve for up to two to three weeks after you start the treatment you
10:47 usually start on a low dose and then try trade your way up side effects include fatigue or being tired having some increased yawning nausea and some diarrhea potentially or some increased sweating but the most important and bothersome side effect is sometimes people notice a decrease in libido which is clearly not desired if you're trying to improve your ejaculatory latency time or the time before you ejaculate usually you'll notice these side effects early on and they tend to disappear after about two to three weeks but it is something to look out for you can also take certain medications on demand meaning before sex the first on-demand medication is called clomipramine and what this is is it inhibits the uptake of serotonin as well as another chemical messenger called norepinephrine this is taken about two to six hours before sex
11:35 and it also has shown significant increase in ejaculatory latency time similar side effects to ssris so you need to be on the lookout for those another medication is called depositing which is not available in the united states it is available in europe and other countries around the world so check if you do have it available to you this one is shorter acting so you can take it a little sooner before sex so you don't have to take it six hours before and it works quickly however many people get frustrated when taking these medications they may find that it's not as efficacious as you thought it was going to be meaning it doesn't work as well or that they're spending a lot of money or they're just frustrated that they have to take a medication at all i will say that if you are struggling with erectile dysfunction or a difficulty getting an erection that's firm enough to penetrate your partner then you want
12:21 to treat that first with medications like sildenafil or tadalafil and you can check out my video to learn more about those medications but typically treating the erectile dysfunction also helps with the premature ejaculation there's also two other off-label therapies that are used for premature ejaculation the first one is called tramadol which which is typically used for pain control and part of the mechanism of the action is it weakly inhibits the uptake of serotonin it's used on demand meaning you take it one to two hours before sex anywhere between 20 and 100 milligrams while studies have shown an improvement in ejaculatory latency time the studies were not really high quality and you do need to know there are certain side effects as because it is a pain medication there is a small risk of getting addicted to the pain medication as well as fatigue nausea vomiting
13:08 dizziness or a headache the second off label medication is an alpha blocker and this medication is taken daily it's you typically use for people who have an enlarged prostate you may see medications like this like tamsilosin cylidosin and these medications typically work by relaxing the prostate tissue to allow urination to flow better in the study cylidosin was the most effective of all the alpha blockers available but again there are very few studies and a common side effect with this medication is having what we call retrograde ejaculation so you may notice a decrease in ejaculatory volume so the amount that comes out when you ejaculate could decrease on this medication hopefully you guys found this video helpful as always remember to take care of yourself because you're worth it
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