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Hello Randy-This is a very common problem among men. Since premature ejaculation is related to the degree and rate of stimulation, it can be reduced by using different techniques that interrupt or slow the process to climax. "Stop-and-start" involves stopping sexual stimulation for about 30 seconds when you are close to orgasm and then restarting-repeat this until the desired time for orgasm arrives. The "squeeze" method is similar but adds a mild squeeze to the tip of the penis (between the shaft and head) when orgasm is close; once the urge passes, wait 30 seconds and begin stimulation again. These methods can be used during manual stimulation to help you become familiar with the feeling of delaying ejaculation and build endurance. An alternative way to help premature ejaculation is to reduce the sensation to the penis through condoms or local anesthetic cream (remove the cream before penetration). Certain medications, such as prozac and similar medicines, have sexual side effects including delayed orgasm and may help, but difficulty obtaining erection may result in some people. Relaxation, as you mentioned, is important--you may also want to consider if you have feelings such as shame, guilt, fear or anxiety about your performance...these can all lead to premature ejaculation in some men. If you have the resources and don't find help with these suggestions, and if the problem regularly occurs, sex therapy or a visit with a psychologist may provide some improvement. A visit to your physician for routine bloodwork, hormone levels and prostate examination might be helpful as well, although biologic problems are less likely the cause.

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