Q: Help my partner ejaculates prematurely and feels pain when he does.

A: There are two things here that I would like to address – you’re partner’s premature ejaculation (PE) and the pain. Firstly, there are some general things men with PE and their partners should know.

1. Premature ejaculation is extremely common – around 30% of men say they are not happy with their ability to control orgasm, but most of them think that their problem is unique and therefore don’t seek help.

2. During intercourse, men with PE focus on their fears “am I going to last” – and the sexual experience changes from enjoyment and pleasure to a “performance” on which they will be judged and criticized.

3. Men often think that the problem is that they become too excited too quickly. They deal with this by distracting themselves and distancing themselves from the sexual experience. However, what they really need to do is to teach their bodies to stay at a pleasurable level of arousal for as long as possible before climax.

4. Often, the women partners of men with PE think that they are selfish lovers. In my practice they often accuse their partners of “only caring about his pleasure, and his climax and he always leaves me feeling unsatisfied.” However, the men often feel shame, frustration and defeat because they are not able to perform to expectations. This shame adds pressure to the situation and actually makes it worse.

5. It is extremely important not to try and avoid the situation as it will only cause more issues in the relationship. It can lead to a decrease in intimacy and an increase in pressure, anxiety and resentment between the partners. But PE is actually very easily treatable. They can learn to teach their bodies to respond differently to sexual stimuli.

The pain that your partner is experiencing could be caused by an inflammation of the prostate gland, called prostatitis. Over 50% of men will experience this at least once in their lifetime, but it can be treated with medication.

Another cause could be chronic pelvic pain syndrome (CPPS) which is characterised by pain or discomfort which lasts several months, and often longer. It is usually at the base of the penis, and around the anus and lower back. Sometimes the pain spreads down to the tip of the penis and/or into the testes. Ejaculation may be painful. The pain may vary in severity from day to day.

I suggest you and your partner visit your GP as soon as possible so that a urine sample can be taken to find out the cause of the issue.

There may already have been some psychological effects of the pain, and your partner may still experience some discomfort after the infection is cured – because his muscles have learned to respond to certain stimuli in a certain way.

If this is the case, I recommend that you seek therapy to ensure that your relationship and intimacy don’t suffer.

In the mean time, here is some information on PE to help get you started:

Learning Ejaculatory Control

Here are some tips for learning ejaculatory control. They may sound too “simple” and mechanical, but they are designed to help men learn to identify and control the sexual stimuli that bring them to orgasm. These techniques have been adapted from The New Male Sexuality by Bernie Zilbergeld.

Stop-Start Masturbation

To learn to control his orgasm, a man struggling with premature ejaculation should practice the following masturbation technique a minimum of three times a week. Remember – always use lubricant! Once you have an erection, hold the base of your penis with one hand to stabilize it and then, using the pads of your thumb and one finger, explore the entire penis thoroughly using short strokes. The idea of this is to identify the most sensitive areas of the penis.

Now masturbate in your usual manner until you approach orgasm. Mentally take not of all of the sensations in your penis and in the rest of your body that signal the approaching orgasm.

Time yourself to see how long it takes you to reach this point.

Stop masturbating and wait till the excitement subsides

Relax the muscles in your buttocks, legs and abdomen and wait 30 seconds to a minute before you repeat the process four times. If you find that you approach orgasm too quickly, try waiting longer before resuming stimulation. If you lose all of your erection between stops, try a shorter waiting period.

With the fourth time, continue masturbating and focus your attention on the sensations in your penis and groin. Slowly build up the intensity of your strokes and allow yourself to reach orgasm.

The more you practice this technique, you will find that the time to orgasm starts to increase, giving you confidence and a way of confirming that you are changing your body’s response to stimuli.

Kegel Exercises

These are not just for women! Kegel exercises help men to gain better control of the muscles that control the flow of urination, semen and the firmness of the penis during erection.

- First, locate your pubococcygeus muscles (PC) muscles. The easiest way to do this is by consciously identifying the muscles you use to stop urination.

- Clench and release these muscles in three sets of 10 a couple of times per day to help strengthen them.

- Concentrate on both the clenching and the relaxation of the muscles.

- Remember, that during intercourse these muscles need to be relaxed. If you become anxious, these muscles will tighten – leading to climax.

- By learning to consciously relax these muscles you will be able to control them when you feel your approach towards climax.