Can men be taught to use their mind to control their body? In some cases, yes, but when it comes to using behavioral therapy to treat premature ejaculation, the results of a new review from The Cochrane Library found little reliable evidence to support this approach.
To arrive at this conclusion, the reviewers evaluated four studies that involved 253 participants. In one study, the men were taught several behavioral techniques, such as different positions and using mental focus to delay ejaculation.
Behavioral therapy discourages men from thinking about other things during sexual intercourse and instead, according to Stanley Althof, an emeritus professor at Case Western University School of Medicine and one of the reviewers, “we teach men to hover in the midrange of excitement and learn to slow down or speed up when they notice where they are.”
Compared with men who were not taught these techniques, the “students” in the one study were able to delay orgasm and got a “thumbs up” from their female partners. Another study, however, found that men who took the antidepressant Celexa compared with behavioral therapy did better with the drug alone than with therapy alone, and a third study had similar findings when men took Thorazine. Complete information on the fourth study was not available.
All in all, the reviewers decided that the four studies did not confirm that behavioral therapy works for premature ejaculation.
How big a problem is premature ejaculation? According to the authors, premature ejaculation affects only 2 to 5 percent of men if a strict definition of the condition is used: ejaculation that occurs within 60 seconds or less after the penis enters the vagina.
However, according to one of the review’s authors, Stanley Althof, executive director of the Center for Marital and Sexual Health of South Florida, “If you ask men themselves if they have premature ejaculation, you’re likely to get 20 to 30 percent who say they have it.”
It remains to be determined exactly what percentage of men really experience premature ejaculation. One challenge is that the cause is uncertain, although experts have a short list of probable culprits, including anxiety, prostate disease, genetics, chemical problems in the brain, and a dysfunctional ejaculation reflex.
When the cause of a problem is uncertain, treatment is typically a challenge, and premature ejaculation is no exception. The results of this latest review could not confirm that behavioral therapy is an effective approach. Althof, however, believes the research has value even if the evidence is not convincing.
Health Behavior News Service (part of the Center for Advancing Health)
Melnik T et al. Psychosocial interventions for premature ejaculation. Cochrane Database of Systematic Reviews 2011 issue 8.