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Dr. Steinberg

Premature Ejaculation: You Can Have Control

You’re in bed with your partner and you’re getting intimate. Sexual intercourse begins and before you can control it, you’ve finished. You lay there, beside your partner and begin spiralling down the rabbit hole with negative thoughts about what is wrong with you. You’re embarrassed and your anxiety about your performance takes over. Sound familiar?

Many men suffer from what is known as Premature Ejaculation. But, just to be clear, premature ejaculation is not defined by the speed in which you finish, but rather whether you finished when you desired to. Being in control of your ejaculation is a more precise definition of what we, in the medical field, call Premature Ejaculation (PE).

Although many men have been known to finish too quickly, there are a large set of factors that distinguish a one-time occurrence from frequent PE. If you ejaculate sooner than you’d like to during sexual intercourse, and this is happening more often than that one time you got too drunk or went a long time without ejaculating, then it’s probably time to see a doctor to figure out what’s going on.

When it comes to premature ejaculation, there is always the possibility that psychological factors (poor body image, depression, relationship issues, and so on), are working in tandem with the physiological causes (abnormal hormone levels, abnormal levels of neurotransmitters, inflammation and infection of the prostate or urethra, and so on). By understanding the full spectrum of the disease, you will be able to begin treating the issue so that sexual intimacy can be improved.

By sitting down with men or couples (depending on the situation), we try to learn where the problem is stemming from. There can be a host of variables that are playing a role in your sexual experiences, by knowing all of the symptoms and how the disease is affecting you (and your relationship), we can better prescribe a course of action that will help you gain control of your ejaculatory function.

We will often recommend sex therapy for patients suffering from premature ejaculation. Counselling is vital for so many reasons, but the main one is whether your premature ejaculation is caused from psychological issues or not, once a man starts to experience PE, anxiety settles in fairly quickly thereafter. Anticipating frustration or shame, or feeling embarrassed about ejaculating prematurely is common and can exacerbate the issue. Talking through the stress of performance can dissipate the anxiety that goes along with it.

In the realm of medication, we typically prescribe anti-depressants (like Paxil, for example) which can help delay ejaculation. We could also explore numbing ointments (such as EMLA cream) in the realm of topical medication. EMLA is rubbed onto the head of the penis approximately 30 minutes prior to sexual activity. There are also a variety of behavioural changes or techniques you could try to help delay ejaculation. These can all be discussed with a counsellor or doctor.

Sexual experiences should not bring on stress, and anticipating ejaculating before desired is no fun for anyone. You can improve your overall sexual wellness by seeking help. It’s that easy. You just need to #HaveTheBallsToTalkAboutIt.

Dr. Steinberg

The Orgasm Gap

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You may have heard of things like the pay gap or age gap, but what you might not have heard of is a little thing called the Orgasm Gap.

Let’s rewind a few decades, way back to the 1960s when the sexual revolution was at its core. The idea of sex being a taboo topic was being challenged in hopes of celebrating the act as a part of normal life. Talking about sex and liberating it from it from the repressive state it was in for so long was quite the feat for the 60s. So much changed for women because of the fight they put up. Take contraception for example, that’s a notion that is so common in this day and age, it’s crazy to think that at one point it was against the law. But, despite the road that was paved by our foremothers, one major inequality remains to this day: equal pleasure.

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Today, sexual education is part of school curriculums as early as Kindergarten. Children are taught about their reproductive organs and the mechanics of sex. But, what about the pleasure aspect of it all? By not describing potential sensations, encouraging self-exploration, and being given the tools to speak to your partner about intimate issues, then sex is not an act people engage in for fun, rather it becomes something more results-oriented. See where we’re going with this? Here’s the thing, as long as pleasure is left out of the conversation, then sex is being misrepresented as being an act exclusive to reproduction. You know what that means?

Think about it. Go through the motions in your head. If sex is for reproduction, then who is the one who orgasms? That’s right. The man. Well, there you have it. The Orgasm Gap.

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The Orgasm Gap refers to men having more orgasms than women in heterosexual encounters (yes, heterosexual, because funny enough, in lesbian sexual encounters, the gap is not quite so big). Culturally, the importance of women “finishing” or feeling pleasure is considered less important than a man reaching the finish line. But why?

A lot of factors play key roles in why a woman’s pleasure is less sought after than a man’s:

  • Sex for reproduction
  • Feeling self-conscious
  • Lack of communication between partners
  • Insufficient clitoral stimulation
  • Not feeling entitled to feeling pleasure

When referring to sexual intercourse, we immediately connect the idea to penetrative sex. However, most women do not reach climax through penetration. Mislabeling clitoral stimulation as “foreplay” is part of the problem, because as long as we think of a woman’s orgasm as the pre-act, the less likely the woman will ever reach an orgasm. Very few women are able to reach orgasm through penetration, unlike what is represented in the media. Most women can achieve orgasm through masturbation, but again, this can make a woman feel uncomfortable during the act… to reach down and take care of herself evokes a take-charge kind of woman. But it shouldn’t.

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In the wake of #MeToo, women of 2019 are picking up where our 60s sisters left off. The Orgasm Gap is just one more challenge to take on. A reflection of today’s woman, roaring, empowered, justice-seeking, the Orgasm Gap is going to be squeezed tight.

Equal pay? Working on it.

#BelieveWomen? We do.

Eternal search for the missing orgasm… On our way!

Lori