The two most common behavioral therapies for premature ejaculation are the "start-stop technique" and the "squeeze technique".
Start-Stop Technique for Premature Ejaculation
Probably the most common behavioral therapy for premature ejaculation is the start-stop technique. The start-stop technique for PE involves the men learning to identify what is often referred to as "mid-level excitement". According to the International Society for Sexual Medicine's Guidelines for the Diagnosis and Treatment of Premature Ejaculation, when a man learns to identify mid-level excitement he is able to prevent ejaculation. The start-stop technique requires the man to stop stimulation (e.g. intercourse) and allows the excitement level to diminish before starting again.
Men are often instructed to begin with self-stimulation. When mid-level excitement is identified and ejaculation is controlled, then the man moves onto partner hand stimulation, then to intercourse with minimal movement, and then to stop/start thrusting.
Squeeze Technique for Premature Ejaculation
The squeeze technique is often recommended as a therapy for premature ejaculation. Just before ejaculation, the shaft of the penis is firmly squeezed between the thumb and forefinger. The squeezing causes a significant reduction in the erection which prevents ejaculation.
Many men claim that the squeeze technique has helped reduce their premature ejaculation. However, most agree that squeeze technique must be practiced in order to learn the proper timing and squeeze location and pressure. Some men have their partners participate, actually administering the squeeze technique. Several uncontrolled studies have described great success with the squeeze technique but upon review of the literature, it appears that no formal clinical studies have been performed.
The valsalva maneuver is is performed by moderately forceful attempted exhalation against a closed airway, usually done by closing one's mouth, pinching one's nose shut while pressing out as if blowing up a balloon. Some men claim that this method is effective for stopping or slowing the on-set of ejaculation.
For additional information, visit our webpages dedicated to general education about premature ejaculation.