Pondering Porn

with Ann Regentin

Premature Ejaculation: Halo vs. the Hedgehog

A recent article on the BBC website, "Premature ejaculation gene," shed an interesting light on premature ejaculation. Also known as PE, the problem affects about one-third of men and is now known to be genetic, connected to serotonin activity and reflexes.

I already knew about the reflexes part, and the serotonin part wasn’t hard to guess, given that SSRIs [selective serotonin reuptake inhibitors] are already being used off-label to slow ejaculation down in some men, a treatment I have a few problems with.

So why do I have problems with this? Why should anyone have problems with this? After all, PE causes a good deal of frustration and can seriously damage self-esteem. Isn’t the greatest sexual insult “two-pump chump”? Shouldn’t we be happy that there’s a cure? Well, I’m not. Maybe I’m a constitutional contrarian, but I’m not comfortable with medicating PE.

First of all, men with PE tend to have quick reflexes across the boards. They might be good athletes, good musicians, good at anything requiring what’s known in the video gaming world as twitch, the lightening-quick reaction time that make the difference between kicking virtual butt and getting your own butt kicked.

What happens when you give these guys an SSRI? I don’t know for sure, but I think it’s a reasonable guess that it’s going to slow them down across the boards, and I don’t think that’s a good thing, especially when other parts of their lives might revolve around those reflexes. What if his job depends on it? Or his favorite hobby? Now what?

The potential for trouble is even greater than just interfering with a man’s Halo score. The FDA declared dapoxetine, one of the most promising short-acting SSRIs, unapprovable for PE because of side effects, which include dizziness, weight gain, stomach problems and, ironically, loss of sex drive. The drug giveth, but the drug also taketh away. Paroxetine, aka Paxil, was somewhat better, but not as good as clomipramine, one of the old tricyclics, a class of drugs with side effects so unpleasant that SSRIs are considered an improvement. These drugs are often prescribed off-label, but there’s a reason why those prescriptions remain off-label in spite of a decent track record of success.

I’ve been on these drugs. They’re lifesavers under the right circumstances, but they’re not bubble-gum. Even in small doses, they have extremely unpleasant side effects, and can behave unpredictably in long-term use. Sometimes they even stop working, leaving the patient to find another drug they can tolerate or go back to square one.

I especially have a problem with prescribing medication for what is essentially a non-problem. Penetrative sex is nice, don’t get me wrong, but the key piece of anatomy where female pleasure is concerned is the clitoris, and it takes some work for it to come into sufficient contact with anything during intercourse for it to make much difference.

Along those lines, when the news came out that only one third of women were capable of so-called vaginal orgasm at all, and less than 10% could do it consistently, the immediate response was to try to figure out why two thirds of women were defective or, in some cases, to try to make sure that a man was with one of the “good” ones. That attitude lingers to this day. When a woman can’t orgasm through intercourse, it’s assumed to be all in her head, and both partners can start feeling inadequate over something that’s outside everyone’s control.

PE, too, was assumed to be psychological, in spite of the fact that it persists in many cases no matter what anyone does. Masturbation techniques don’t accomplish much, and the intercourse-related techniques can take over sex to a point where it’s not fun anymore. Sex that revolves around the penis to that degree essentially cuts the partner out, except as a possible scapegoat for the frustration when things don’t go as desired. That frustration is assumed to be the result of the PE, but I’m more inclined to say that it’s the result of the joy being sucked out of sex by compensatory efforts, not to mention dealing with the level of overall defensiveness provoked by living with an issue like this.

What would I suggest in a situation like this? It might help to remember that Ian Kerner, who literally wrote the book on cunnilingus (She Comes First), had problems with PE. His wife, by all reports, has no problem with him in the bedroom at all, but it’s not hard to see why.

Another possibility is to run on his refractory time, if his brain doesn’t completely conk out after he comes. The second round should last a bit longer, if longer is what’s desired, but even still, an open attitude toward foreplay is probably the best bet, and this is true even when PE isn’t an issue.

What about satisfying the guy? Think about the refractory time thing. That’s two orgasms per session for him. Fellatio to completion should be a piece of cake. It might also be fun to see if he could orgasm on prostate stimulation alone, something that’s difficult or impossible for most men. Or what about other forms of sensual, non-penile contact? Even non-physical? Tie him to the bed, and wind him up visually until he comes from a kiss on the (little) head.

Seems counterintuitive, doesn’t it, to deliberately exploit what’s usually considered to be a flaw, but I’ve laid out the problems with the alternatives. All of them suck, and none of them make it go away. Whether it’s stop-start techniques, desensitizing cream, circumcision or SSRIs, there’s no reliable, safe way of making a man not have PE.

So what is PE anyway? The definition is that a man who ejaculates before he wants to has PE, which helps explain why it’s so prevalent. By that criterion, it’s a rare man who hasn’t had an incident or two in his life. Define it as lack of ejaculatory control, and you have the same prevalence.

What happens if you put a time limit on it? According to the International Society for Sexual Medicine, premature ejaculation can be defined by ejaculation within 60 seconds of penetration on a consistent basis, plus negative consequences. But what about men who ejaculate within 60 seconds but don’t engage in vaginal intercourse? And what about men who ejaculate within 60 seconds without suffering negative consequences?

Is this even possible? With so much of masculinity hinging on control of what is now known to be an involuntary, reflexive response, I’d say that it’s extremely rare, but not because it’s impossible. It’s rare, because when we fall significantly short of the cultural ideal, we usually take an attitude toward ourselves that is, in and of itself, a negative consequence.

Why am I writing about this when PE isn’t likely to be a problem for me? Because anything that has a negative effect on a man’s sense of himself sexually has an effect on the woman in his life, and that effect won’t be good. It’s especially bad if every effort to fix the “problem” has failed. That’s when the compensation starts, and it doesn’t matter what form that takes, either. It’s not going to be positive.

The solution doesn’t lie in a pharmaceutical magic bullet. It comes down to a basic risk-benefit assessment, because there’s no “problem solved” approach. Instead, you trade one set of problems for another, and SSRIs are a classic example. Okay, so the PE is gone, but now you’re dizzy, nauseous and have no sex drive. From a partner’s point of view, you’ve made things worse by making yourself more difficult to live with.

The FDA is not approving these drugs for this use for a reason. People kill themselves while on them. They are appropriate only in dire situations when no other remedy is available, and this is a situation where there is no remedy, period. Quick reaction reflexes aren’t a disease.

So why are men asking for SSRIs for PE? For the same reason women are getting plastic surgery, which is why I wonder if it’s really worth it. This is especially true when you consider the long-term, psychological effects of major interventions designed to heighten sexual attractiveness. Researchers at the Vanderbilt University Medical Center in Tennessee found that women who got breast implants were at three times the risk for suicide than the general population.

This worries me. As men are at higher risk for suicide anyway, and SSRIs can trigger suicidal thoughts and behavior, it seems we have the potential for a kind of perfect storm here. I don’t know, though. I might be wrong. I hope I’m wrong.

Mostly what bothers me is that in the quest to create the ideal human being via science, we’ve sliced and diced ourselves, underfed ourselves, stretched out on tanning beds, gobbled untested supplements, injected ourselves with botulism toxins, and now we’re going to medicate a man’s reflexes away? With a drug known to cause suicide?

I’d ask what kind of world this makes sense in, but I live in that world. It’s true that I’d probably be more attractive with a breast lift and a bit of Botox on that frownie between my eyebrows, but last I checked, being 41 isn’t a disease. There’s no need for medical intervention.

What’s really so horrible about quick reflexes? The sex itself? Or the inability to live up to expectations? Because unhappiness is often best measured by the gap between expectations and reality, regardless of what we’re unhappy about, and when expectations are set using criteria that don’t amount to much anyway (endless, porn-star pumping), trying to meet them won’t make us any happier.

None of this will stop a man hell-bent on relief from what may seem like an ultimate shame, and I understand shame. I’m a disabled by invisible chronic illness, and as with PE, there’s a strong genetic component. I’ve heard the insults from people who didn’t know, sucked up the red-faced, half-hearted apologies, and had to deal with people who think that a few exercises or a change in attitude will fix me. I’ve done some very stupid things in search of a cure, only to find that there isn’t one. There’s just a lot of difficult decisions to make. I also know that acceptance makes a world of difference in how well I make those decisions. It keeps us from getting self-destructive.

I guess that, to those who are doubting, I’d just like to suggest that they think, please, before turning their brains inside out with an unapproved drug to solve a problem that can probably be fixed with their tongue. PE isn’t a disease, nor is it a character flaw. It’s a genetic quirk that gives quick reflexes. At the raw, biological level, there’s no more to it than that and frankly, I think that’s a better place to start a romantic evening than a Ron Jeremy video even will be.

Ann Regentin
www.annregentin.com
February 2009

Find Ann Regentin Pondering Porn in ERWA 2008 Archive.

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© 2009 Ann Regentin. All rights reserved. Content may not be copied or used in whole or part without written permission from the author.


About the Author:  Ann Regentin was introduced to erotica at a tender age, when a raid of her mother's bookshelves netted such gems as The Perfumed Garden and Lady Chatterly's Lover. She started writing it during her ninth grade biology class, then dropped it for about twenty years to become a musician, a college student, a cripple, a bookstore clerk, an artist, a model, a mother, a parrot rescuer, and finally a reference writer before coming full circle back to erotica.
Her stories and articles have appeared in a variety of places both online and in print, and she is a Contributing Editor at CleanSheets.com. She lives in the Midwest with her son, two parrots, and an elderly Gibson guitar.
Visit Ann Regentin at: www.annregentin.com

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