Premature & Delayed Ejaculation
Specialty
What it is
These two show up as opposites but they're really cousins — both are about timing you can't control, and both wear down confidence fast. Premature ejaculation (PE) means climaxing sooner than you or your partner want, often within a minute or two of penetration. Delayed ejaculation (DE) is the reverse: you can't get there at all, or it takes so long that intercourse becomes a marathon nobody enjoys.
Both have physiological and psychological ingredients. PE often traces to nervous- system sensitivity, early conditioning, or high arousal that overwhelms control. DE is frequently tied to antidepressants (especially SSRIs), specific masturbation patterns that partnered sex can't replicate, low arousal, or performance concerns. Neither is a character flaw. Both respond to real, structured work.
The Approach
How therapy helps
The starting point is a straightforward assessment: how often, in what contexts, with or without a partner, on or off which medications, and how long this has been the pattern. That picture usually points directly at whether the work is behavioral, relational, medical, or (most often) a mix of all three. If medication side effects or a physical cause are contributing, we coordinate with your prescriber or a urologist.
For PE, we use sex-therapy techniques with a long track record — arousal awareness, pacing, the stop-start and squeeze approaches — practiced in a way that fits your actual life, not a textbook. For DE, we look at masturbation style and stimulus, work on transferring sensation into partnered sex, and address any avoidance or over-focus on the endpoint that's making it worse.
Partner dynamics are almost always part of the picture. If your partner is involved, we can bring them in for one or two sessions to defuse the mind-reading, reduce pressure on both sides, and turn sex back into something you're doing togetherinstead of a test one of you keeps failing.
20–30%
of men report significant PE or DE at some point in their lives. The good news: this is one of the most responsive areas in all of sex therapy.
You're not alone.
Frequently asked questions
How long does it usually take to see progress?
I take an SSRI and I think it's causing my delayed ejaculation. Do I need to stop it?
Does this only work if I have a partner?
Book a Session
Ready to work on timing without the shame?
A private, direct, 50-minute session focused on what's actually going on and what to do about it.
Talk to Paul