85 - 97% of men/penis owners can learn to control their arousal and with that are able to overcome premature ejaculation (PE) (calculated according to: (Gao et al. 2013; Serefoglu et al. 2010; Waldinger et al., 2009)).
This guide will briefly cover the fundamental principles and exercises to attempt to master your sexual stamina. It will not fully explain why these exercises or principles work. 

  

Physiological Treatment Options

The general idea is that your body should be in a calm state, free of anxiety and tension. Most men who struggle with PE have a tense pelvic floor that involuntarily contracts when they are exposed to sexual stimulation. The most prominent muscle that is causing a tight pelvic floor is the pc muscle. 

PC Muscle Identification

  1. Go to the toilet
  2. Start urinating
  3. Deliberately stop the urine flow
  4. The muscle that you used to stop the flow of urine is the pc muscle. To start urinating you relax this muscle. 

Now that you know where your pelvic floor muscle is located, you need to assess whether it's overly tight. 

 

Pelvic Floor Self-Assessment

  1. Get yourself hard.
  2. Seize all stimulation for a few seconds.
  3. Touch your penis (while erect) with your hand as if you were masturbating
  4. Observe: Does your penis make sort of a "jump" as you first touch it? That's an indication of a very tight pelvic floor. Can you fully relax your pelvic floor as you are stimulating yourself? If the answer is yes, then you most likely don't have an overly tight pelvic floor. If the answer is no, then your pelvic floor might be too tight.

As you observe your pelvic floor area more during masturbation and sex, you will realize that the stronger the stimuli, the more difficult it is to relax your pelvic floor. In other words, it's possible that you can relax your pelvic floor while jerking off, but still can't relax it while you are inside a vagina. A tight pelvic floor is normal no reason for worry.

Disclaimer: This is, of course, a simple exercise and doesn't substitute a proper diagnosis by a medical professional.

 

Exercises to relax the pelvic floor

Since a tense pelvic floor contributes to PE, we want to help our body by relaxing our pelvic floor muscles. There are three ways to achieve this:

 

Stretches

The most effective stretches that target the pelvic floor are: 

Holding these stretches between 60 and 120 seconds is recommended. Please warm yourself up beforehand to avoid injuries. 

 

Massages

You can use a massage or a tennis ball to punctually release tension in your pelvic floor area. 

This video shows you how to do that effectively:

 

Reverse Kegel Exercises

Reverse Kegels are practically the deliberate relaxation of your pelvic muscles. These pelvic exercises get often referenced as bread and butter exercises. There is a tutorial on how to do them: 

Typically, it's advised to start slow and slowly increase the volume. A good starting point is 5 x 30 seconds reverse kegel holds with 5 seconds breaks in between sets twice a day. 

 

Masturbatory Practice

Generally, when we grew up we were always hiding when we masturbated. So typically we developed the habit of rushing to the orgasm while staying as silent as possible. At the end of the day, masturbation should be a safe space that remains fun. So try not to transform every pleasure session into a workout. 

The four most effective masturbation training sessions are:

 

Edging

Here you try to go as close to the point of no return (PONR) and stay there for as long as possible without having an orgasm. Edging teaches you to withstand high levels of arousal and trains your willpower to resist the urge to ejaculate.

Example session:
Stay 15 minutes at 8-9 on the arousal scale (from 1 to 10, 10 being the highest). Taking breaks and seizing stimulation is okay.

 

Medium Endurance

Here you stay in the medium range on your arousal scale while consistently stimulating yourself. Breaks are typically not allowed. However, it's okay to reduce the level of stimulation by going slower or reducing friction. Medium Endurance teaches you to stay at a comfortable level of arousal and maintain an erection. This is what you strive to do during sex most of the time. 

Example session:

Stay 25 minutes at 5-6 on the arousal scale. It's okay to reduce the level of stimulation to stay on the desired level of arousal. 

 

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Stop-Start

The stop-start technique is probably the most famous masturbation/sex exercise to overcome PE. Here you stimulate yourself until just before you reach your PONR and then stop for a while until your arousal has reduced again. This exercise teaches you to arousal self-awareness, willpower and to reduce your arousal levels rapidly. 

Example session: 

Do 20 minutes of start-stop. Take a 40-second break after each time you stop. 

 

Full stroke and stop

Here you do one full stroke and take a rest until you have reached a low level of arousal. Full stroke and stop teaches you to do actual full strokes like in sex and trains you to reduce your arousal level rapidly if it's elevated. 

Example session:

Do 150 full strokes. Take a break after each stroke until you are at a 4 on the arousal scale before doing the next stroke. 

 

You can use your hand for masturbation practice alongside lube or oil. Please make sure not to use products with aggressive scents. Once you have practiced a while with your hand it makes sense to invest in an artificial vagina like a Fleshlight. The stimulation is going to be way more realistic and consistent. This way, your progress is easy to track and more closely represents real-life gains. 

Typically, I have seen that people have greater success if they don't ejaculate at the end of their practice. It's okay to ejaculate on that day. However, there should be at least an hour in between the end of your practice and your self-pleasure session where you allow yourself to ejaculate. 

You can translate all of these exercises to sexual activity as well. You just need to have an understanding and supportive partner which in reality is the exception, unfortunately. 

 

Slow and deep breathing

We usually breathe rapidly and shallowly into our chests when we get aroused. By breathing slowly and calmly in a way that our belly lifts we tell our body to stay relaxed. This way it's much easier to last longer. 

Practicing diaphragmatic breathing is a good starting point. 

Kegel Exercises

Kegels are not necessarily to increase the strength of your pelvic floor. Rather, these pelvic floor exercises are an important tool to help you to gain motor control over that area of your body. It's much easier to relax a muscle that you can contract. Doing Kegels will teach you. 

Here is a tutorial:

 

Psychological Treatment Options

Most people who suffer from PE also suffer from sexual performance anxiety. This is is when you experience stress, anxiety, or fear related to sexual activities or thoughts. The general approach here is to dissolve anxiety and build up a confident belief system. The most promising self-help treatment for premature ejaculation in that regard is Cognitive Behavioral Therapy (CBT). You can find the guide for this here. 

Additionally, stress and anxiety can be resolved through relaxation techniques such as:

  • Meditation
  • Diaphragmatic Breathing
  • The Physiological Sigh
  • Performance Visualization
  • Progressive Muscle Relaxation

I have covered all of them extensively in this overview. 

 

Approach PE systematically 

Realistically, you don't know what causes your PE and there are limited means to find that out. That's why it's vital to be strategic about your approach to self-treat your PE. You don't want to waste years on exercises that don't do anything. Usually it's best to track your progress and be persistent with a certain set of exercises or potential solutions for a set period of time (like one month). After you've completed this period you want to conduct a fair assessment whether you are seeing any improvements or not. If you see improvements than you continue and if not you move to the next thing. Then you iterate until you've found what works for. I wish you all the best on your journey to reclaim your sex life and sexual function. 

 

References

Gao, J., Zhang, X., Su, P., Liu, J., Xia, L., Yang, J., ... & Liang, C. (2013). Prevalence and Factors Associated with the Complaint of Premature Ejaculation and the Four Premature Ejaculation Syndromes: A Large Observational Study in China. The journal of sexual medicine, 10(7), 1874-1881.

Serefoglu, E. C., Cimen, H. I., Atmaca, A. F., & Balbay, M. D. (2010). The distribution of patients who seek treatment for the complaint of ejaculating prematurely according to the four premature ejaculation syndromes. The Journal of Sexual Medicine, 7(2), 810-815.Waldinger, M. D., McIntosh, J., & Schweitzer, D. H. (2009). A five-nation survey to assess the distribution of the intravaginal ejaculatory latency time among the general male population. The journal of sexual medicine, 6(10), 2888-2895.