Ejaculation is a reflex that involves the pelvic floor muscles - the same ones that hold urine. That means they can be examined and trained, and control over the timing of ejaculation grows with them. Studies of pelvic floor training in premature ejaculation show a significant increase in latency in a considerable proportion of patients.
Counter-intuitively, the problem is not always weakness. Very often it is the opposite: the pelvic floor works in constant excessive tension that the patient cannot feel, because it has been there for years. The first step is then not strengthening but learning to release - which is why therapy always begins with an examination, not with a set of exercises.
And there is a part no exercise replaces: tension and stress affect the reflex directly. Where anxiety and pressure are the main drivers, I say so plainly and refer to a specialist in sexual medicine - physiotherapy is then a complement, not the answer.
Therapy
- Detailed history
- Functional examination of the pelvic floor muscles
- Learning to recognise and distinguish muscle tension
- Control training - contraction and conscious release
- Work on breathing and whole-body tension
- Releasing an overactive pelvic floor
- A home programme
- Biofeedback and EMG