I am suffering from premature ejaculation…

I am currently suffering from premature ejaculation, a problem which is negatively impacting my sexual relationship with my wife. I wish I was a “minute-man” — I’m more like a “30-second-man”! I’ve been prescribed Paxil, which has helped, but I don’t like the way SSRIs make me feel, and I’d rather not become dependent on them for sexual function. At the very least, I’d like to start incorporating other techniques such as kegel exercises and edging in addition to medication in my attempt to treat my PE.The problem is that edging is just another term for masturbation, something that ranges from unquestionably condemned at worst to a gray area at best. I know you’re not my bishop and that you’re not a substitute for maintaining a prayerful relationship with God. I also know that God expects me to use every resource at my disposal, and I’d consider you one of those resources!

Do you have any thoughts/experience regarding masturbation being used as an exercise to improve your sexual relationship with your spouse?

It sounds like you have received some sound advice as to treatments for premature ejaculation (PE).  Everything you are trying and incorporating is right on track: SSRIs, kegel exercises, and controlled penile stimulation leading towards ejaculatory control.  

I assume you have had a complete physical to rule out any biological reasons that could be affecting your sexuality?  I always recommend this be the first step when it comes to any sexual dysfunction. 
You could also speak with your doctor about the possibility of using an anti-anxiety medication in addition to the SSRI.  During the initial treatment of PE I would encourage you to not be concerned about becoming dependent on medication.  SSRIs are not known to be habit forming and you may choose to decrease your use of them as you see progress in your PE treatment and gain in confidence.  I strongly recommend you go off your meds the same way you went on – with the oversight of your physician.  
As part of a comprehensive treatment for PE, I would also encourage sensate focus exercises, relaxation exercises and sex therapy to address any psychological issues (i.e. intimacy fears, unrealistic sexual expectations, sexual anxiety, body image issues, current stressors in your life, sexual cooperation between you and your wife, communication of emotion, sexual education, family/cultural/religious history, possible abuse history, etc.).  Some mental health disorders (i.e. generalized anxiety disorder, obsessive compulsive disorder, etc.) can exacerbate symptoms of PE – so those are important to rule in or out as well.  A sex therapist can offer guidance in relaxation skills and formulate a treatment plan incorporating tools you and your wife are most comfortable with which fall within the bounds of your value system.  I recommend you and your wife attend these sessions together (at least to begin with).  

Genital self and partner exploration exercises are encouraged for the treatment of a variety of sexual disorders for both men and women.  As a Mormon therapist, I am completely comfortable prescribing these types of exercises.  These are some reasons why:
  • These exercises have the specific purpose of enhancing and improving the overall sexuality of the marriage.  They are not being used for selfish reasons and are negotiated and agreed upon by both partners.
  • I believe in “relational sexuality” supported by the stance of the church that sexual behaviors be decided upon by marital partners in a way that is cooperative and comfortable (leaving out anything coercive, forceful or abusive).  If the couple jointly agrees that these exercises are in the benefit of their sexual future, then they have the physical and spiritual right to make this decision for themselves.  This falls under their marital stewardship. 
  • I encourage everything occurring sexually within a marital system to take into account the needs of both partners, to be open and disclosed – it is only when masturbation is done in secrecy or in disagreement that it can cause marital tension, a sense of betrayal and/or a disinterest in sexual unity.  
  • Your joint goal is to have a healthy, satisfying, bonding and pleasurable sex life.  Treating PE is part of the sexual journey you are both on towards that worthy goal.  So using treatment strategies such as masturbation, joint stimulation, medication, sensate focus, etc. is, as you well stated, the “resourceful” thing to do.  Not doing so would more than likely cause ongoing and unnecessary conflict, frustration and sadness for both you and your wife.

I encourage you and your wife to see your PE treatment as a sexual adventure and journey you are embarking on together.  I also encourage you to clearly see PE as the enemy, not each other.  This is neither one of your fault.  You may not have wanted PE as one of your trials, and that is understandable.  At the same time, going through this treatment will open up doors and possibilities within not only your physical intimacy – but your spiritual and emotional intimacy as well.  Ones you may not have otherwise experienced.  I wish you both the very best.

I would recommend the following book: Coping with Premature Ejaculation by Michael Metz and Barry McCarthy. 
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