Kegels & Premature Ejaculation: What's The Story?
January 09, 2023
“Premature ejaculation” (also known as PE) is a bit of a loaded term. But it really shouldn’t be, since it is quite common: it affects nearly a quarter of all men in the US. And, sexual stamina is definitely a spectrum – so if you also factor in guys who don’t meet the technical definition for premature ejaculation (which is actually a bit vague but generally means involuntarily climaxing within 1 minute of beginning penetration) but are interested in improving their stamina and being able to better control the timing of climax / orgasm, the number gets a LOT higher.
But because some men find climax control challenges embarrassing, it’s particularly tricky for them to figure out how to deal with it. In fact, fewer than 10% of men struggling with this issue talk to their doctor about it. In this article we’ll look at some of the approaches that are commonly taken and their pros and cons, with a particular focus on pelvic floor / Kegel exercise (since doctors and PTs have identified that as a preferred approach for managing premature ejaculation and improving sexual stamina).
What Solutions Are Out There?
There are a number of approaches that are pretty common (besides Kegels, which we’ll dive into more thoroughly in the next section).
Drugs
There are currently no drugs on the market that are FDA-approved for premature ejaculation. But there are a few (prescription) drugs that are sometimes prescribed off-label (in other words, the FDA hasn’t approved them to treat PE but some doctors still think / have found that they can help in that context).
- Sertraline is an SSRI-class antidepressant that, in addition to depression, is also FDA-approved to treat OCD, panic attacks and PTSD, among other conditions (but NOT premature ejaculation). It is a daily pill and it comes with a laundry list of serious potential side effects (including seizures, abnormal bleeding, hallucinations, etc).
- The other main option is paroxetine, which is pretty much the same story: daily pill, FDA-approved as an SSRI-class antidepressant, prescribed off-label for premature ejaculation, another long list of potential side effects.
Numbing
Another common approach is to try to numb or deaden the nerves in and around the penis, which can delay climax. There are a number of creams, wipes and sprays on the market for this purpose. Generally speaking, they use a topical anesthetic such as lidocaine which is intended to reduce sensitivity (ideally without completely numbing all sensation). But again here, this is far from a perfect solution. There is an inherent tension present between wanting to delay climax and increase stamina on the one hand vs. wanting to actually enjoy the physical sensations that are a big part of what can make sex so great.
An example of benzocaine desensitizing wipes.
Psychological / Training
The last main class of non-Kegel solutions falls under the umbrella of psychology. Sex is, of course, a complex experience with both mental and physical components and addressing the mental side of things can definitely be quite helpful in trying to improve climax control.
As far back as the 1950s, techniques like the Start-Stop method were publicly proposed (the basic idea is to take a break when you feel like you may climax soon, then start back up when the moment has passed, so to speak). Another option is the Squeeze technique (where you apply a little pressure to the head of the penis when you feel like you are close to climax, which can reduce arousal).
There is also some preliminary evidence that Cognitive Behavioral Therapy (CBT) programs designed for improving ejaculatory control can help (although other research has been more skeptical, while acknowledging the need for further study). Overall, it is probably fair to say that psychological approaches can be helpful but obviously their power is limited in cases where physical causes are part or all of the issue. So their sweet spot is probably being used in addition to strategies that can address physical causes.
What About Kegels?
While, as mentioned, there are certainly men out there who the above options have helped, it seems clear there is room for improvement with each of them. Numbing undermines the feelings and sensory experience that is part of what makes sex enjoyable, drugs come with potential side effects and aren’t even FDA-approved for use with PE, and psychological approaches aren’t able to address the physiological aspects of stamina and climax control.
So the door is open for a solution that can avoid some of the tradeoffs with these other options and/or be useful as a complement. That is where pelvic floor, or Kegel, exercise comes in.
What Does The Pelvic Floor Have To Do With Stamina? Do Kegels Actually Help?
Climax and ejaculation is a surprisingly complex mechanism and one which science is still working to perfectly understand. It involves multiple muscle activations in multiple locations (including the prostate gland and urethral sphincter), but it is already known that the pelvic floor is a key piece of the puzzle.
Research has found that pelvic floor strengthening (Kegel exercise) can improve stamina in men struggling with premature ejaculation. For instance, this study found that 83% of the participants were able to improve how long they could last during sex before orgasm. And this meta-analysis (in other words, a review of other published research) found that pelvic floor muscle training should be “a preferred approach” for managing PE because it is “simple, safe and noninvasive”. On top of that, Kegel exercise is something that can be done privately and without involving others.
At the beginning of the article, we mentioned touching on both pros and cons for all of these approaches, and we’re not going to skip Kegels. There are two potential issues to be aware of. First of all, because climax control is a complex issue that usually involves multiple physical and mental aspects, Kegels are not guaranteed to work for everyone. But that is true for every option out there, and as evidenced by the findings in the research papers linked above, Kegels work frequently enough to be a go-to recommendation for many clinicians. And second of all, Kegels are similar to any other type of exercise in that it is possible to overdo it. In particular, if you have trouble with pelvic pain (especially if you were having pain before you even started doing pelvic floor exercises), that could be a sign of an overactive or high tone (overly tight) pelvic floor (you may have also seen this called "hypertonic"). In that case, Kegels are definitely not the right solution.
How Do You Do Kegels?
It’s quite simple. Imagine that you are peeing and then think about how you would stop the flow of urine mid-stream (without using your hands). Those muscles you just tensed are your pelvic floor muscles, and you just did a Kegel. It may also help to imagine that you’re trying to prevent passing gas at the same time, and to picture a squeezing-and-lifting sensation. Doing pelvic floor exercise is basically just doing Kegels repeatedly – there are lots of good routines you can follow in terms of how hard to squeeze, how quickly, how long to hold the squeeze, etc. but like we said, the basic idea is very simple.
In fact, it can be a little too simple – imagine if you were trying to stick with a workout routine that consisted only of squeezing and relaxing your hand into a fist… over, and over, and over, and over. One common problem for guys trying to do Kegels is boredom, which makes it hard to stick with a consistent routine. That’s where something like Boost can come in – Boost is a Kegel exerciser for men that is designed to make Kegels easier, more fun, and more sustainable.
Boost men’s sit-on-top Kegel exerciser.
It provides biofeedback (to help you know whether you’re doing the exercises correctly), exercise history data (to quantify and track your progress) and guided workouts / games (to help you get a balanced workout that isn’t boring). And, in contrast to many of the other tools for measuring Kegels, Boost does not use a rectal/anal probe to measure your pelvic floor muscle activity – you just place it on a chair and sit on top like a bicycle seat, keeping your clothes on.
The Bottom Line
Whether you want to call it premature ejaculation or just a desire for more stamina and ability to control your orgasm timing, this is a topic that impacts a LOT of men. There are a number of approaches that are commonly used to try to improve performance, but a lot of them (especially the physical ones) have some pretty significant drawbacks. Research has shown that Kegel exercise can be an effective tool for many men to improve stamina, and particularly because it is so simple and private, it’s definitely worth checking out (perhaps together with psychological techniques so you can address both the physical and mental side of sexual performance).
