I hear from men who had no worries about lasting in bed. They felt confident, they felt in control. One guy recently said he could pretty much decide when to finish.
And then something changed. One day, they came quickly, and then it happened again. It keeps happening and they can’t get back in control.
These men are experiencing acquired premature ejaculation, and they can’t seem to unacquire it
What causes acquired PE?
First things first – if this is you, I’d recommend a medical checkup just to rule out any prostate problems. Cover that off.
But when premature ejaculation shows up suddenly, we’re most probably looking at a psychological cause.
Also, how about masturbation or receiving oral sex? Does the problem show up then? Often it doesn’t, or not so much. This also points to a psychological cause.
Some kind of reflex response to intercourse has developed. Maybe to the sensations of intercourse, or a heightened sense of performance pressure.
So what was going on at the time? A new partner perhaps, or some significant change going on in our lives? Any recent trauma or stressful event?
Often the answer is no. Everything was business as usual, I just suddenly couldn’t last in bed.
As a psychotherapist, I’m here to tell you that acquired PE is common
And it’s weird and frustrating, and a bit scary, I know. Unwanted mind-body changes can occur, out of the blue.
Take sportsmen suddenly developing the yips, for example. One day they can’t perform, they’re all anxious in the moment. And they expect it to happen next time.
And sex can feel like performance pressure, which absolutely doesn’t help.
Other bodily functions too. A common one is a choking incident, or just feeling like we’re choking or a crumb going down the wrong way. We recover really quickly. It’s no big deal until we try to eat again and our throat closes up, and the next time and the next.
Erections too. We had trouble getting hard for some non-obvious reason and it happens again the next time, and becomes a thing.
This is all thanks to your fight-flight-freeze response
In the moment the unexpected thing happens, the amygdala – the part of the brain looking out for threats – says ‘oh, that was bad and unexpected – I’m going to freak out if we find ourselves in this situation again. Sorry about that, boss. I’m just doing my job protecting you.’
So it happens again the next time – we ejaculate almost instantly or we go soft or can’t function – and we start to expect it. We dread it. What’s my partner going to think?
Anticipatory anxiety plus a freaking out amygdala is never optimal for satisfying sex.
That’s why reversing this, changing the expectation, isn’t just a matter of mind-over-penis. Our brain has learned to pattern-match penetration – specifically penetration – with ejaculating quickly.
What’s the best treatment for acquired PE?
My recommended approach is gradual relearning. Incrementally creating a new expectation without putting yourself under pressure.
In many ways, this is similar to how we treat lifelong PE. Gradual reacclimatisation to penetration, along with relaxation of your pelvis and lower body.
Some solo training can help here: self-stimulating in a relaxed state. But we know that masturbation is probably fine already.
So using a toy, a Fleshlight or a MyHixel device that can emulate penetration, is helpful. Especially with some heating and lube and some thrusting movement. We want to feel that triggered response just a bit, in order to get past it.
Take your time with this. Your amygdala unlearning the freak-out response is a process. It’s a matter of ‘oh, it’s that scary, stressful situation again but I’m OK and oh look I’m doing a bit better this time… maybe this can continue‘. This is how we rebuild confidence.
And your previous experience of control and the old ‘muscle memory’ might kick back in. But it needs to happen organically and without stress. So treat training as an experiment rather than a concrete goal.
Keep having sex too
Sex with your partner that doesn’t treat intercourse as the main event. This also helps relieve that pressure and expectation.
Guys don’t like this idea, I know. ‘It’s not proper sex if we’re not going at it‘ – but it really can help. And you broaden your sexual repertoire and pick up some new tricks in the process.
So yes, PE can show up suddenly. But don’t have nightmares – it’s perfectly treatable. See my self-help course and my other videos for more lasting longer advice.
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