The most common male sexual difficulty is premature ejaculation (PE) (Strassberg,

2007) . Almost all men ejaculate quickly during their first intercourse, which may be dis­appointing but should not be seen as a sexual problem unless it persists after more expe­riences. The International Society for Sexual Medicine defines premature ejaculation as a pattern of quick ejaculations (under one minute) combined with a man’s inability to delay ejaculation during vaginal penetration and with distress about or avoidance of sex­ual intimacy because of his rapid orgasm (McMahon, 2008). In general, approximately

Sexual Difficulties and Solutions

22% of sexually active men experience PE (Steggall et al., 2008), and about 30% of those men ejaculate early without a full erection (Lue, Giuliano et al., 2004). Research indi­cates that men with PE underestimate the intensity of their physical arousal, experience rapid high arousal to penile stimulation, ejaculate before reaching full sexual arousal, and report less enjoyment of orgasm than men who do not have problems with rapid ejaculation (Rowland et al., 2000). Some men with PE may also have penile hypersensi­tivity that contributes to their rapid ejaculation (Wylie & Hellstrom, 2011).