Why can’t I last longer in bed?

You may find it difficult to last as long as you would like during sex due to:

• premature ejaculation, where you regularly ejaculate sooner than you or your partner would like
• erectile dysfunction, where you cannot get or keep an erection for long enough to have penetrative sex

These may be linked to factors such as:

• performance anxiety, stress, and depression
• emotional trauma or a history of sexual abuse
• thyroid or prostate problems, which can affect your ability to have sex
• cardiovascular problems like high blood pressure and heart disease
• neurological conditions like MS or a stroke
• hormonal problems like low testosterone levels

How long am I supposed to last in bed?

Research into how long men last in bed has been limited and often focuses on heterosexual couples. One study of heterosexual couples in 2005 found that the average time between penetration and male ejaculation was 5.4 minutes. 

About premature ejaculation

Premature ejaculation is a condition that affects how long you last in bed, causing you to orgasm more quickly than you or your partner would like. 

Premature ejaculation is defined as ejaculation within 1 minute of intercourse starting, and it is estimated that it affects around 30% of the male population.

There are 2 types of premature ejaculation:

• primary premature ejaculation, where you have always experienced this
• secondary premature ejaculation (or ‘acquired premature ejaculation’), where you have only recently begun to experience this

There are many reasons why you may ejaculate more quickly than you want to. How you and your doctor treat your premature ejaculation depends on what is causing it.

Psychological factors which can cause premature ejaculation include:

• relationship problems
• performance anxiety
• stress
• depression
• conditioning around ejaculation resulting from sexual abuse, strict beliefs about sex, or early sexual behaviours like masturbating quickly to avoid getting caught

Physical factors include:

• problems with your thyroid or prostate
• taking recreational drugs
• having a particularly sensitive penis

Can my premature ejaculation be treated?

There is no permanent cure for premature ejaculation, but you can treat it. Treatments include behavioural and lifestyle changes, as well as medical options like tablets and topical numbing creams. The most appropriate treatment for you will depend on what is causing your premature ejaculation.

About erectile dysfunction

Erectile dysfunction (ED, also known as ‘impotence’) is the medical term for when you cannot get or keep an erection. ED impacts how long you can last in bed because if you don’t have an erection, you cannot have penetrative sex. It is very common, especially in men over 40. It is estimated that 50% of men have experienced erectile dysfunction.

Like premature ejaculation, there can be psychological and physical factors that cause ED:

Psychological factors include:

• anxiety
• stress
• depression
• relationship issues

Physical factors include:

• alcohol use
• recreational drug use
• smoking
• medications
• diabetes
• high cholesterol
• obesity
• heart disease
• nervous system conditions such as Parkinson’s disease and multiple sclerosis
• hormonal conditions such as a low testosterone level

Can my ED be treated?

Like premature ejaculation, you cannot cure ED, but you can treat it. Treatment depends on what is causing your ED. Your doctor may recommend lifestyle changes, sexual therapy,  medical options such as Viagra, or a combination of these.

Ways to last longer in bed

Before you try medication, your doctor will suggest several different lifestyle changes or techniques you can try to last longer in bed.

Diet & exercise

Improving your fitness and maintaining a healthy weight ensures your body is in good physical condition. Having good vascular health means fewer blood flow issues which can cause problems with erections and ejaculation. Reducing how much alcohol, red meat, sugar and full-fat dairy products you consume and eating plenty of fruit, vegetables, and whole grains are vital to having healthy blood vessels.

Doctors also recommend pelvic floor exercises for men as these muscles control ejaculation.

Sexual activity

Changing your sexual habits can reset what happens when you have sex if you suffer with premature ejaculation. To help you last longer in bed, you can:

• masturbate 1 or 2 hours before sex
• slow down when you have sex
• spend more time on foreplay and non penetrative sex
• try new things in the bedroom such as new positions
• ask your partner to go on top and to pull away when you are close to ejaculating 
• distract yourself while having sex
• try the ‘stop-start technique, where you stop just before ejaculating and wait until this feeling has passed before starting again
• use a thicker condoms, or condoms with numbing agents, to reduce sensitivity and prevent premature ejaculation

Therapy

Talking to a sex or relationship therapist can help you understand the issues contributing to how long you can last in bed. Therapy can help you communicate better with your partner, work through performance anxiety or relationship problems, and build self esteem. 

It is hard to prove the impact of therapy scientifically. However, a review in 2016 found that physiological interventions are a favourable treatment option as they address the actual issue and what is causing it.

Medicated treatments to help you last longer

There are medical treatments available to help you last longer in bed. The most appropriate treatment will depend on whether premature ejaculation or ED prevents you from lasting as long as you would like.

Treatments for premature ejaculation 

You can treat premature ejaculation with either tablets or cream.

Tablets

Tablets such as Priligy work by increasing the serotonin levels in your blood, which can lead to an increase in the length of time it takes you to ejaculate. The active ingredient in Priligy, dapoxetine, is an SSRI (Selective Serotonin Reuptake Inhibitor). SSRIs are usually used to treat depression but one of their side effects is that they can delay ejaculation, if taken 1 to 3 hours before sex.

Creams

You can also try a cream such as Emla Cream, which contains two local anaesthetics (lidocaine and prilocaine). Applying an anaesthetic to the skin of the penis reduces how sensitive it is and can slow down how quickly you ejaculate. A small amount of Emla cream should be applied to the head of the penis 15 to 20 minutes before sex. Remember to wash off any excess cream just before you have sex so it does not make your partner numb.

Treatments for ED

Treatments for ED include tablets, creams, and penis pumps. They only work when you are sexually aroused but can help you get and keep an erection that is hard enough to have sex.

Tablets

There are many different tablets for ED, all of which belong to the same group of medicines called PDE-5 inhibitors. These work by relaxing the blood vessels in your body and increasing blood flow to the penis so you can get and keep an erection.

ED tablets include:

• generic sildenafil and its well known branded version Viagra. Both start working about 30 minutes after you take it, and last between 4 and 6 hours. It has the best results if taken on an empty stomach.
• generic tadalafil and its branded version Cialis. Both start working in 30 minutes. The effects can last up to 36 hours, which is why it’s referred to as ‘the weekend pill’.
• generic vardenafil and its branded version Levitra. Both work similarly to sildenafil.
• generic avanafil and its branded version Spedra. Both work in 15 minutes and last about 6 hours.

Creams

Erectile dysfunction creams, such as Vitaros, relax the blood vessels in your body to allow more blood to flow into your penis. The active ingredient (Alprostadil) belongs to a group of medicines called prostaglandins. These relax your blood vessels in the same way as PDE-5 inhibitors in ED tablets do. 

Vitaros cream should be applied to the opening of the urethra using the applicator provided. Vitaros cream usually works within 5 minutes and lasts 1 to 2 hours.

Penis Pumps

Like the other ED treatments, penis pumps also increase blood flow to the penis. They can help you get and keep an erection. Pumps do not make your penis larger.

Penis pumps are less discreet to use than tablets or cream since you need to fit the pump over your penis and complete the pumping action for it to work. They may be suitable for some men who cannot use ED medication.