Because premature ejaculation is associated with infrequent sex, men with low frequencies of sexual activity often get extra excited and aroused, which can manifest as performance anxiety when sex presents itself.

What is the No. 1 sexual issue that men face today? OK, the guy who said finding a sexual partner wins

- By Dr. Hernando Chaves

I will give you that one. What’s the second then? Chances are most of you said premature ejaculation and most of you likely had a reaction to that term -- you felt some anxiety or thought about clicking back to your streaming porn that’s taking forever to download. It’s time to stop avoiding the issue and look at it. Why? For the simple reason that we only live once and having the best possible sex life should be an item on our bucket lists.

The Diagnostic Statistical Manual of Mental Disorders (DSM IV) defines premature ejaculation as a persistent or recurrent ejaculation with minimal sexual stimulation before, on or shortly after penetration and before a person wishes. Wow, that’s not a sexy definition. Personally, I define it as you come quicker than you or your partner wants.

How often does this occur in different age groups for men? According to the 1999 NHSLS survey by Laumann et al., 30% of men ages 18-29, 32% ages 30-39, 28% ages 40-49, and 31% ages 50-59 stated climaxing too early was an issue. I know some of you were hoping age would slow things down. If men were asked if they’ve ever had at least one experience of premature ejaculation, almost every guy would get in line for their membership card.

What causes premature ejaculation? There’s not one cause; it’s a combination of factors. Some believe anxiety is the culprit, repetitive learned behaviors, excessive or insufficient arousal, or muscular tension. They’re all associated, and addressing each of them is the key to curing premature ejaculation. Evolutionary psychology suggests men learned to ejaculate quickly to ensure they completed the sex act before a predator attacked, a female escaped, a male interrupted, or to increase the chance of procreation. Maybe we can blame the cavemen? For our purposes, let’s leave the scientists to figure out the causes and let’s focus on tips for curing premature ejaculation.

Premature Ejaculation: Anxiety Reduction

Let’s start with what we can do before our penis comes into play. First, you need to learn to calm yourself down and lower your performance anxiety levels. Because premature ejaculation is associated with infrequent sex, men with low frequencies of sexual activity often get extra excited and aroused, which can manifest as performance anxiety when sex presents itself. Even men with frequent sex can get extra aroused. Reducing anxiety is different for everyone. Meditation, hypnosis or imagery exercises may help for some. Just like an athlete works with the sports psychologist to envision their performance, you can do the same sexual imagery for the bedroom. How many of you imagine positive sexual scenarios, envision your interactions and what behaviors you would engage in? Imagery can be like a positive mental plan, something you can fall back on that can help you manage your anxiety beforehand -- and in the moment.

Communicating your anxiety is also helpful. We hear the expression, “a big relief to get that off my chest,” yet it’s rarely used for premature ejaculation. Talking with a partner, friend or therapist opens the door for anxiety relief and can help address and alleviate some of our fears. Men are notorious for keeping things inside and it’s no different for a delicate subject like this. Things like our penis size, body image, relationship difficulties, and stressors in life (work, financial, family, health) can all add to our anxiety levels in the bedroom. Lastly, pick up some sex education books/DVDs on sex technique and sexual expression. There are thousands out there and the more sex education you have, the more competent, confident and less anxious you’ll feel.

At first, masturbate alone using the start-stop method, then use it during partnered manual stimulation, hand job

Premature Ejaculation: Pelvic Muscles

Ever notice the tension you feel in your body? Men are less likely to find ways to release pelvic tension. Often, men are engaged in actions and behaviors throughout their lives and during sex that reinforce muscular tension. During sex, if you’re holding your breath, flexing your abs and muscles, or supporting your weight in certain sexual positions (missionary), you’re creating muscle tension that increases the potential for premature ejaculation.

The classic example is men who tighten their muscles as they push out their erection to feel and appear larger to their partner. Since orgasm is muscular contractions that release muscular tension, it’d be wise for us to work on our muscle tension levels. Activities like yoga, stretching, anxiety reduction skills, and working out are all ways to decrease the tension in your pelvic and abdominal regions outside of the bedroom.

I also recommend you allow your partner (or masseuse) to give you a full body massage. Be mindful of the performance anxiety you experience and the tension release you feel as they touch your stomach, your thighs, your buttocks, and other areas of your body. It’s not about genital stimulation; it’s about managing the discomfort we may feel with our bodies, being touched and feeling exposed. Men that are comfortable with their body image and with being touched often have lower ratings of sexual anxiety.

Another important technique to lasting longer is doing Kegel exercises. If you haven’t tried them, what are you waiting for? There’s no better method to strengthen your pelvic region and to create strong pubococcygeus muscles. One of the reasons Peyton Manning and Tom Brady are two of the great quarterbacks in the NFL is because they spend thousands of hours watching game films to prepare for the game. What are you doing to prepare for sex? You can’t expect greatness if you don’t put in the time.

Premature Ejaculation: Start-Stop Method

The start-stop method is a tested method to learning ejaculatory control and lasting longer. A male will stimulate his penis until he is ready to have an orgasm and then cease stimulation. Why this self-administered torture? You’re training yourself to find when your ejaculatory inevitability occurs, or your point of no return. This is the moment before orgasm when you’re about to explode. Instead of ejaculating, you refrain from stimulation and allow the feeling of orgasm to subside. People will often squeeze their PC muscles (a Kegel contraction) to help hold back orgasm and ejaculation. Essentially, you’re teaching your mind and body to get comfortable with being in heightened states of arousal and learning when the onset of orgasm approaches. The goal is to stretch out the plateau phase of the sexual response cycle and put more distance between the excitement and orgasm phase. People will do the start-stop method repeatedly for months and most gradually notice changes in their control, duration of maintained stimulation, and their anxiety and confidence levels. At first, masturbate alone using the start-stop method, then use it during partnered manual stimulation (hand job), fellatio (blow job) and, finally, incorporate the start-stop method with intercourse.

Masturbation is the best practice for sex

Premature Ejaculation: Masturbation

Masturbatory patterns are a form of learned behavior that often need to be unlearned. Most guys have a fast-track orgasm approach to masturbation. Whether it’s because mom always knew the worst time to knock on your door, or your decision to rub one out fast when stressed, we often train ourselves to be quick on the orgasm trigger. You need to change this masturbation mentality of goal-oriented orgasm to one that focuses on taking your time and getting comfortable with heightened sensations. Masturbation is the best practice for sex. Instead of racing to orgasm, take at least 20 minutes of masturbation time before allowing yourself to ejaculate. During this time, you’ll focus on the start-stop method and penile stimulation of the shaft and glans (head). The glans are generally the most sensitive areas of the penis and is continuously stimulated inside the vagina. However, most men masturbate using an up-down stroking motion of the shaft and neglect glan stimulation.

Start off your 20-minute stroking without lube and just your imagination. In future masturbation sessions, work up to imagery and lube, and then incorporate an adult magazine without lube, an adult magazine with lube, porn without lube, porn with lube, and eventually porn with lube and a sex toy. What kind of toy? Anything that will mimic vaginal stimulation, such as a tenga egg, penis sleeve or artificial vagina will suffice it. Each of these likely have internal ribbed and studded portions that offer heightened states of stimulation, which you will learn to enjoy and control. Any of these toys can be ordered online and delivered if you’re uncomfortable buying them in person. This gradual increase in stimulation that you can manage, sustain and control will eventually be transferred to sex with a partner.

Premature Ejaculation: Sex Positions

Who would’ve thought the positions we have sex in can impact premature ejaculation? Oddly enough, the most popular position in the U.S. is male superior (missionary), which is also the position associated most with premature ejaculation. This is because muscular tension is increased as the male is supporting his body weight with his arms and core strength. For a male looking to cure premature ejaculation, utilize positions that limit muscular tension such as female superior (female on top), side-to-side (spooning) and rear entry (doggy style) when both partners are on their knees. Incorporate deep breathing with these sex positions to keep the blood and oxygen circulating.

Premature Ejaculation: other treatments

Personally, I think desensitizing creams are a short-term fix. Why would you want to reduce your sensation? Isn’t the whole point of sex to feel sensation and find ways to enhance this? Condoms have similar desensitizing aspects but at least protect you from STIs and pregnancy. Ejaculating before intercourse is another way to last longer. The more times we ejaculate in a sexual experience, the longer lasting we become and less semen we produce. Lastly, some MDs are prescribing psychotropic medications known for their sexual side effects of delaying ejaculation. Interesting -- you last longer and feel less depressed or anxious.

Manage Premature Ejaculation

Most of you can eradicate premature ejaculation in a few months if you stick to your program. There are a lot of self-help books, videos, therapists, and sex coaches that can help you through this process. One issue with training yourself to last longer is that once you start lasting longer it’s difficult to go back to quickies. But, I guess most of you can live with long sessions of intense sensation, arousal and partners screaming your name in ecstasy. It’s a decent trade-off.

Advantages of Dating After 40

- By Lisa Firestone

On Dec. 31, 2009, one day before the baby boomer generation turned 65, a New York Times article reported, "79 million baby boomers, about 26 percent of this country's population, will be redefining what it means to be older."

Today, in 2013, this statement may be proving to be true. The healthier, harder working and simply younger-seeming face of middle age and senior men and women is something worth acknowledging. And a generation that refuses to take on the stigmas of old age and give up vital aspects of themselves in the process? Well, that's something worth celebrating.

One of the worst of these stigmas is that a person can be "too old to fall in love." The 2009 census showed that of the 96 million Americans who are single, 17 percent of them are over 65. Imagine these 16.2 million people writing off the possibility of spending the rest of their days with someone they love. Then picture the millions more 40- and 50-something men and women who are buying into the belief that it's just too late for them to be in a happy, fulfilling romantic relationship.

When it comes to dating later in life, the scene is far from hopeless. A 2003 AARP survey of 3,501 single men and women aged 40-69 showed that 63 percent were dating. An additional 13 percent wanted to find a date, while 14 percent were interested "if the right person happens to come along." Almost half of those surveyed stated that their main reason for dating was "to have someone to talk to or do things with." Companionship is incredibly important at every age. The better we know ourselves, the better able we are to choose partners who complement us and enhance our daily lives. Thus, there are certain real advantages of dating after 40, 50, or any age in which you are able and willing to reflect on your years of experience and genuinely learn from your past.

One benefit of dating after 40 is that by this age, most of us have had a variety of experiences in at least one serious relationship. This gives us the opportunity to reflect on our patterns. We can think about the people we have chosen and question the traits we are looking for. We often wind up with the same kind of partner in the same kind of relationship -- without even realizing how we got there. An important concept to keep in mind when dating is that we aren't always attracted for the right reasons. Relationships tend to fail when we seek out and pair up with people whose defenses and negative characteristics perfectly complement our own.

When it comes to pursuing a romantic relationship, we don't have to act automatically or get stuck in old patterns. We can resist falling into a relationship based on form or familiar dynamics, choosing a real connection over what my father psychologist and author Robert Firestone refers to as a fantasy bond, an illusion of fusion in which two people seek a feeling of safety and familiarity by choosing people who fit with old identities. Couples in a fantasy bond tend to merge their identities, relating as a unit instead of two independent individuals

By understanding our history, we can make a conscious effort to make different choices, to look for new kinds of partners, and to challenge destructive tendencies in ourselves. It's no wonder that in the same AARP survey both men and women listed their biggest romantic frustration as "dating people with a lot of baggage." The more we are willing to look into our own emotional baggage and uncover our real selves, the more successful we will be in our intimate relationships.

As we get to know ourselves, we are certain to find out things we don't necessarily like that hurt us in past relationships. Clients of mine often recognize in retrospect ways they were overly controlling, jealous, passive, or victimized in their marriage or a serious relationship. They've also learned a great deal about the people they've chosen. Many of us tend to be drawn to partners who recreate familial dynamics from childhood. We may choose people who treat us in ways that were similar to how we were treated in our household. We may choose someone who doesn't respect or acknowledge us or someone who is intrusive or demanding toward us. When we accept the fact that some of the people we're attracted to aren't always the ones who treat us the best, we are better able to be open to people who are different from our "type."

A woman in her 50s realized that her whole life she'd only dated men who were unsuccessful, struggled financially, and who she somehow wound up supporting. This dynamic fit with her identity growing up: Her father had called her "the son he never had" and pressured her to become a self-reliant businesswoman. Meanwhile, he himself drove the family to bankruptcy with his own corrupt business practices. The woman's feeling that she needed to "take care" of a man was deeply rooted in her past. When she finally dated a man who was self-sufficient and supported himself, she actually felt insecure, as though she were no longer needed. However, by becoming aware of this tendency in herself, she was able to break the pattern and achieved happiness in her relationship.

After seeking the same sort of partner for years, it can be difficult to tell if we are attracted to someone for the right or wrong reasons. One helpful approach is to enlist the help of friends. Another advantage of dating later in our lives is that, by now, we usually have at least a small network of solid, longtime friends who we really trust. Sometimes our friends are more aware of our negative tendencies than we are.

Try taking your friends' advice on who you should date. If you're looking into online dating, try going out with someone your friend suggests. Years ago, a friend of mine in her late 60s refused to go out with a highly interested bachelor she was introduced to on Match.com. She wrote him off as "too persistent, too formal," and even "too old." Eventually, she allowed another female friend of hers to talk her into accepting a date with the man. Despite her initial resistance, she couldn't deny that her friend was right. The man made her laugh, made her happy, and she's enjoyed her relationship with him ever since, experiencing more emotional closeness than ever before.

One downside of dating later in life is that we tend to use our negative past experiences to color our outlook on relationships in general. No matter how many "insensitive losers" we think we've dated, that does not mean every man or woman out there is another "insensitive loser" waiting to be unmasked. When we enter the dating world, we should expect to have countless "critical inner voices" toward ourselves and our potential partners. These negative thoughts may tell us we are too old or that it's too late for us, that love is not for us, or that we are not attractive anymore. Our "voices" about our partner or potential partner may include thoughts like, "All the good ones are already taken," or "There must be something wrong with him/her," or "He/ She is only interested in you for security."

These thoughts must be acknowledged and challenged whenever they arise. Don't succumb to critical inner voices about yourself or the people who might make you happy. Don't be quick to put yourself down or pick your partner apart. Instead, take chances and tune in to how you feel in your heart, instead of tuning in to the running analysis in your head. The online dating world in particular opens up the doorway to meet new people; however, be careful to avoid the allure of the critical voice telling you that there is always something better out there instead of making it work with someone who you could have a real connection with.

The best case scenario for any relationship is for two strong, independent people to get together and truly enjoy each other. When you date later in your life, you're often forced to acknowledge that both you and your partner have your own separate, adult lives. You may even have two families, two sets of children, etc. You can use this reality to exercise respect and patience with each other as autonomous individuals. In this way, you can become close while maintaining your separate identity. While it may feel like there is more pressure to find someone the older you get, some of the pressure is actually off. You may no longer be feeling the societal pressures of looking for a spouse, having kids, or seeking financial support. Instead, you are simply looking for true companionship -- someone who makes you happy, a person you enjoy spending your time with.

When we do find someone, it's valuable to remember that all close relationships stir up existential fears. When we value another person, we value life more, and it becomes much more frightening to think of losing it. When we are older, more of these fears naturally tend to arise. Yet, we can use this reality to be even more present in the moment and to enjoy and appreciate the preciousness of the time we have with someone we care for. We can experience the real joys of life and uncover more aspects of ourselves.

Anxieties about getting older make it all too easy to succumb to the stereotype that love is for kids. It is neither foolish nor undignified to be in love at any age. Love actually helps us live longer. It brings us out of our shell. The part of us that wants to connect with someone else is always alive within us. It doesn't burn out or fade away. The more we develop as individuals and discover new aspects of ourselves, the better able we are to be close to someone else. Because of this, it is truly never too late to fall in love.

Psychology expert on relationships, parenting, self-destructive thoughts and suicide; author, 'Conquer Your Critical Voice'

Dating After 50: Should Secrets Be Revealed?

- By Renee Fisher - July 09, 2013

Science has proven that an overwhelming number of people who choose to enter the dating world after age 50 have already lived at least 50 years. And, if they are like most people over 50 (and many people under), some of their early choices in life, while not resulting in a life term in a maximum security prison, may still fall under the category of "Actions I Took Which May Have Been Beneath My Highest Possibility."

Unless you have perpetrated crimes against humanity as a youthful despot, your behavior is more than likely not a matter of public record, and the indiscretions you may have involved yourself in years ago may now be causing you a bit of conflict. Just how much do you reveal to a new partner? A few readers asked me this very question and below, you'll find their questions as well as my advice in reply:

As a very broke and self-supporting 20-year-old college senior, I donated my eggs in exchange for money. It was a horrendous experience, and I rarely speak about it. Although I assume that some children resulted, I regret my participation and do not wish to know the results. I am now 35, engaged and planning to start a family. Must I tell my fiancé that there may be teenagers walking around with my genetic material?

We suggest you not tell your fiancé. However, we do suggest that in another 15 or 20 years or so, you check in with all these offspring. There may be someone among them with the financial resources to care for you in your declining years, especially if the children you produce with your fiancé turn out to be slugs.

A friend tried stripping at a "gentleman's club" when she was just out of college to earn some quick money before starting law school. It was 30 years ago, but she still cringes (she's since become a women's rights attorney) at the memory and isn't eager to reveal this little blip in her career path to her new boyfriend. Is she wrong?

First of all, cut out the "friend" crap. We know it's you. And the boyfriend of a women's rights attorney is no less deserving of seeing his girlfriend clad in pasties and a G-string sliding upside down on a pole than some sweaty drunk with crumpled dollar bills in his paw.

Back in college, I had an affair with my instructor. Should I reveal?

Unless your grade went down even further after the affair, you can reveal this.

I have a large tattoo of Bill Clinton on my butt. Should I have it removed?

Not before you post it on Facebook.

I briefly dated several men at the same time and was having sex with all of them. What, exactly, should I reveal?

If you had sex with them individually, nothing. If it was a group situation, do you have photos? If so, please send them to this writer and a determination will be given.

In college, I once went out and ordered a glass of beer. I was underage, but the bartender didn't ask for ID. I drank the beer.

If this is the worst thing you have ever done, we suggest that you repeat your first 50 years.