Cold vs Flu

Relieving Symptoms: Self-Care for a Stuffy or Runny Nose

For most cases of a stuffy or runny nose, symptom relief is the main treatment. Here's how to keep your nose healthy, and how to get relief when it's not:

Use a saline nasal spray or rinse to keep your nose moist. They've been shown to significantly reduce nasal symptoms and may help make your nose more resistant to irritants and bacteria. Read this tip for more on nasal irrigation.

Drink plenty of fluids. Staying well hydrated will help keep the lining of your nose and sinuses moist, in good working order, and less susceptible to infection.

Use a humidifier to keep the air -- and your nose -- moist. But make sure your humidifier stays clean and free of fungus, which can aggravate a stuffy or runny nose.

Avoid irritants or triggers and stop a runny nose before it starts. Smoke, dust, pollen, and animal dander are some of the most common culprits.

Consider using vitamins, minerals, and herbal remedies to help prevent or shorten colds. Find out what works and what doesn't.

Relief for a Stuffy Nose (Congestion)

Steam away stuffiness. For temporary relief of a stuffy nose, take a hot shower, or put the kettle on for an old-fashioned steam inhalation. Steam helps shrink the swollen mucous membrane and promotes drainage. Add menthol or eucalyptus if you like, but the jury's still out on whether they help. Some studies suggest the cooling sensation of menthol creates the feeling of breathing more easily, even if it doesn't reduce congestion.

Get a little exercise if you feel up to it. Exercise acts as a natural decongestant by triggering the release of adrenaline, which narrows swollen blood vessels, including the ones blocking your nose.

Try a decongestant medication. Over-the-counter oral decongestants may help relieve a stuffy nose. Nasal decongestant sprays may also provide temporary relief, but if they're used for 3 days or more, they can actually increase stuffiness, so don't overdo it.

Consider a decongestant/antihistamine combination. Some studies suggest these combo medications may relieve congestion, but other studies report no evidence that the medications are effective. Talk with your doctor about whether a decongestant/antihistamine combination is right for you.

Relief for a Runny Nose (Rhinorrhea)

Blow gently and frequently to help your nose remove excess mucus. If your nostrils get chapped and sore, apply a little petroleum jelly.

Try an antihistamine, but only if your symptoms are caused by allergies. Studies show that antihistamines on their own do little, if anything, to stop a runny nose caused by a cold, nonallergic rhinitis, or sinusitis.

Consider a decongestant/antihistamine combo if your symptoms are making you very uncomfortable. These combination medications tend to be more effective at relieving a runny nose than antihistamines alone, and some are available over the counter. Talk to your doctor about whether a decongestant/antihistamine combination is right for you.

Finally, to avoid spreading or picking up germs, wash your hands thoroughly and frequently, and use tissues instead of a handkerchief.

Check out these other natural allergy remedies to help relieve your seasonal allergy symptoms.

The No-BS Guide to Boosting Your Immunity and Avoiding the Common Cold

The runny nose, hacking cough, sore throat, headache—it's no wonder people resort to all sorts of absurd remedies to cure the all-too-common cold. We talked to experts to get a better idea of the tried-and-true things that actually work, and got a stuffy-nose full of commonly held myths that you should avoid.

Yes, you could keep buying into those sketchy cold remedies at the drugstore this cold season, but rather than throwing money away on unproven snake oil, stick with the health measures that doctors agree will decrease your cold potential. We spoke with infectious disease physician Dr. Amesh Adalka, ER doctor John Shufeldt, and nutritionists Joshua Duavuchelle and Trudy Scott to uncover the proven ways to fend off a cold.

What Works: The Indisputable Basics

Who better to ask for cold prevention advice than a doctor? Besides specializing in healthcare, these are the people at the frontline of germ attacks. So how do they manage being exposed to all of us sick people day after day without taking hundreds of sick days every year? It's pretty simple:

1. Get Sufficient Sleep

Little wonder lack of sleep and sickness are tied together: You haven't had enough rest, so your mind and body are taxed and you just can't function properly (in fact, you might as well be drunk according to one study). Poor sleep has been clearly associated with an increased susceptibility to illness: In a study published in Arch Intern Med (and cited by Eric Barker's personal blog Barking up the wrong tree, of the 153 healthy people given a rhinovirus (the predominant cause of the common cold), those who slept fewer than 7 hours were almost three times more likely to develop a cold than those with 8 or more hours of sleep. Just one hour's difference! Demographics, body mass, health practices, and other factors were ruled out in this study; "feeling rested" also had no association with developing a cold, so you do needactual sleep.

Dr. Amesh Adalja, a board-certified infectious diseases physician, listed sleep at the top of his three things to do to prevent a cold, saying decreased sleep efficiency or duration leads to a greater likeliness of catching a rhinovirus infection. So, seriously, make sleep a priority.

The other two basic cold prevention tactics that Dr. Adalja and other doctors said really work:

2. Wash Your Hands Often

Unsurprisingly, all of our docs recommended hand washing. WebMD reports that "about 80% of infectious diseases are transmitted by touch" and notes that "Operation Stop Cough," which had military recruits wash their hands at least five times a day, reduced cases of respiratory ailments by 45% simply through hand-washing.

Dr. John Shufeldt, an Arizona ER physician and founder of MeMD, told me that:

Most cold and flu viruses are spread by direct contact and something as simple as sneezing into your hand and then touching your phone, a doorknob or keyboard. These germs can live for hours, in some cases weeks, only to be picked up by the next person who touches the same object. Washing your hands often or at the minimum using an alcohol-based hand sanitizer will help knock out the majority of cold germs.

This might sound really obvious to you, but research shows a majority of college students and adults have poor hand-washing habits: 47-60% of the 3,000 US and Canadian adults surveyed sometimes skip soap when washing their hands, and nearly a quarter don't wash their hands after coughing or sneezing. When we looked at how to wash your hands correctly, one doctor cited a study where 45% of college students neglected to wash their hands at all after using the bathroom. Gross. If you needed motivation to wash your hands several times a day, just think about those people.

Dr. Adalja recommended washing your hands several times a day, singing the "Happy Birthday" song twice while you're at it, and avoid touching your face.

3. Don't Smoke or Drink

Yup, more reasons to ditch your favorite vices: Cigarettes and alcohol are associated with greater likeliness of catching a cold—and colds that last longer and are more severe, to boot. Dr. Schufelt notes that:

Even exposure to smoke profoundly zaps the immune system, drying out your nasal passages and paralyzing cilia (delicate hairs that line the mucous membranes in your nose and lungs whose movement sweeps cold and flu viruses out of the nasal passages). *One* cigarette can paralyze cilia for as long as 30 to 40 minutes.

Alcohol dehydrates your body, and cold germs love that dry environment. This leads us to the fourth thing that can help you avoid a cold:

Tier Two: The Little Things that Help

The three previous techniques are without a doubt the most important to keep in mind, and according to our experts, they're your best bets for steering clear of the common cold. If you're looking for a few more simple and helpful options, try these next four options.

4. Get Steamed Up and Moving

A 1989 German study found that people who steamed up at a sauna or spa twice a week got 50% fewer colds than those who didn't steam, Dr. Schufelt said. Perhaps it's because cold and flu viruses can't survive in air hotter than 80 degrees.

In a recent study involving 1,000 people, those who exercised for at least 20 minutes five or more times a week—with exercise intensive enough to break a sweat—nearly halved their chances of developing a cold:

People who were physically active on five or more days of the week were unwell with a cold for about five days of the three-month period, compared to nine days for those who did little or no exercise.

And even when they were ill, they suffered less with their symptoms.

Joshua Duavuchelle, a nutritionist and health writer, suggests combining the power of exercise with a warm, moist environment: e.g., Bikram ("Hot") Yoga.

5. Eat Chicken Soup

The age-old chicken soup cure is one of the most popular home remedies for fighting the common cold, with ingredients possessing anti-inflammitory effects, according to University of Nebraska Medical Center research labs, but can it stop a cold from taking over your body in the first place? Yes and no, said Duavuchelle. While studies haven't focused specifically on their preventative aspects, chicken soup has a lot going for it: hydration, heat, and, often, garlic, which has been cited in one small study as potentially boosting the body's immune system; garlic's active compound, allicin, may have helped reduce the incidents of colds for those of the 146 participants who took garlic daily for three months. So while there's nothing particularly special about chicken soup in and of itself, a bowl of soup never hurts.

6. Get More Sunshine or Vitamin D

During the winter, our vitamin D levels tend to drop, thanks to our cold season cave-like habits. Trudy Scott, nutritionist and president of the National Association of Nutrition Professionals, said that getting your vitamin D levels tested and supplementing if you have a vitamin D deficiency is vital to strengthening your immune system. Because sunshine is most people's main source of vitamin D, look to other sources like eggs, salmon, shrimp, and milk or orange juice fortified with vitamin D.

7. Get a Massage

Any excuse to get a massage works for me, so here's a new one: treating yourself to a stress-relieving massage can help prevent a cold. Dr. Adalja said that massage therapy as a stress reliever could have some benefit in enhancing the immune system, especially since psychological stress is known to increase risk of catching a cold (a study published in 1991 by Carnegie Mellon University concluded that the risk of catching a cold was related to the person's degree of stress; in a follow-up study, people with chronic stress, in particular—stress lasting at least one month— were more likely to catch a cold than those with acute stress).

Relaxation "activates the interleukins in your immune system, leaders in the immune system response against cold and flu viruses," Dr. Schufelt added.

What You Might Think Works But Probably Doesn't

At this point, chances are you're not completely surprised by what actually helps you avoid the common cold. Basically, if it's known to keep you healthy in general, it'll also keep colds at bay. Getting sleep, exercising, laying off the extracurricular substances, and getting a handle on stress will go a long way toward keeping the sniffles at bay. What are we wasting our time and money on?

Basically, except for the basics above, nothing has been undisputedly proven to help reduce the risk of getting the sniffles this season, according to Dr. Adalja and the other medical experts.

As USA Today notes, this includes:

• Vitamin C: The jury is still out on Vitamin C's role against colds; a review of studies with 11,000 total participants found 200mg or more of vitamin C a day didn't reduce the risk of getting a cold, though it reduced the duration by just a few hours.
• Echinacea: Likewise, studies are mixed for echinacea, possibly due to differences in the echinacea plants used and their preparation. The largest study of echinacea found a placebo worked as well as the herb for preventing a cold.
• Zinc: A recent review of 15 studies did find zinc lozenges or syrup can shorten colds by one day if the person takes the zinc within 24 hours of getting cold symptoms. However, the quality of the studies has been questioned and further research is still needed. Duvauchelle points to a meta-analysis published in Oxford's "Clinical Infectious Diseases" medical journal; over 14 placebo-controlled studies of zinc combatting the common cold, 7 showed positive effect and 7 showed no effects.
• Saline nasal spray: Can provide relief from congestion, but won't make a cold disappear or keep from invading your body.
• Over-the-counter cold medications and antihistamines: As with saline spray, they might make you feel better, but won't prevent a cold or shorten how long a cold lasts.
• Antibiotics also don't work on colds, because a cold is a virus while antibiotics only work on bacterial infections.
• Increased exposure to people with colds: I wondered if doctors and other people who are often around sick people (e.g., teachers) build up their immunity by exposure, but Dr. Adalja said, not really. There are too many variants of the cold virus that you couldn't really build your immunity to all of them.

Some may swear by tactics above, and while there's something to be said for feeling like you're doing something to help, the results of studies for these preventive measures and remedies are at best uncertain.

So, I say to you once again: Get a decent amount of sleep, wash those hands, and relax (I'll take massage, thanks!). Doing so will pay off in more ways than one this cold season.

---

Dr. Amesh A. Adalja is a board-certified infectious diseases physician and clinical assistant professor at University of Pittsburgh Medical Center.

Dr. John Shufeldt is an Arizona ER physician and founder of MeMD.

Joshua Duvauchelle is a health writer and consultant who specializes in helping clients achieve their lifestyle goals in well-being, fitness and diet. Duvauchelle holds a nutrition certificate from Cornell University.

Trudy Scott, Food Mood expert and Certified Nutritionist, is President of the National Association of Nutrition Professionals and author of The Antianxiety Food Solution.

Chiropractic: An Introduction

Chiropractic is a health care profession that focuses on the relationship between the body’s structure—mainly the spine—and its functioning. Although practitioners may use a variety of treatment approaches, they primarily perform adjustments (manipulations) to the spine or other parts of the body with the goal of correcting alignment problems, alleviating pain, improving function, and supporting the body’s natural ability to heal itself.

Key Points 


  People seek chiropractic care primarily for pain conditions such as back pain, neck pain, headache, and extremity (e.g., hand or foot) problems.
  In the United States, chiropractic practitioners must meet the licensing and continuing education requirements of the state in which they practice. All states require practitioners to complete
a Doctor of Chiropractic degree program at a properly accredited college.
  Most chiropractic-related research has focused on the efficacy of spinal manipulation, especially for low-back pain. Researchers are also gathering evidence on the safety of spinal manipulation.
  Tell all your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated
and safe care.

Overview and History 


The term “chiropractic” combines the Greek words cheir (hand) and praxis (practice) to describe a treatment done by hand. Hands-on therapy—especially adjustment of the spine—is central to chiropractic care. Chiropractic is based on the notion that the relationship between the body’s structure (primarily that of the spine) and its function (as coordinated by the nervous system) affects health.


While some procedures associated with chiropractic care can be traced back to ancient times, the modern profession of chiropractic was founded by Daniel David Palmer in 1895 in Davenport, Iowa. Palmer, a self-taught healer, believed that the body has “innate intelligence” or a natural healing ability.

He theorized that “subluxations” (misalignments of the spine) can interfere with this ability, and that manipulation of the spine can help to restore or maintain health. Evidence-based explanations for the effects of chiropractic manipulations are the subject of ongoing scientific investigation, including studies supported by the National Center for Complementary and Alternative Medicine (NCCAM).

Spinal adjustment/manipulation is a core treatment in chiropractic care, but it is not synonymous with chiropractic. Chiropractors commonly use other treatments in addition to spinal manipulation, and other health care providers (e.g., physical therapists or some osteopathic physicians) may use spinal manipulation.


Treatment 


During the initial visit, chiropractors typically take a health history and perform a physical examination, with a special emphasis on the spine. Other examinations or tests such as x-rays may also be performed. If chiropractic treatment is considered appropriate, a treatment plan will be developed.

During follow-up visits, practitioners may perform one or more of the many different types of adjustments and other manual therapies used in chiropractic care. Given mainly to the spine, a chiropractic adjustment involves using the hands or a device to apply a controlled, rapid force to a joint. The goal is to increase the range and quality of motion in the area being treated and to aid in restoring health. Joint mobilization is another type of manual therapy that may be used.

Chiropractors may combine the use of spinal adjustments and other manual therapies with
several other treatments and approaches such as:
 Heat and ice
 Electrical stimulation
 Relaxation techniques
 Rehabilitative and general exercise
 Counseling about diet,


If You Are Thinking About Seeking Chiropractic Care
 Ask about the chiropractor’s education and licensure.
 Mention any medical conditions you have, and ask whether the chiropractor has specialized training or experience in the condition for which you are seeking care.
  Ask about typical out-of-pocket costs and insurance coverage. (Chiropractic is covered by many health maintenance organizations and private health plans, Medicare, and state workers’ compensation systems.)
  Tell the chiropractor about any drugs (prescription or over-the-counter) and dietary supplements you take. If the chiropractor suggests a dietary supplement, ask about potential interactions with your medications or other supplements.
  Tell all of your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

For tips about talking with your health care providers about CAM, see NCCAM’s Time to Talk campaign at nccam.nih.gov/timetotalk/.

Urination - difficulty with flow

Difficulty starting or maintaining a urinary stream is called urinary hesitancy.


Considerations

Urinary hesitancy affects people of all ages and occurs in both sexes, but it is most common in older men with enlarged prostate glands.

Urinary hesitancy usually comes on gradually. It sometimes goes unnoticed until urinary retention (complete inability to urinate) produces distention and discomfort in the bladder.

Almost all older men have some degree of difficulty in starting urination, dribbling, or decreased force of their urinary stream.


Causes

Urinary hesitancy can be caused by:

• Benign prostatic hyperplasia (enlarged prostate)
• Urinary tract infection, especially if chronic and recurrent
• Prostatitis (inflammation or infection of the prostate gland)
• Drugs (some cold remedies, some nasal decongestants, tricyclic antidepressants, and anticholinergic drugs which may be used for incontinence)
• Shy or bashful bladder syndrome (inability to urinate when another person is in the room)
• Neurologic disorders
• Recent surgery (postoperative retention)

Home Care

• Monitor, record, and report your urination patterns to your doctor.
• Apply heat to your lower abdomen (below your belly button and above the pubic bone). This is where the bladder lies. The heat relaxes muscles and aids urination.
• Massage or place light pressure over your bladder to stimulate emptying.
• Drink plenty of fluid
• For infections, antibiotics from your doctor will be needed. Symptoms that suggest a possible infection include burning or pain with urination, frequent urination, cloudy urine, and a sense of urgency (strong, sudden urge to urinate).
• Pay close attention to any medicines or supplements you take.

When to Contact a Medical Professional

If you have not been evaluated for this problem previously, you should call your doctor for urinary hesitancy, dribbling, or weak urine stream.

Call your doctor right away if:

• You have fever, vomiting, side or back pain, shaking chills, or are passing little urine for 1-2 days
• You have blood in your urine, cloudy urine, frequent or urgent need to urinate, or a discharge from the penis or vagina
• You are unable to pass urine

What to Expect at Your Office Visit

Your doctor will take your medical history and perform a physical examination, paying special attention to your pelvis, rectum, abdomen, and lower back.

Medical history questions may include:

• How long have you had difficulty starting your urine flow?
• Did it come on gradually or suddenly?
• Is it worse in the morning or at night?
• Is the force of your urine flow decreased?
• Do you have dribbling?
• Do you ever leak urine uncontrollably?
• Does anything help? Like heat or massage to the lower abdomen?
• Does anything make the hesitancy worse?
• Do you have other symptoms like fever, pain or burning when you urinate, cloudy or bloody urine, back or side pain?
• Do you have a history of bladder or kidney infection? Prostate enlargement or infection? Neurologic disorders?
• Have you had a recent injury, surgery, or diagnostic procedures on the pelvis or bladder?
• What medications do you take, including over-the-counter drugs?

Diagnostic tests that may be performed include:

• Urinalysis and culture
• Urethral swab for culture
• Transrectal ultrasound of the prostate (similar to a transvaginal ultrasound)
• Catheterization of the bladder to determine residual urine volume and to obtain urine for culture (a catheterized urine specimen)
• Cystometrography
• Voiding cystourethrogram

Treatment of urinary hesitancy varies depending on the underlying cause. Often, medications such as alpha blockers can relieve the symptoms. If a bacterial infection is present, antibiotics may be prescribed. A surgical procedure may be required to relieve prostate obstruction (see TURP).




Alternative Names

Delayed urination; Hesitancy; Difficulty initiating urination




References

Gerber GS, Brendler CB. Evaluation of the urologic patient: History, physical examination, and the urinalysis. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier;2007: chap 3.

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Scott Miller, MD, Urologist in private practice in Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Tips for Curing Premature Ejaculation

From: http://www.askmen.com/dating/dzimmer/14_love_answers.html

What’s the No. 1 sexual issue that men face today? OK, the guy who said finding a sexual partner wins -- I’ll 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.

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.

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.