The basic research on this issue was meticulously conducted by the and published in a book in 1966. The studies contain accurate information on the different stages of the sexual response and on how orgasm is achieved in each of the partners.
Since then, many new discoveries have been added to the basic knowledge in this field, but generally, Masters and Johnson’s theory is still accepted and we would like to present it here.
The First Stage – Arousal
This stage is characterized by a rapid response of the penis to physical or psychological stimuli, and it is similar for all men whether or not they suffer from PE. The tissue swells with blood as do the testicles, and the penis erects.
This initial stage is accompanied by tensing, most desired, of the muscles throughout the body, and also by an increase in the heart rate and blood pressure. In this stage, there is also redness in the skin of the chest, which spreads toward the neck and face.
At a young age, this stage is fast – it takes about 30 seconds for the changes described above to occur. With age, this stage becomes more prolonged, and at a mature age, a few minutes of direct physical stimulation is required in order to complete this stage.
The Second Stage – Plateau
The physiological process is similar in all cases. The testicles lift toward the body, the penis reaches a full erection, the tenseness in the muscles continues and may be expressed in uncontrolled spasms in the hands and legs, and sometimes in the face.
The redness of the skin increases, the number of breaths per minute might be over forty, and there is an additional increase in the blood pressure and heart rate. The latter might reach, before the third stage – the orgasm – up to 100 beats per minute and even more. At a mature age, this increase is more moderate.
The main difference between men suffering from Premature Ejaculation and those who are not is the ability to extend and maintain the plateau stage.
During a regular sexual encounter, the man can experience sexual pleasure while maintaining control of his ejaculation reflex. A man will ejaculate when he feels an intense desire to reach an orgasm.
For a man suffering from PE, this stage is short to non-existent. The ejaculation occurs within a short time, mostly before he wanted it to and with no capability of delaying it.
The key to overcoming PE is achieving control over the plateau stage, which will enable the man to extend or shorten the intercourse. There are different exercises that can be practiced in order to achieve control of the ejaculation reflex.
The way to overcome PE is to develop an awareness of the sensations prior to an orgasm and use this awareness to extend the plateau stage.
For men who suffer from PE, the plateau stage is so short that they cannot identify the approaching orgasm or control it.
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The Third Stage – Orgasm
This is a short stage. Physiology-wise, it is expressed in rhythmic convulsions of the genital muscles – about 8-tenths of a second between convulsions, which affect the entire body including the overall sensation.
For the man, a part of the orgasm includes ejaculation, a phenomenon that might not always occur at a very mature age or following prostatectomy (then the ejaculation is done in the bladder). In some cases, due to fatigue or other reasons such as mental issues or due to medicaments, the man finds it difficult to reach an orgasm and therefore to ejaculate.
It should be noted that the convulsions, which are initially strong and then weaker, are an expression of the quality of the orgasm. In the seconds during which the orgasm takes place, the heartbeats might reach 160-180 beats per second, and the breathing up to 40 per minute. The redness spreads over the body.
With the end of the orgasm, usually, a man requires a certain period of time during which the erection subsides and any additional sexual stimulation might not lead to an additional erection or orgasm. This time can be very short, at young ages, and it becomes longer and can reach 30 minutes to several hours or even days the older the man gets.
The Fourth Stage – Resolution
At this stage, the intense blood flow to the genitals and the rest of the body rapidly subsides, followed by an additional slower decrease during which the body returns to a resting state as before the stimulation. The tense of the muscles eases, the redness decreases, the heartbeat, breathing, and blood pressure return to normal.
In the years following the publication of the Masters and Johnson research, it was discovered that there is an additional stage – and not the least important: sexual desire  – which is prior to the four stages. Kaplan and Lief were the first to discuss the fact that 30% of patients seen in sexual consultancy had come with the same complaint: a lack of sexual desire.
This stage is affected by mental and environmental issues. Desire is determined by attraction or lack of attraction to the partner, strong responses of anger, fear, rejection, and guilt. It is possible to say that every relation and emotion between partners might – or could – affect sexual desire.
Basically, there are different levels of desire. For some men or women, it is a very low level, and they are not interested in or feel a need for frequent sexual experiences. Others have high levels of desire and seek frequent sexual experiences. It is without a doubt that the ideal state is a similar or equal level between the two partners. Issues might occur when there is a difference in that respect.
Sexual desire might also be affected by medications that are used for specific goals and to treat a different illness. The consequences are mostly expressed as a decrease in sexual desire, and sometimes in men as impotency.
There are specific, very limited types of medicine, developed from the male hormone testosterone like Nugenix, which increase sexual desire – if this hormone is lacking in the body. If the decrease is felt after taking medication, you should inform your doctor regarding that possibility.