Q. I have suffered from premature ejaculation for years. Recently, I have even had orgasm and ejaculated without any direct penile stimulation, just heavy kissing and nipple play. Is this normal? I didn’t think it was possible. It’s quite embarrassing! How can I overcome this?

A. Orgasm is a learned response. In a man who suffers from premature ejaculation, the trigger mechanism for orgasm is very sensitive. The stimuli to climax can be visual, auditory or physical (direct penile stimulation). Regardless of which form of stimulus is involved, the man’s brain learns to interpret it in such a way that the orgasm is triggered.

To overcome your problem of premature ejaculation, you must see your doctor. Your doctor can offer several solutions, either behavioral therapy or medications. For more information on the options, see my earlier column on premature ejaculation. The most important thing is not to worry — medication or therapy can correct this problem.

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