What is it? Well, a pragmatic answer is male orgasm and ejaculation before you wanted to. Most men are able to reach orgasm, on continued and satisfactory stimulation, within about 2 minutes. Women, on the other hand need around 8 minutes of stimulation - providing for a potential 6 minute mismatch.

Conventional approaches to this have concentrated on reassurance and advice on diversionary thoughts. So for example, when orgasm is approaching before the desired time, patients were encouraged to think about something banal and boring - like what they had for breakfast, coupled with keeping still and reducing physical stimulation to an absolute minimum. This "stop/start" manoeuvre is largely unsuccessful though useful for some so worth trying.

Another technique is the "squeeze" method. Here the couple is encouraged to sit facing each other and both to masturbate until the man (or the man with the premature ejaculation) is near orgasm. He then squeezes hard between finger and thumb just behind the glans (head) of the penis. The idea is slowly for the man to gain confidence in firstly telling when orgasm is approaching, but also in his ability to halt the premature ejaculation.

As progress is made, penetrative sex is allowed, but again, if premature ejaculation threatens, then movement ceases and the penis is withdrawn and squeezed until the sensation eases and then intercourse can be resumed.

An alternative strategy is to reduce the intensity of the stimulation from the outset, for example by masturbation to orgasm and then trying again a short while later. Again, this is not the most convenient of options, because it does require a rather staged approach.

Latterly, low doses of selective serotonin reuptake inhibitors like fluoxetine, sertraline and paroxetine have been used to some good effect in causing ejaculatory delay.