Table of Contents
Introduction
Welcome to the complete theory on premature ejaculation and its causes, particularly in relation to the pelvic floor and the rest of your body. I call this the unified theory because it's finally a framework that makes sense of it all. It combines all the knowledge that is relevant and eliminates all the garbage and misinformation. It does so in a logical way, and everything fits in nicely with everything else. And more importantly, it just makes sense.
I'm not a scientist or a doctor, but I'm a guy who's had severe premature ejaculation all my life and I've eventually solved it. I read everything there is to read, and studied all there is to study. And I quickly realized that the information that's out there on the internet is a pile of steaming shit. You'll find lots of useless advice with no explanation on why it supposedly works, and you'll come across confusing albeit well-intentioned information from fellow dudes who don't really understand what they're talking about. In general, even among the more reputable sources of information (i.e. people that actually solved their problems), you'll find inconsistent terminology, poor understanding of why things work, and all in all lots of conflicting ideas.
Every time I seemed to have found a good piece of information I'd find another that would somehow be incompatible with it. So I set out to make sense of all this mess once and for all. I armed myself with the power of logic and critical thinking and began this work. I weeded out all the garbage, all the conflicting information, and distilled everything down to a consistent framework that manages to explain how everything ties in together, and more importantly, the reason why things work the way they work.
We begin with one fundamental assumption, and that is the idea that the pelvic floor is at the core of it all. This seems to be what all the information points to, and it's the only way to make everything fit together. We don't really have a proven scientific answer on what the causes of premature ejaculation are. There is actually no single research that has been done on this, very surprisingly given how commonplace of an issue it is. I thus believe that the framework I hereby present is the closest we get to a complete and logical understanding of premature ejaculation.
Let's begin!
The Pelvic Floor
The pelvic floor is the set of muscles at the bottom of your pelvis. They form the floor of your abdominal cavity, whose other boundaries are the diaphragm which forms the ceiling, and the abdominal wall all around - on the front, sides, and back. The pelvic floor muscles are essentially holding all your organs from falling through your pelvis.
These muscles also have a large role in urination and defecation (and in holding the contents in), and most importantly they're responsible for pumping blood into your penis for erections and for enabling ejaculation.
These are literally the muscles that control your arousal and your orgasm. They control how much blood gets to your cock, therefore erection quality and arousal, and they contract to push out semen when you ejaculate. You bet they're key to anything related to sexual performance. The general idea is that if your pelvic floor is tight and overactive it will do more work than it should, and since its role is to increase the blood flow to your dick and control your ejaculation, it's easy to see how it being overactive is going to make you cum faster.
The reverse is of course also true. If your pelvic floor is too loose then it will fail to properly contract, therefore it won't provide enough blood for erections or it won't be able to bring you to orgasm; namely resulting in erectile disfunction or delayed ejaculation.
But let's now better understand what situations can the pelvic floor be in. For our purposes we can describe the state of the pelvic floor within two areas, which I'll call strength and tone. Strength is how weak/strong a muscle is. Tone is how tight/loose it is, that is whether the muscle is too tense and overly contracted or too slack and unresponsive.
Before we move on let me clarify a common misunderstanding. These two concept (strength and tone) are independent of each other; that is one doesn't necessarily correlate to the other - or not as you think anyway. For example, it's common to think of a tight muscle as a strong muscle, and a loose muscle as a weak muscle. But those are both generally wrong statements, as again, one thing does not imply the other.
Now that we know what these concepts are, I'll propose a chart of the actual relationship between strength and tone.
On the strength axis, what you see is actually the value of potential force production of the muscle, not the strength value itself. That is to say that it is not a guarantee that if your tone is at a good middle ground you will necessarily be at the peak of your strength, but rather that it gives you the potential to be maximally strong.
On the tone axis we go from tight to loose. The pelvic floor can be tight if it's tense, overactive, or has become shorter over time, and loose if it's inactive, under-recruited, or always in a slackened position due to lengthening over time. More on this later.
I chose to plot the graph as a normal distribution curve as it seems most appropriate. Graphs of the actual length-tension relationship of muscles follow similar shapes, and this is a closely related concept.
In essence, this graph represents the idea that there is only one best tone for your pelvic floor to be in in order for it to function correctly, and that is when it's at its proper resting length in the middle. If your PF is too tight or too loose it won't be able to work properly. That's because the way a muscle contraction works is by essentially shortening the muscle. If the muscle is too loose, it fails to achieve a contraction as there's too much slack and it can't shorten enough. If the muscle is too tight it's already under tension or shortened so you can't have a contraction on top of an already contracted muscle. A good muscle contraction happens when the muscle length is at a good middle ground, firm but not tense. From there it has enough strength and shortening room to achieve a good contraction.
Simple enough, right? Now let's look at why your pelvic floor can have an improper tone.
What Affects The Pelvic Floor
There can be many factors that affect your pelvic floor situation, but the three main ones are bad posture, improper breathing, and weak or inactive muscles.
These three things actually tie in with each other on a fundamental level. Weak muscles create bad posture, and bad posture creates bad breathing patterns. Likewise, bad breathing doesn't inspire good posture, and bad posture doesn't inspire muscle activation. It's a vicious cycle. These problems all stem from the same root really: modern society and its ways of living. Namely sitting all day and limited movement (and no, going to the gym three times a week doesn't count as movement). Muscles go unused, we develop bad postures, and there's no incentive for breathing properly. The human body has spent a few hundred thousands of years to adapt perfectly to having to move all the time. Now that we don't move anymore our body ends up developing defectively because - evolutionary speaking - it is not how it was meant to be used.
But let's now go into a bit more details on how these three elements impact the pelvic floor.
Posture
Bad posture is bad news for lots of things really and can cause problems anywhere in your body. The pelvic floor is certainly affected as well. The two most common postural problems, and unsurprisingly the ones we are also interested in, are actually related to the position of your pelvis. These are anterior and posterior pelvic tilt.
Anterior tilt is when the pelvis is rotated forward, that is when the top of the pelvis moves forward compared to the bottom. Posterior tilt is when the pelvis is rotated backward, that is when the top moves backward compared to the bottom. In anterior tilt, your spine goes into extension (it arches so that the lower back moves forward compared to the upper back). In posterior tilt, your spine goes into flexion (it rounds forward, hunching). Both anterior and posterior tilt are sub-optimal postures, and we rather want to be at a middle ground; what we call neutral tilt. Keep in mind that when you're standing, neutral tilt does not mean your pelvis points straight up, but there is rather a natural small amount of anterior tilt in a neutral pelvis, just like the lower spine has a natural small amount of arching.
It's important to understand that pelvic tilt is always defined in relation to the spine. For example if you bend forward by hinging at your hips but you're keeping the spine and pelvis in the same configuration compared to each other throughout, then you haven't changed pelvic tilt, even if your pelvis is obviously pointing forward.
So how is the pelvic floor affected by pelvic tilt?
Your pelvic floor stretches between the tailbone and the front of the pelvis, and laterally between the two sit bones. When your pelvis tilts anteriorly, the tailbone moves away from the front of the pelvis and the sit bones move apart from each other. When the pelvis tilts posteriorly, you get the opposite, or the tailbone moves closer to the front of the pelvis and the sit bones move closer to each other. This means that in anterior tilt your pelvic floor muscles are being lengthened as the points it attached to are moving away from one another, and in posterior tilt they're slackened as the attachments move closer.
Two situations can then develop depending on your posture.
Posterior pelvic tilt
If you're in posterior pelvic tilt (PPT), for example every time you're rounding your back when sitting on a chair or slouching on a couch (which is probably a lot), you're keeping your pelvic floor muscles in a slackened position for long amounts of time. That means that over time your pelvic floor muscles become tighter as they're trying to adapt to always being too loose.
The human body is a master of adaptation. If a muscle is always slackened, the body will make it tighter to be able to make use of it. Remember, when we talked about muscles earlier, we determined that the best state for a muscle to be in is at a middle level of tension (what I called firm but not tense), and that if the muscle doesn't have enough tension, or too much slack, it will fail to activate. If you're always in a position that causes a muscle to be slack, the body compensates by making the muscle tighter, so that the muscle will be able to be of some use even if it ends up shortening to a length that is smaller than the optimal resting length of that muscle. This way it regains the ability to contract at the expense of potential strength (as the previous graph showed). To be clear: your body doesn't know what the proper muscle length is supposed to be. If the muscle is never used at the proper length but is always kept slack instead, the body will "think" that's the length it's supposed to be at and adapt accordingly.
So in short, posterior pelvic tilt creates slack in the pelvic floor muscles, which in turn over time creates tightness.
Anterior pelvic tilt
When you're in anterior pelvic tilt (APT), two things can happen. One is the reverse of posterior tilt: your pelvic floor muscles are being stretched, and over time it can create an overly loose pelvic floor. The other outcome is maybe a bit counter-intuitive: your pelvic floor muscles actually tighten up because they're actively trying to resist the stretch by always staying contracted. This is actually what your muscles always do when you try to stretch them. In order to prevent you from overstretching and breaking they will tighten up making conscious excessive lengthening impossible. It's the reason why stretching muscles is a difficult task and takes a long time to show results; you're essentially gradually teaching your body and mind that it's okay to be in that stretched position and that it's not going to break.
The anterior tilt situation is then a bit more complex, and it can cause either a loose pelvic floor, or again, like posterior tilt, a tight one. For the purpose of premature ejaculation we only need to worry about this latter case.
Breathing and alignment
Let's now look at breathing. I promise this is not some new age yoga meditation woo. There's a good reason we're talking about breathing, and it's a very physical one.
Earlier we introduced the abdominal cavity. It's the space in your belly where many organs reside; the space delimited by your diaphragm at the top, your pelvic floor at the bottom, and your abdominal wall all around. We all know the diaphragm is responsible for breathing, but what happens to all the rest of the abdominal cavity?
The diaphragm is a thin layer of muscle placed as the ceiling of your abdominal cavity and when it's relaxed it takes the shape of a dome. When you inhale your diaphragm contracts and flattens, and by doing so it increases the pressure in the abdominal cavity. It's essentially pushing down on everything else in the cavity. So in order to maintain equilibrium, the natural response of your body is then to have the pelvic floor relax and stretch out creating more space at the bottom and allowing the intra-abdominal pressure to remain the same. Your abdominal muscles also expand outwards to help create space as well. The abdominal effect is more prominent, and you were likely already aware of your belly expanding on deep in-breaths. The pelvic floor does just the same, although you might have never noticed it. The opposite happens when you exhale: the diaphragm relaxes and returns to its dome shape, and the pelvic floor and abdominal muscles go back to a more neutral firmer position. Some call this the pelvic piston: your whole abdominal cavity is moving down and up on every in and out breath.
The result of this, under normal circumstances, is that your pelvic floor stretches out and relaxes on every in-breath. When your breathing is too shallow (as it usually tends to be), or if you're unconsciously keeping a contracted pelvic floor, you miss out on this stretching effect. Less stretch means of course that it's more likely to tighten up over time.
So breathe!
It's no wonder most of the practices that revolve around achieving a healthier life focus so much on breathing. Think all the kinds of yoga, meditation, tai chi and other martial arts, and even just exercising and properly breathing and bracing your core. Breathing is the one thing they all have in common, and it's very likely that breathing should be quite high on our priority list of things to get right. It's like somewhere along the way we forgot how to properly breathe and how to properly use the muscles that surround the abdominal cavity.
A somewhat related concept is alignment. With this I mean the way the top of the abdominal cavity is aligned with the bottom, that is whether your chest is stacked on top of the pelvis or whether it ends up outside of the line of balance. If your diaphragm is correctly aligned on top of the pelvic floor, this whole abdominal cavity system works correctly. If it isn't aligned, some muscles are going to have to compensate to keep things working and to keep you upright against a higher force of gravity (as you'd be leaning either forward or backwards of your center of balance). For example your abdominal muscles might have to do extra work, or more worryingly your pelvic floor might. This again all leads to tension, stiffness and tightness.
Proper alignment is once again related to proper posture. The great thing about breathing is that when it's done correctly, attempting a deep breath is itself going to suggest what the proper posture should be, as a good in-breath is only possible when your torso is properly aligned and excessive tension in your body is neutralized. Breathe.
Glutes and related muscles
The last important piece of the puzzle is the gluteal muscles. The glutes are possibly the most important muscle in your body. They are essential for maintaining proper upright posture, for walking, running, jumping, stepping up and down stairs; virtually every time your body moves. And ironically these tend to be some of the more underdeveloped muscles in modern humans. We mentioned it before: it's cause we sit, and sit, and sit. And we don't do any meaningful amount of movement. Glutes are apparently one of the first muscles we stop using when we sit all the time. They're not activated enough if we don't stand and walk, and they completely turn off while you're sitting. In some extreme cases people can actually forget how to contract the glutes, with obvious disastrous results caused by other muscles stepping in to compensate anytime you attempt to move.
Furthermore, the glutes attach to the back of the sacrum, and glutes that are firm and function properly keeps the sacrum back, counteracting the pull of the pelvic floor. Remember, the pelvic floor attaches to the back of your pelvis at the sacrum, and it pulls the sacrum towards the front of the pelvis when it contracts or if it's too tight. Strong glutes will naturally prevent the pelvic floor from staying tight by pulling the sacrum away from the front of the pelvis, resetting the pelvic floor to a neutral position. We need a strong ass!
There are a couple more muscles that we should finally talk about, as nothing in the body works in isolation. These are the hip flexors and the hamstrings, which are the muscles that work especially closely together with the glutes.
The hip flexors are part of the anterior chain (muscles in the front of your body), and they are the muscles that directly oppose the action of the glutes and hamstrings. Proper balance with the opposing muscles is important. If a muscle is too tight for example, the opposing muscle will be lead into a stretched position: a set of opposing muscles will use one muscle's contraction and the other's relaxation to move one way, and the reverse for the opposite way. To allow the glutes to do their job properly we then need to have a proper situation at the hip flexors as well. And it's very common for hip flexors to be tight and weak from sitting. In a seated position the hip flexors are slackened and they end up weakening and tightening up over time. It's the same principle that works on the pelvic floor, i.e. the body adapts and tightens up slack muscles. Being these the muscles that oppose the glutes, if these are too tight they will pull the glutes into a stretched position, which makes their activation more difficult leading to inactivity. Moreover, if the hip flexors are tight they will pull the front of the pelvis downwards, potentially resulting in excessive anterior pelvic tilt when standing and all of its problems we talked about earlier.
The hamstrings belong to the posterior chain, just like the glutes, and they fire together with them for many movements. We probably want these to be at a similar level of strength of the glutes in order to have both of them activate when needed, without the need for one to take over the work of the other. Prolonged sitting can, again, lead to tight and weak hamstrings: while seated - with your legs bent at the hips and knees - they are in a slackened position and they'll end up weakening and tightening over time. Furthermore, if the hamstrings are too tight they will pull the back of the pelvis downwards (the opposite of what the hip flexors do), resulting in excessive posterior pelvic tilt that can lead to a tight pelvic floor as we went over earlier. Regarding pelvic tilt, since both tight hamstrings and tight hip flexors can pull the pelvis either way, the tilt of your pelvis comes down to which one of them is tighter than the other.
One more muscle that is worth mentioning is the calf, as it's very closely linked to the hamstring. If your calves are tight they'll tend to make the hamstrings tight as well.
As you're surely starting to see, everything is connected. It's a long chain of little things, each one affecting the next. We started at the pelvic floor and ended up at the calves!
In general, we want all these muscles (glutes, hip flexors, hamstrings) to be equally strong and healthy (not tight), without any one overtaking the others. Each one has to do its own job for everything to work well together.
One last important set of muscles we'll talk about are the abdominals and the lower back muscles. These are all part of your core (just like the pelvic floor is!), and they work together to keep your body stable and balanced. They're essential to good posture you'll have to take good care of these as well. They also play a role in excessive anterior or posterior tilt, working together with the hamstrings and hip flexors to keep your pelvis and spine in good alignment. Tight lower back and hip flexors combined with weak (but not necessarily tight) abs and hamstrings will pull you into APT, whereas Tight abs and hamstrings combined with weak lower back and hip flexors will pull you into PPT.
Other
Now a final touch on a couple other things that can affect the pelvic floor, although probably not as prominently as the others.
Stress
This is one that comes up a lot in mainstream "advice" on how to cure premature ejaculation. I'll lump it into the bigger category of purported mental causes of premature ejaculation, and they appear on the internet under the names of stress, performance anxiety, depression, lack of confidence, and similar ideas. And the advice on how to fix it usually goes along the lines of "don't worry about it too much", "be confident", "be calm and don't be stressed". Yeah. Cool. Real helpful.
So while most it if is mumbo jumbo, there is one consequence of stress that is measurable and is worth looking at. It turns out that humans in a stressful situation tense up a variety of muscles, including… the pelvic floor! There is some evidence that shows that the pelvic floor is actually one of the first muscles that tenses up when we're faced with a sudden stressful stimulus. The greater the amount of stress we experience, the more the tension in our body becomes evident. Think of fight or flight response. During the fight or flight response the human body tenses up considerably, readying itself to quickly act in explosive fashion with whatever movement seems appropriate (e.g. fighting or escaping). When confronted with smaller amounts of stress the reaction is actually still the same, just in smaller doses. For example, a notch down from the panic of an actual life threatening situation, think of performance anxiety (e.g. giving a speech, participating in competitions, giving musical performances) which triggers noticeable and to some extent disruptive fight or flight responses. Another notch down and you can find your everyday stress accumulated from modern living: work worries, commutes, relationships, social media, and whatever else you have. Yes, these still have an effect on your body. Your body reacts in the same way no matter where your stress comes from. The trouble here is that these tend to be less noticeable forms of tension (like pelvic floor tension, shoulders, neck) that we might end up ignoring if we lack awareness. Other than trying to avoid the stressful situations (sometimes impossible), or learning to deal with them in a healthier way (takes lots of practice), what one can and has to do is to become aware of the tension and releasing it when it's noticed, through stretching and relaxation. If awareness is completely lacking, one might tense up during stressful situations and then be unable to relax for the rest of the day. This is especially true of the pelvic floor, as most of us don't even know it's a thing, let alone knowing how to notice and defuse tension!
You'll find more details on how to relax the pelvic floor on other posts.
Habits and physical activity
The other way your pelvic floor might accumulate tension is by habits you have developed or specific repeated physical activity you might be doing.
A few common bad habits one can pick up are things like sucking your belly in (don't do it), and holding in pee, farts, and shit. The whole mad idea of having to hold in excretions is, again, a result of modern life. If this has become a habit of yours, start fixing that. Take every opportunity to go to the bathroom, especially before travelling, and if you're the kind of person that sometimes avoids taking a shit because of the noise you'll make then you need to man the fuck up.
Certain physical activity like running is also quite taxing on your musculature relaxation and tends to generally tighten everything up, including the pelvic floor. But while your tight calves and hamstrings might be an easier thing to notice and therefore stretch out, your pelvic floor might easily be going under the radar. Do keep an eye on that, and try to notice what effect whatever sport you might be into is having on your pelvic floor.
Conclusion
This article was meant as a comprehensive overview of what the premature ejaculation issue actually entails. It's a complete and self-consistent framework that explains what the problem is and takes into account all the components that relate to it. It's finally a system that makes sense to a logical mind, in contrast with all the dubious and incoherent information you'll find elsewhere.
This write-up was to lay out the foundations of our work, and I'll go into more details on how to practically tackle premature ejaculation in another post.
To sum things up, in order to tackle the premature ejaculation issue you first need to understand the problem. You need to understand what the pelvic floor is, and how posture, breathing, and muscles balance affect it. You need to become aware of the situation of your pelvic floor, and actively think about its relaxation.