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Edward, who came to me saying he wanted Viagra. After I determined that he was perfectly healthy and had no erectile dysfunction, I asked him about his sex life. He said that he rarely had sex with his wife and went to prostitutes instead. Wondering how this related to his desire for Viagra, I asked how long he lasted during sex. His answer was, “Less than a minute.” In other words, he had premature ejaculation.
    As we discussed it further, the pieces started to come together. He wanted to have sex with his wife, but he worried that his premature ejaculation would upset her. That wasn’t a problem with the prostitutes, who pretended all was well and gushed over hismanliness. Of course, a prostitute or a mistress won’t tell a client that his blink-and-you-miss-it pumping isn’t satisfying. She’s getting compensated not to.
    Edward had no idea he could be treated so that he could last longer in bed, please his wife, and stop seeing strangers for sex. If he wanted to save his marriage, he needed to understand that sex was about his relationship with his wife and not about a quick orgasm with a paid stranger.
    He also had no idea the average man lasted about seven times longer than he did. At the time, I don’t think he cared to know because he was deep in denial. He thought he was a stud.
    But if a man can’t satisfy his partner and can only satisfy himself by going to prostitutes or masturbating, how do you think his partner feels? Awfully upset, of course. Not only are they unsatisfied, but their lover is going elsewhere for satisfaction. Yet women in this position often feel responsible for not pleasing their lover…that something’s wrong with them . Not surprisingly, this can lead to friction, frustration, and fighting, which further reduces both partners’ chances for good sex.
    I realized this was probably the case with Edward and his wife when I asked, “Can you bring your wife with you next time?”
    “Huh?” he said. “Are you kidding me?” He clearly wasn’t thinking about her needs.
    I explained that it was extremely important for me to also treat his partner, adding that nearly every case of premature ejaculation has a simple explanation. It’s one of the most common types of male sexual dysfunction, affecting 20 to 30 percent of all men. In fact, premature ejaculation is a reflex, not a psychological abnormality.
    Dear Dr. Fisch: Is Chronic Masturbation Cheating?
    Dear Dr. Fisch,
    I know my husband thinks about other women when he’s jerking off. This is driving me crazy because it feels to me like he’s cheating. Am I wrong to get so steamed?
    Signed, Hands Off
    Dear Hands Off,
    Some women I’ve spoken to think of masturbating as cheating. You may wonder why, but the answer is easy. They know that their partners are indulging in whatever flights of fancy are needed to help them get their rocks off. This might mean fantasies about their second-grade teacher, the hot neighbor next door when they were teenagers, the red-haired executive assistant at work who is happily married and the mother of three, the yoga teacher with the most flexible spine in the Western hemisphere, the sultry actress with the perfect figure you’ll never have, the porn star with the surgically enhanced body you’ll never have (and never would have even if you could afford it!)… You get where I’m going with this.
    My advice is: Don’t look for other problems when you don’t have them. Instead, take a step back and assess the real problem. I understand your frustration with your husband, and I wonder if you’re looking for something to blame him for doing. Chronicmasturbation may be a very real problem in your relationship, but it’s a fantasy issue, not a cheating problem.
    The important questions to ask are: Why do you think this is such a problem? Does your husband name the objects of his fantasies when he’s masturbating? Does he ask you to watch and then not want to have sex with you? Is he doing it in