PE in Men (How short is “premature” & how long is “sustained”)

The definition of “premature ejaculation” evolves. The formal definitions (those used by doctors and therapists) work well for conducting research but not so well for bedroom purposes.

For example, the following set of questions are used as a tool to make the diagnosis of “premature ejaculation”; the man (only the man) answers five questions, and the score determines diagnosis:

1. How difficult is it for you to delay ejaculation?

2. Do you ejaculate before you want to?

3. Do you ejaculate with very little stimulation?

4. Do you feel frustrated because of ejaculating before you want to?

5. How concerned are you that your time to ejaculation leaves your partner sexually unfulfilled?

Notice that this survey has no way of directly knowing what the woman thinks; the survey only questions the man.

So, a man who only waits thirty seconds before ejaculation with every encounter, who leaves his lover very frustrated, but who is not concerned with her, and who thinks thirty seconds duration is always adequate would score well on the test and not be diagnosed with premature ejaculation.

Even if the man does worry about the emotions and fulfillment of his lover, the test assumes that his lover will tell him of her frustration; but, many women do not tell their partner of their frustration, and the man is not connected enough to his lover to perceive her feelings.

So, the double bind is that if the man truly loves his wife, then he would be concerned enough to actually score poorly if his partner opened to him about her frustration. But, partly because of his great love, his wife may not risk offending him by voicing her frustration about his sexual endurance.

His love nurtures her love, which (because she fears hurting him) keeps him stupid about her emotions, which leads to less satisfaction for her, a strain on their sex life, and eventually to a fracture of the very love he treasures.

Still, even with the limits of the above survey tool, if the man is alert and is blessed with a lover who is honest with him, the tool converts his answers into a score that can be used to quantify and compare the effectiveness of different therapies.

But this test, and most tests, do underestimate the incidence of premature ejaculation because the researcher has no way to truly know the mind of a woman if only surveying the man. There are many more frustrated women on the planet than the premature ejaculation research would indicate. Remember, around ten percent of women prefer to be in the bed with other women—they enjoy wonderful sex with no penis in the bedroom at all. Sustaining penile tumescence truly is less important than understanding your lover; I cannot stress this enough.

Still, women (at least the ones who enjoy sex) often wish that sex—done in an understanding way—would extend much longer than what the man thinks brings satisfaction. Moreover, I have often found that even when a woman has had an orgasm and thinks she has enjoyed an amazing sexual encounter, even then, after more time, with continued and artfully provided mental and physical attention, she will reach a different level of pleasure and connection, a different dimension of her sexuality, a new side path in her garden of desire that she did not know exists. She discovers herself in extended sex; that is, she finds parts of herself she didn’t know when she explores (with an understanding lover) the farther ends of the paths of her secret gardens. These deeper levels of connection and pleasure are not acknowledged or found under the present definition of premature ejaculation.

Being satisfied with “wonderful,” couples often never find “soul-opening-amazing.”

I am absolutely NOT proposing that men force sex to last longer than what a woman wants on a particular day. But there is a very good chance that your lover is completely content (be grateful for that); but, with more extended lovemaking (always done artfully), you and your lover may find that the stairway to heaven goes much much higher than what you both thought.

So, the current definitions of premature ejaculation work well for research but, maybe, not so well in the bedroom.

A New Definition of “Premature Ejaculation”

In defining “premature ejaculation,” rather than considering only the man’s impression of the sexual encounter, or even an arbitrary number of minutes of sexual intercourse (another way of defining “premature ejaculation”), I propose a new Bedroom-Definition of Premature Ejaculation (in contrast with the research definition):

“Bedroom Premature Ejaculation is when ejaculation blocks the path of either you or your lover to the level of arousal, pleasure, and soul connection that is possible and intended for a specific sexual encounter.”

Important Corollaries to this Definition

By this proposed definition, ejaculation before the point of “possible and intended” pleasure would be considered “premature” regardless of the number of minutes of the encounter: on some days, ejaculation after 1 minute would be absolutely perfect; while with the same couple, on another day (or another time on the same day), ejaculation after 1 hour of vigorous sex may be premature.

This definition of premature ejaculation, Bedroom Premature Ejaculation (BPE) would require that the couple communicate.

Also, avoiding BPE would require that, if the female partner experienced occasions of exceptional appetite, the man would require exceptional, on-demand endurance or else he would (for that couple on that occasion) suffer from bedroom premature ejaculation.

Are You a Golf Cart or a Limo?

I live in a tourist town near the Gulf of Mexico where it is legal for you to drive a golf cart on the street with automobiles. Many people use their golf cart for short trips to the store and are perfectly happy to drive only the golf cart most days. But, those same people would never use their golf cart to drive the five hours it takes to get to the nearest mountains. Most men do not want to be the golf cart, requiring their lover to find another means of transportation if she wants to travel to the mountains.

In art, the masterpiece appears after most people quit.

Every man who considers sex an art worthy of lifetime attention should study how to Extend Sex.

Hope this helps!

Charles Runels, MD




Research about the diagnosis of premature ejaculation<--

Orgasm College™<--

Extend Sex. Chapter 2. The 30-Second Trick

Chapter 2
The 30-Second Trick

Warning: Jack Hammers & Space

Even though, by studying this course, you can become a man who is able to provide jackhammer sex—extended, mindless, unrelenting thrusting for hours and hours and hours (and hours)—actually performing in this way every time you enjoy sex with your lover should not be your goal.

To understand sex as passion, love, and art, to know sex as dangerous strength, and sacred tenderness, listen to George Winston’s piano in his album December. This is not a rhetorical request; buy the album (preferably on vinyl); then listen to its entirety in one session, in the dark, without speaking and without allowing anyone else to speak. Notice the space between notes—the silence. Notice that Winston, on occasion, demonstrates superior finger speed. But, most of the time, when he plays, he shows no need to demonstrate speed or endurance. Instead, he often rests in silence, not to make you want the next note (although you will), but to show you silence. He demonstrates patience and connection to the music, not a need to demonstrate his skill. He gives you the next note only after making you wait longer than you expect; then, when the note comes—you more than hear it.

Here’s another way to hear why extended sex does not equate to good sex: re-listen to Led Zeppelin’s “Stairway to Heaven.” You likely can bring it to mind, but actually re-listen to it. That classic starts with a tinkle, gradually turns into ripping and screaming, before ending with a whispering collapse.

Artful sex and artful music (which at its best is sex) both require rising and falling, spring and fall, exertion and rest. Being able to thrust jackhammer style for hours does not mean that you should.

Conversely, to perform as a master musician, both Winston and Zeppelin must be able to play rapidly with strength and volume; we expect and demand kinetic force at the proper time—or else we put away music as impotent and bland.

Similarly, men should claim the solid mechanics of their penis and learn to maintain speed and force for hours. But such mechanics without art turns sex into a nuisance worse than a child relentlessly banging the keys of a piano.

The Anatomy and Physiology of the 30-Second Trick (They Didn’t Teach You This in High School)

You may wonder why even think about how to extend sex.

The first time that I had sex, the summer of 1978, I was 18; it lasted less than five minutes. The short duration disappointed me (and I’m sure my lover as well).

Because I ran cross-country track during high school (and so was accustomed to running nonstop for hours), I had endurance; but, I needed to discover how to maintain an erection during exertion. But, then, before the end of that summer, after discovering the 30-Second Trick, I could enjoy sex with my lover for hours—literally hours. During those longer sexual encounters, I would see not only my lover orgasm, but also see her cry with pleasure and release: sweating, sobbing, moaning, enjoying orgasm after orgasm, and melting into bliss. So, it seemed to me that, at least on occasion, longer-lasting sex was better than brief sex.

The simple 30-Second Trick that I figured out during that summer, works based on human anatomy. And, even though I did not, in the summer of 1978, understand the anatomy, the 30-Second Trick still worked. But, years later, after better understanding the anatomy, the trick works even better. So, before you practice the trick, take a short look at the relevant anatomy of the penis and the vagina.

In developing from an embryo into an adult, both men and women develop the same parts (even the same genitalia). Like the rest of the body, the genitalia simply develop into different sizes and different (but similar) shapes based on the sex of the person. The corpus cavernosum and the corpus spongiosum develop into a penis in a man and into a clitoris in a woman—but the tissue in both men and women is of the same composition and of similar shape (but of different sizes).

As another example, the man develops a prostate gland; a woman develops Skene’s glands (also called periurethral glands): both secrete fluid identical biochemically and that tests positive for prostate-specific antigen (PSA)—yes, the woman’s Skene’s glands secrete fluid that contains PSA. Women can even develop cancer in the Skene’s glands that if the same cancer were in a man would be called “prostate cancer.”

Also, the woman’s labia and the man’s scrotum are analogous.

In the man’s embryological development, the testicles descend into the scrotum; in a female, the ovaries remain inside the abdomen; but, both testicles and ovaries serve analogous functions and share analogous anatomical connections.

Also, (and important to extending sex) in both men and women, the spinal nerves travel down the spinal column and branch into the nerves of micturition: the nerves that allow you urinate or to hold your urine in the bladder until you make it to an appropriate place. The spinal nerves (thoracic, lower thoracic, lumbar, and sacral nerves) connect to ganglion; and these nerves also branch to become the pudendal nerve, which extends to the penis and to the prostate gland.

Important: Sensations from the bladder come through the spinal nerves to tell your brain when your bladder is full so you do not urinate on yourself; these same nerves also communicate to your brain the sensations that tell you when your bladder is empty.

When a woman ejaculates (expels fluid from the urethra during orgasm), sometimes the fluid comes from her Skene's glands; but, the fluid of ejaculation can also come from her bladder (she urinates with orgasm)—either way, the same nerves control both urination and ejaculation.

Also, (whether from the bladder or from the Skene’s glands), when a woman or a man releases fluid with orgasm, pleasure increases and emotional response deepens.

Pressure Release Causes Pleasure

Here’s a general principal that applies to both men and women: when a space in the body which has been expanded with a substance to the point of increased pressure then releases that substance to cause a sudden release of pressure, then the release of pressure brings pleasure.

Whether the pressure release is called a bowel movement, popping a zit, urinating, nose-blowing, ear wax extraction, or abscess draining—pleasure occurs with the release. All examples of pressure release do not bring the intensity of pleasure felt with orgasm; but in every case of pressure release, one feels pleasure.

With orgasm, the combination of the release of ejaculate from the Skene’s glands (woman), combined with the simultaneous release of hormones from the pituitary, and sweat from pores can be so physically and emotionally moving that orgasm can be followed by the release of tears of joy and by a change in the woman’s overall physiology—the Chinese, 2000 years ago, called this type of orgasm a “little death.” Indeed, the woman does experience with ejaculatory orgasm an emotional death to that which may be blocking her (mentally, physically, and spiritually), so that she both dies to those blocks and to her old life, and then melts into a resurrected space where she shares ecstasy and clarity with her lover and with her GOD.

The Urge to Urinate Affects the Urge to Ejaculate

I cover the details of a woman’s “little death” in another course of study, Total Surrender Orgasm with Female Ejaculation; that’s a subject for later. For now, the point is that the sensations sent to the brain with both the urge for urination and the urge for ejaculation (for both men and women) are mixed together, all connected to the brain through the same nerves; and because the sensations of both urination and ejaculation travel together to the brain through the same nerves, the dual functions of those nerves make it difficult for the brain to tell the difference between a full bladder and a full prostate gland.

Said another way: you feel the urge to urinate and the urge to ejaculate through the same neuronal pathways to the same part of your brain; therefore, anything that increases your urge to urinate will also increase your urge to ejaculate; and, anything that decreases your urge to urinate will also decrease your urge to ejaculate. In summary,

Increasing the urge to urinate increases the urge to ejaculate; decreasing the urge to urinate decreases the urge to ejaculate!

For the most control of your urge to ejaculate, decrease your urge to urinate so much so that, even if you try to urinate, nothing will come out.

Learning to apply this one concept can change your love-making abilities tremendously.

Factors that Change the Urge to Urinate

Many factors affect the urge to urinate, or even the ability to urinate. For example, some of the cold medications can cause complete urinary obstruction, where a man cannot urinate at all.

Acetylcholine, prostaglandins (some of them released with massage), and nitric oxide are a few of the factors that can affect the urge to urinate. If you study a list of all factors that affect the urge to urinate, the following principle applies: anything that causes relaxation of the bladder neck could make it more difficult to hold your urine (and easier to urinate); these same factors would make it more difficult to hold your ejaculate (or easier to ejaculate).

If something inhibits relaxation of the bladder neck, then it causes contraction of the bladder neck; if something causes contraction of the bladder neck, then it helps you hold your urine and helps you delay ejaculation—therefore helping you extend sex.

Therefore, whatever inhibits relaxation of the bladder neck will help extend sex.

Serotonin going up relaxes the muscles of micturition so you have less urge to urinate (and therefore the urge to ejaculate). Remember, from the last chapter, raising serotonin levels through exercise and light and meditation helps prolong sex; now you understand one of the reasons why.

Nitric oxide also inhibits the efferent firing of the nerves—also decreasing the urge to urinate.


In one research study of men undergoing surgery for rectal cancer, researchers measured both urinary and sexual function and saw that with the decreased nerve function in the area, the men in the study saw the ability to prolong sex (sometimes completely losing the ability to ejaculate at all).

Aerobic Exercise

When raising serotonin levels with exercise, in the same way you cannot run only one day and then enjoy fitness for the rest of your life, with methods of avoiding the urge to ejaculate by avoiding the urge to urinate, you get benefits the day of exercise, but they do not carry over to the next day unless you repeat the exercise. The effects may, if you're really fit, start to carry over for more than one day at a time. But usually, the best effect is the day you exercise.

For example, on the female side, there was a study showing that women who have sex right after aerobic exercise can more easily enjoy an orgasm (and they enjoy a stronger orgasm than if they do not exercise). So, part of foreplay could involve going for a walk or a jog or a swim with your lover; the result would be that the man could delay ejaculation and the woman could more easily orgasm. 1

The runner's high only lasts for a day, but your baseline sense of wellbeing gradually goes up when you exercise daily. In the same way, the immediate effects from exercise, from the serotonin, which lead to longer sexual encounters for you and to better orgasms for your lover, those effects are going to be short-lived until you get your baseline serotonin up with consistent daily exercise. The benefits probably peak around the 25-mile-a-week mark.

But if you go for a week or so without exercising at all, then the benefits of exercise can decrease to nothing.

Full-Bladder Sex

All of the above-mentioned ideas can help prolong sex; but, I promised you a 30-second trick that works. Now that you better understand the anatomy, you will better understand why my trick works.

One of the easiest ways to decrease the urge to urinate (and so decrease the urge to ejaculate) is to simply empty the bladder!

Try the following exercise the next time you have sex: have sex with a very full bladder. You will very quickly have the urge to ejaculate.

Empty-Bladder Sex

Then, the next time you have sex, completely (and I mean absolutely completely) empty your bladder less than a minute before you have sex. You want your bladder to be as empty as you can get it. That means that you urinate; and, then as you're urinating, you do the shiver-Kegel where you empty out the last two or three drops. Then, when you start penis-in-vagina sex, you will find a less-than-usual urge to ejaculate.

Remember my definition of premature ejaculation: if you're ejaculating before you (or your lover) want to ejaculate, that's “premature.” I don't care if you have been having sex for 30 minutes or for 3 hours; if both you and your lover are enjoying the intimacy (whether you are doing tantric sex or you are doing circus, wide-open-jack-hammer sex on your neighbor’s roof), if you ejaculate before you want to ejaculate, by my definition, that's premature. That means that sometimes if you ejaculate after 30 seconds, that is not premature because both you and your lover wanted quick sex before leaving for work; but, sometimes, if you ejaculate after 2 hours, but you wanted to go longer, then that would be premature. Your intention, not the clock, defines premature ejaculation.

The 30-Second Trick: Empty-Bladder Sex Followed by Interruption Combined with Urination (ICU)

The next time you have sex, urinate right before you start (less than a minute before putting your penis in your lover’s vagina). Then, after making love for a time, when you feel the first urge to ejaculate (whether you feel that urge after 30 seconds or after an hour), instead of only doing the basic interruption technique, interrupt your thrusting, and urinate! You will be amazed at the difference in the urge when you start back.

Oftentimes, if you urinate immediately before you have sex (which you should if you want to decrease the urge to ejaculate), then, when you feel the first urge to ejaculate and you stop to urinate, you may only feel a few drops come out; then you start back and only a few minutes later, you might again feel the urge to ejaculate—even if it’s only been a few seconds, urinate another drop or two.

After stopping to urinate only once or twice, the urge to ejaculate will decrease dramatically. The urge that's almost unbearable in the beginning of a love-making session will become less and less until you reach the “Safe Zone” (where you can have sex with abandon for hours at a time if you and your lover have the physical stamina)—your urge to ejaculate will quit being a limiting factor at all.

More about the “Safe Zone” can be found in my complete course, Extend Sex, but the main point of this lesson is simply this, the nerves of micturition are the same as the nerves of ejaculation and erection; at least, there's crossover in the sharing of afferent and efferent nerve conduction for both sensation and contraction.

So if you completely take away the signal to urinate, and then you take it away again when that signal recurs, you can greatly decrease or even eliminate the urge to ejaculate.

Further Tips about the 30-Second Trick

Remember the parasympathetic and sympathetic nervous systems we talked about in the previous lessons? The parasympathetic nervous system has to do with erection; parasympathetic becomes dominant when you relax. The sympathetic nervous system kicks in to help you move when you need to “fight or flight”—and the sympathetic system activates with ejaculation.

Here’s a key point: you can enjoy the ability to keep your parasympathetic system active—staying relaxed and avoiding ejaculation while actively having sex—when you are fit. In other words, if you are aerobically unfit (with a low VO2max), then you need to kick in your sympathetic nervous system at a lower activity level—and when your sympathetic nervous system kicks in, then you begin to have a stronger urge to ejaculate. So, being aerobically out of shape makes it more difficult to avoid ejaculation when you enjoy active sex.

Exertion Combined with Relaxation

So one of the things you can practice this week is walking or jogging (with your doctor’s permission) while simultaneously keeping your body relaxed, the muscles of your face, your arms, even your legs should stay relaxed while you walk or jog.

When I ran marathons, I would focus on keeping face, arms, even legs completely relaxed while running (talk with a marathoner to learn more about how this can be done). You can practice this while doing any work, even desk work or reading: simply notice the muscles of your body; notice now; are you contracting muscles that are not needed to do the work in progress?

Are you contracting the muscles of your neck and back now, while reading or listening to this lesson? If so, then right now, breathe in and out deeply and keep reading while letting go of the muscle contraction in your shoulders, back, and arms, and legs.

In other words, practice working your body (sitting is more work than lying supine) while simultaneously relaxing your body so that your parasympathetic nervous system stays dominant, not your sympathetic nervous system.

Then, after you practice walking, running, and sitting while keeping your parasympathetic nervous system dominant; after you practice doing your daily work while staying relaxed; then practice doing the same thing (staying relaxed even during exertion) when you next enjoy vigorous sex.

So, as you enjoy vigorous sex, the idea is that you are aroused, you are into your lover, you enjoy the sensations, you enjoy the sounds and the connection, and the emotion and you actively and forcefully thrust yourself into your lover, but your body stays relaxed while you move.

Whether the motion of you and your lover demonstrates tantric sex that is maddeningly slow, or whether you and your lover grow outrageous with screaming, sweating, panting, and the walls of your house shake so much your neighbors think you are remodeling the kitchen—either way, your body stays relaxed.

If one can sprint a hundred yards at the Olympics and stay relaxed while doing it, then you can enjoy sex and stay relaxed.

Note: If you masturbate to practice these ideas, do the same thing—urinate right before you masturbate and stay relaxed while masturbating. If you practice penis-root massage, either by you or by your lover (see Extend Sex for more details), urinate right before practice, then practice the penis-root massage in the same way, except, if you feel the urge to ejaculate during your penis-root massage, stop, urinate, and then start back.

Where do you aim it?

When you create a state where your parasympathetic nervous system becomes dominant (and your sympathetic system downplayed), you will see much better erection and ejaculation control so that (with practice) you can extend sex much longer. Now, here's the problem and why are you not going to want to do this simple little 30-Second Trick of emptying your bladder before and during sex: your lover will feel frustrated when you stop sex to urinate.

Think about it: she’s moaning, she’s moving in synchrony with your body and both of you move in synchrony with the spinning of the Milky Way, she's on the verge of an orgasm that feels like it will become a prayer of devotion and love and screams and visions of prophecy—but now, you need to stop on that precipice so you can pee!

She's not going to like it.

And so, you should tell her what you are doing and why; inform her that if we do this, once, twice, three times, maybe, it will become easier to prolong sex and we can find that powerful space in prolonged intimacy that is without words.

Keep the Momentum of the Music

In the meantime, when you stop to urinate, to keep from losing all the momentum (though she will usually lose some), she can masturbate while you “take a leak.” If you are outside, taking a leak (urinating) might just meaning taking a step away and aiming at the grass. Or, in your home, you maybe only need to take a few steps to the bathroom. But, when you go to the toilet, now you left the room where a woman who was on the verge of a magic space waits without you. She will not to like it. But she is going to love it when she figures out that by you taking a pause or two, now you can provide for her two minutes or two hours, or a full day of sexual intercourse—whatever she and you desire that day.

Other things you can do to help keep her from feeling frustrated when you practice the 30-Second Trick interruption combined with urination (ICU) include the following:

First, hopefully, you have made it to a psychological place where you are not jealous of a vibrator; let her masturbate with her vibrator until after you urinate and until you climb back into her love saddle. People cloister different ideas about masturbation; some men become furious that their wife might be sexually pleased by anything other than her husband’s penis; you may want to rethink that attitude if that describes you. Just give her something else to play with for the few seconds it takes you to step to a place where you can urinate.

In addition to the vibrator use, another (perhaps more outrageous) thing you can do is to go onto Amazon and buy an old-school, plastic, bedside urinal (like what hangs on the side of a bed in the hospital). Stick that urinal under the bed (it does not look too sexy sitting on the bedside table next to your olive oil and incense). Then, when you need to stop and pee, just turn your back to her, pee into the urinal and you do not need to leave the room. This strategy allows you to still speak words of arousal and to perhaps touch her with one of your hands while you urinate (assuming you like to multitask).

The simple plan that works best for most is to give her instructions (or “permission” or “encouragement” or whatever you want to call it) to keep her arousal heightened with her hands while you step away for a few seconds to the bathroom to urinate.

Remember: once you make it to the Safe Zone, then ICU becomes unnecessary and you can enjoy continuous lovemaking for as long as your VO2 max and your collective desire may allow.

Avoid the Erection Killer

One practice that will help ICU (and the other strategies that I teach) work better is if you do not drink alcohol right before sex. Remember: alcohol (when the man drinks) will kill the 30-Second Trick (ICU) in at least two ways:

First, alcohol is a diuretic; alcohol causes your body to make more urine, which makes it more difficult to keep your bladder empty, which makes it more difficult to avoid ejaculation. Not that you need to be dehydrated to have sex, but if you just guzzled a six-pack and now you go to it, it might make it harder to keep your bladder empty not only because of the extra liquids but also because alcohol causes your kidneys to make more urine (and so your bladder to fill more quickly) for the same amount of liquid consumed.

The second way that alcohol interferes with the implementation of ICU is that you simply can’t focus as well after you drink alcohol; so you have more difficulty perceiving the edge of ejaculation approaching. You need to be able to enjoy the sex with your passion or “lizard brain” while at the same time your left brain stays attentive to the beginning of the edge so that you can stop to urinate before you reach the point of no return. Using both your lizard brain (midbrain) and your left brain at the same time is much easier if you are sober.


  1. Question: What's the 30-second trick?

Answer: Interrupt penis-in-vagina thrusting for 30-seconds to urinate whenever you feel the urge to ejaculate (Interruption Combined with Urination, ICU); keep the bladder completely empty down to the last drop before and during your sexual encounter.

  1. Daily, practice keeping your parasympathetic system dominant by practicing relaxed activity.

For best results, practice for at least a week all the methods described in the previous lessons in Extend Sex (all the methods, not just the walking). Then. practice ICU and aerobic exercise for the rest of your life.

  1. Carefully notice: how does the feeling (in your head and in your genitals) of the urge to ejaculate change after you urinate? After you stop to urinate, and then resume sex, how does that feel to you compared to simply interrupting sex without urination?
  2. Also, this week, keep your aerobic exercise going (with the goal to consistently do 25 miles a week on foot), especially try to do aerobic exercise right before you have sex. Try to do aerobic exercise at least six days a week; keep a record of miles walked per week so you keep yourself honest with yourself.
  3. Continue to do the other practices we discussed in previous lessons in Extend Sex concerning the adjustment of serotonin and the parasympathetic nervous system.
  4. Every time you have sex, urinate before you start your sexual encounter. Then, while you are enjoying the sexual encounter (either with penis-in-vagina, or penis-in-whatever-orifice sex, or if you're masturbating with you or your lover), while you are enjoying sex, purposefully stop before you ejaculate, urinate, then start back; then, stop and urinate again (when needed to avoid ejaculation), and start back.
  5. Do at least two cycles of ICU before you allow yourself to ejaculate; more is better when practicing.
  6. Do not keep your practice a secret from your lover. Recruit her loving understanding and participation for your pleasure and for hers.

Remember: every love encounter does not need to be an all-night symphony; sometimes, a minuet is absolutely heavenly and more would be an intrusion.

But, when an all-night concert is wanted, I think you will find that my 30-Second Trick (ICU) will help deliver a private “Stairway to Heaven” for both you and your lover.

©2021 Charles Runels, MD

More resources at ,, and

  1. I do not recommend bicycles at all. They can damage the pudendal nerves that help you feel the pleasure of sex (even with a properly fitted seat. ↩︎

Jack Hammers, Space, & Sex

Even though by studying my course Extend Sex, you can possibly become a man who can provide sex like a jackhammer with extended, mindless, unrelenting thrusting for hours and hours and hours (and hours), actually performing in that way every time you enjoy a sexual encounter should not be your goal. To understand sex as both passion, love, and art, dangerous strength, and sacred tenderness, listen to George Winston's December Album (one of the compositions can be heard in the following video).

This is not a rhetorical request, buy the album (preferably on vinyl); then listen to it from start to finish, in one session, in the dark, without speaking or allowing anyone else to speak. As you listen, you will learn about lovemaking and sex: notice the space between the notes—the silence. Notice that he, on occasion, demonstrates technique, finger speed, and dexterity sufficient to play as quickly as anyone. His fingers can and do sometimes move magically fast. But, when he plays, Winston shows no need to prove his abilities. Instead, he uses silence to make you want the next note.

He often only gives you the next note after making you wait a long second more than you expect; then, because you waited, when the note finally comes, you hear it, really hear it—you more than hear it. When he does give you “fast” and “loud,” slams your ear with a forceful stream of notes, he does so only after enticing you with “slow” and with “space” until you want “fast” and “loud.” Then, he makes you wait a little longer.

The space between the notes, the silence, makes the notes magic; and, maybe, more importantly, the space between the notes becomes as thrilling as the notes.

After you understand George Winston, you will see that artful thrilling connecting sex is like his compositions. Being able to thrust jackhammer style for hours does not mean that you should any more than George Winston should make his fingers move as forcefully and as quickly as possible throughout an entire album or concert just because he can.

Of course, to perform as an excellent pianist, Winston must have the ability to play quickly and with strength and volume—and we expect that and demand it or else we put away his music as weak and impotent; but much of the time, he plays very softly and leaves long space between the notes.
With sex, you must, as a man, claim the solid mechanics of this glorified water balloon we call a penis and learn to maintain its fullness for hours at a time; but the mechanics without the art turns sex into a nuisance at best.

More details<--

Extend Sex…Cats, Cars, & Old Guitars

Examine the 10-Week Course at the Orgasm College™: Extend Sex...Dr. Runels "Secret Man-Map to Prolonged Pleasure & Deeper Intimacy" (90-Day, Money-Back, Guarantee)<--

Willie Nelson's Guitar, "Trigger"

Law of Health

If you want to find the laws of driving, you go to the courthouse or read a sign.

If you want to know the spiritual laws, you read the scriptures.

But, if you want to find the unchangeable Law of Health, if you want to know what rules of health have always been and will always be, where do you go?

Eleven years ago (after 20 years of studying those who suffer from disease and those who enjoy superior health) I wrote my best understanding of the unchanging Law of Health. Considering the current worries and needs of the current coronavirus pandemic, I thought the laws might be helpful to reconsider.

To examine the Law of Health, enter your info in the form below; you will receive the first lesson on the first law as an email. The lessons are completely free and of course, you can unsubscribe at any time and your email is never sold or shared.

Study the law (will come as an email most days for the next 10 weeks). If it makes sense to you, then do some of the actions suggested (to have a better life requires doing-not just knowing).

DO NOT GIVE UP THE ADVICE OF YOUR PHYSICIAN. Simply consider these specific laws of health with your physician and other health advisors.

Live the truth you know today (in an imperfect human way) and tomorrow you will find more truth. Look for the next email lesson within 24 hours. If you do not receive, please let me know at

A Novel New Tool for Treating Infertility in Women


This is a very important, extremely important article about the very difficult and heart-wrenching problem of how to help a woman become pregnant who is struggling with a particular form of infertility where the lining of the endometrial cavity is or the endometrium is too thin. If you think about it, and this was pointed out in the article, it's really miraculous that a woman can have bleeding and shedding of the endometrium every month throughout her reproductive years without scarring. Any other tissue in the body would have trouble with scarring. But unfortunately, there are some women who do scar, it's talked about in this study, is Asherman's syndrome where intrauterine adhesions happen, which the miracle is that all women don't have that as this bleeding and shedding takes place every month. Or then some people just seem to have somewhat genetic propensity to it. And then there is this lactobacillus-dominant endometrial microbiome that's supposed to be happening and sometimes that happens to not be the case. There's something other than lactobacillus dominating the endometrial microbiome.

And I know that there are those who poo-pooed the studies of putting yogurt in the vagina, but just as a sideline, it makes sense. There's only two places I know of in nature where lactobacilli live, the woman's vagina, the endometrial cavity and in yogurt. So unflavored yogurt, it really just does help change the flora and there are studies to support that. How many studies we need to make it a prescription accepted thing, I don't know. But I know this, if there was a medicine that had the same sort of biological and logical reasoning for working and I had a patent behind it, you'd see ads about it on television. But anyway, that's a sideline. The bottom line is that some people don't have lactobacillus-dominant endometrial microbiome and some women do have scarring and some people do have thinning.

So there were two studies that are referenced in this article about using PRP, which is known in dentistry and known in wound healing, plastic surgery, orthopedics for 20 years. This is not new science in those arenas, but as pointed out here, it's new to the arena of gynecologists. And you see gynecologist jumping up and down saying, "There's no research to support this." Well, this as in using PRP or platelet rich plasma to help women with urogynecological problems, it's because they've lived in a bubble where this research hasn't existed. If you read dental research or if you talk with dentists, orthopedists, they've quit debating about whether platelet rich plasma does anything. It's not the magic cure-all be-all, but their discussions are on a deeper level about what does it do and what can we do with it and what can we not do with it.

Hence, you're starting to see, as pointed out here, that there has been minimal investigations in date in gynecology about PRP, but minimal in relations to other domains or specialties like dentistry and orthopedics, but still a growing number. And hopefully in the next 10 years, it's usually 20 years for a new idea to take effect, we're 10 years in with the O-Shot®, so probably in the next 10 years it will become widely done. Just watch, it will happen.

So what's happened is there've been two people published studies showing that infusing the uterine cavity or in bathing the endometrium with PRP helps rejuvenate the tissue to make it healthier, to enhance the probabilities of becoming pregnant for a woman with the problems that happen with endometrial thinning. So hence, this study to say, "Okay, we have those clinical reports. Let's look on a cellular basis in vitro, in a culture, outside of the body with those cell types and see what happens with platelet rich plasma."

So they use saline as a control. They use platelet rich plasma and platelet poor plasma, and they found that platelet rich plasma does enhance the growth of the right kind of tissue and migration of the right kind of cells to the right place for the same things you see in dentistry to prevent scarring and to grow healthier, more vascular tissue, which in theory would explain why they saw the effect in the two studies that were done to show that it may actually help women with this as a cause of their infertility. The other thing is that we have in vitro studies showing that PRP, which is what your body normally makes ... It's not some esoteric thing. When you scraped your knee as a child, PRP is what caused the scab and the healing and the regeneration of the skin. PRP's what happens every time you have surgery or you have a wound. That's how it heals. The platelets bring growth factors, the [inaudible 00:05:11] cascade happens and you recruit stem cells to the area and you grow new tissue.

It's not a new idea. It's been around since people have been wounded. When people fought in the middle ages with swords, the PRP healed the wound. So it's not a new idea. The newness is, how can we take what's already happening in the body and harness that to help people with disease. The other thing is because we know that's part of the healing process, we have multiple studies showing that PRP has anti-microbial ... It acts as an antibiotic. And it could be that's another reason that's happening, because it may help take care of the bad microbes and therefore help the good microbes or lactobacilli flourish.

That's a reach for the explanation, but it's in line. It's not homeopathy or some weird idea from outer space. Homeopathy as not in nutrition as some people apply it, but homeopathy is one part in 10 million somehow make something happen, which doesn't happen. So this is not homeopathy. This is a logical thing that's backed up by every time you heal a wound and by 20 years of research in other arenas and now it's finally becoming more commonly done. We've done it with the O-Shot® now for the past 10 years to help rejuvenate the tissue around the urethra. It doesn't work in everybody, just like antibiotics don't' working in everybody. 5 to 10% of people in the hospital with pneumonia still die, even with antibiotics. 30% of the people in the intensive care unit with pneumonia still die even with antibiotics. But we don't say antibiotics don't work. They just don't work all the time because sometimes a person, their milieu or their body's not able to heal itself for whatever reason.

In the same way, maybe the problem isn't the vagina. Maybe the problem with infertility is hormonal issues or low sperm count with a man. This isn't the end-all, be-all, cure-all, but it's a very intelligently designed way to help a woman who has endometrial thinning or scarring of the endometrium as a cause for her infertility and it should definitely be studied. The problem is, as we found with the O-Shot® procedure, funding is difficult because there's no patent on blood, so yay for these investigators who had to do this out of their own pocket as we have had to done with the O-Shot®. I've spent over $300,000 just in a couple of years with research on the O-Shot®. More coming. We'll spend another 100,000 this year. It's funded by the physicians in our group, who by the way, should be giving money back and almost all of us do, if a patient isn't happy.

You can't be preying on people's pocketbook if you're not keeping their money, if they're not happy. I started taking cash in 2003. I've never kept a penny of a patient who wasn't happy. In that case, we've lost our money and we've lost our time and we're very sorry the person isn't well and we try to find something else to help them. Every procedure is with risk and without 100% guarantee. Every procedure has risk and every procedure is without 100% guarantee. So there's a consent form with our procedure. If you have the O-Shot® or if you have PRP infused into your endometrium, you should read the consent form. You should understand that you don't have to be treated at all. You certainly don't have to be treated with PRP. You should make sure that someone in our group has agreed to use FDA devices that are designed to prepare platelet rich plasma to go back into the body.

If things don't work well, you should discuss it with your physician and continue to demand that someone help you. Don't give up. Sexual function is so important. It's more than about pleasure. It's about relationships. It's about the psychology of feeling whole. It's about even spiritual enlightenment. Hence, the ideas of chastity when it comes to spiritual enlightenment in many cultures and religions. Sexuality has to do with creativity and personality. So it's not just about pleasure, it's about part of the foundation. Emerson said it was the scaffolding of love, hence the scaffolding of our families to build. Maybe you don't need a scaffolding after the empire is built, but it helps build the building of your relationship with your lover. So consider this talk with your physician about it. If your physician wants training, we have training. We have teachers around the world. We have over 2000 doctors in our group. We have people in over a dozen medical schools. We have ongoing research. Read it, think about it, talk with your doctor about it, and let's push our tools for healing women.

It breaks my heart when, when it comes to sexual dysfunction, we keep offering women vibrators and lubes or psychological. Everything's not in your head. If you have an endometrium that's thin, that's not in your head. That's in your endometrium. If you have scarring from having a big baby that tore the vagina, that's not in your head. Hence, the treatment is not psychological medicines that affect the brain. And there's better treatments than just a lube and a vibrator. We have so much better science than we did. I hope that you'll investigate. Read the science for yourself. Don't just blindly listen to the naysayers. Usually, 20 years for a new procedure to take effect in medicine. Read the science. Talk with your doctor and take care of your body and value your sexuality. I hope this helps you or someone you love.

Read the research-->>(click)-->In vitro evidence that platelet-rich plasma stimulates cellular processesinvolved in endometrial regeneration<--

Yogurt for healthier vagina-research

PRP as antibiotic--research

More O-Shot® research<--

Find nearest O-Shot® provider

Physician training for O-Shot® procedure

Cellular Medicine Association

Total Surrender Orgasm With Female Ejaculation

Total Surrender Orgasm with Female Ejaculation

Action Group for Men ONLY

What's the Real Problem with Most Love Relationships, and How Do You Fix It?

What if when you made love to a woman, you left her completely limp, exhausted, covered in tears of happiness, wet with her own ejaculate, and basking in the afterglow of a pleasure so amazing that she collapsed in happy bliss and in obedience to your wisdom and skill in helping her to pleasure and safety?

Yep--That's a mouth full; but it's possible.

When you look at all the courses on lovemaking, all the supplements and courses to improve connection, and sex, and appearance and even the size of the penis, when you study all the info on the best way to dress (even why people read the scriptures)--for what do most people search in the way of sex and love?

After talking with over 3,000 women about the intimate details of their health and their lives, after writing the best-selling sex manual that brought to me male patients and letters from readers around the world, after way too many lovers (on a personal basis), after studying the latest in sexual research and even doing my own research in the areas of sex and physiology---this is what I consider the problem that persists that most cannot even articulate: no matter how controlling on angry she may seem, most women want to rest in the love of a man who is on an adventure, she wants to be the beauty that motivates and inspires, and (now here's the politically incorrect part that may make you gasp)--she wants to feel so secure and loved and trusting that she relaxes and becomes--OBEDIENT.

I know there will be many angry people, just because I wrote the "O" word. But, ironically, the angriest, the most denying, are the most unhappy because they have not found a safe place to rest in the "O" word (and I don't mean "orgasm").

She wants to be obedient, but you must be worthy and able to accept her. Most women are unconsciously testing men to see if the man is strong enough to rule her (in a loving way) and become disrespectful and angry when the men come up short.

Scary word. "obedience", and most women would rather you ask them for anything other than obedience. But, in the right situation, they will gladly give it to the man: the right situation is--"Total Surrender Orgasm with Female Ejaculation."

Just for me to write the "O" word took much courage on my part because I know how much it's misunderstood and can even provoke more anger than most four-letter words.

But, wait, please let me explain the real secret of the "O" word...

What if she knew the man loved her enough to die for her with a completely unselfish love? What if she knew that he loved her so much he would never want anything for her except the very best, even if it brought him pain.

What if she trusted his judgment (because of his love); thought him strong and wise and connected to a higher power; what if she thought his soul connected to hers so that she knew that when she cut her finger that he would bleed--that when she had an orgasm, that he would feel ecstasy?

What if he really knew her body better than anyone--including herself?

Do you think that then, perhaps, she would know that whatever he asked would at least be the best for her, then, knowing that, could actually become eager to know what he wanted of her, and start living the "O" word even if her ladies magazines have taught her to deplore it?

If she knew that she would blossom with beauty and with happiness and with pleasure if obedient to him, would she want to be obedient?

It's pretty straight from most scriptures: The man loves the woman enough to die for her. The woman obeys the man with devoted surrender.

He gets respect. She gets love.

Sounds pretty cool, but how to pull that off?

More importantly, how do you relate to a woman emotionally and physically to find this very sweet surrender (and I mean sweet for her even more than for him).

Just being a "good lover" will not do it; she could have many "good" lovers who are mechanically adequate in bed, but she's looking for "something more."

Just listening will not do it; her friends listen.

Just being strong or rich or having large biceps or a large penis or a handsome face--none of these will do it.

She may think that when she meets the man with any combination of the above that she has found the man to whom she can surrender--but after a time, she realizes that none of these are enough and she will start to pull away, grow dissatisfied, and look elsewhere or settle into a tasteless routine.

An Experiment to Prove the True Nature of Men and Women

Show me a woman who is totally surrendered to a man who does not love her completely and I will show you a woman being abused by a man (physically, emotionally, or both).

Show me a woman who is not surrendered (and obedient) to a man who completely and unselfishly loves her, and I will show you a man who is broken physically and financially by the emotional (and yes sometimes physical) abuse of the woman he loves.

Here's the Experiment...

Stop now: Prove the truth of these words by thinking of couples who fit both categories.

  1. The surrender of the woman without the unselfish love of the man leads to the abuse of the woman.
  2. Unselfish love of the man without surrender of the woman leads to abuse of the man.

Could you think of examples of both cases? Women find it easier to think of cases of the first situation. Men find it easier to think of cases of the second example.

It takes both to have the perfect match. A wise, strong, loving man. A wise, strong, and surrendered woman.

Show me a woman who is totally surrendered to a completely loving man and I will show you a loving, excited, happy couple.

For this to work, the man's love must be greater than the woman's to earn the surrender of the woman. That is the way of the ancients and it's what's missing from the modern that results in the turbulence and the breakups of most marriages.

When the man puts on the suit, or lifts weights, or studies martial arts, or reads a book--he wants the surrender of a woman--but none of these will work.

When the woman puts on the dress, or gets the manicure, she wants the love of the man--but none of these will work.

Why the Problem Continues...

So, if this is the highest way between man and woman, and it's been spoken for at least 2,000 years, then why does the problem continue?

Here are several reasons:

  • Sometimes the man is fearful of the woman, when what the woman really wants is for the man to be man enough to stand up to her--to not be afraid. If he can't stand up to her, how can he be strong enough to stand up for her?
  • Sometimes the man loves the woman dearly but simply does not know how to communicate to the woman that he loves her enough for her to find rest with him (If he thinks his words or his money will do it, then he's in for some pain).
  • Sometimes the woman is so fearful of giving up control to a man (who might then abuse or neglect her) that she cannot find the courage to surrender (and he does not know how to help her find that courage).
  • Sometimes the man truly does not love the woman enough, nor is he strong enough, or wise enough to give her a place to rest--so she cannot surrender--it would be like stepping off a cliff to fall into an abyss.
  • Sometimes everything is in place (the man is able and loving, the woman is able and wanting) except for the man understanding a way to make it happen. Here the man struggles to find a better way to talk, or buys more things, or tries to have more sex, or less sex, spending more time, spending less time--until he's exhausted and she's confused. Until, with a deep feeling that everything could be perfect but with exhaustion from not being able to set it up, finally the couple splits to try to find bliss another way.
  • Or, without knowing what or how to find the total surrender to the perfect love, both parties settle into a place of mostly peaceful cohabitation. Never going deeper and never splitting apart. Never knowing the full bliss of a male and female union but living together to avoid the pain completely being alone.
  • Plainly this level of devotion and understanding is not easy, which is exactly why it cannot be found in the quick and meaningless encounters. This situation is the reward of those truly devoted to each other and is one way to define the heavenly bliss that should define a committed love. So, this situation only comes about with at least the idea of being together in some way forever (which ironically most people fear because they do not know what is possible).

How sad that some people think the only reason for a long-term relationship is either the rearing of children or the avoidance of sexually transmitted disease or to keep from being lonely. You can accomplish all of these ends fairly well and be reasonably promiscuous with only short-term relations.

But, to accomplish what I am describing demands that you go to the core of your being as a man

and find the core of her being as a woman.

And, the reward is the definition of love and of sexual bliss.

The Problem Continues Because Most Men are Learning Bed-Room Tricks and Lifting Weights and Buying Gifts Instead of Finding the Holy Pilgrimage to a Woman's Soul

The path to this blissful place cannot be explained in a 3-page article in Cosmo Magazine or in Men's Health Magazine. You won't find it exactly laid out in the scriptures or in the sex manuals or in the gym (though there are ingredients and clues in all of those places).

To really successfully follow this path requires a working knowledge of at least the following:

  • The psychology of a woman's surrender both emotionally and sexually (almost the same).
  • The different types of female orgasm and how to help a woman to each type.
  • The physiology and endocrinology of excellent female health and sexuality.
  • The detailed anatomy of the female body, especially how it relates to the different types of orgasm.
  • The sexual techniques of a man that allow him to have unlimited sex (not worrying about premature ejaculation).
  • The special techniques that best provide a deep, earth-shattering, ejaculating orgasm for the woman (one of these I developed and have seen in no other book).
  • The spiritual laws of sexuality that allow unbridled passion without boredom.
  • The how to find the courage to love her fearlessly (and why it's your own emotions that you should most fear). Why you won't take her to bliss and obedience without this because she will know your fear and hold back.
  • How to find the connection to a higher power from which she can draw strength through her connection to you. Are you really brave enough to become the "priest" of your house that sanctifies her sexuality and then fills it with exploding passion that show's her heaven on earth?
  • How to be loving without becoming wimpy. If you cater to her every need in a wimpy way, then she has castrated you and will look at you with disdain because you allowed that castration. If you love her unselfishly but with strength, then you have discovered the art of a manly love and she will surrender to you. Men who make idols of their lover will eventually know their lover's disdain.
  • According to ancient scriptures, the man who loves his woman in the wrong way will literally have his prayers "hindered" --eventually being cut off from both wife and God.

In summary, the reason the problem continues is that these are not easy skills and they are nether widely known nor widely taught. It took me until the age of 40, a few thousand patients, too many lovers, a study of scripture and physiology, sex manuals, anatomy, psychiatry, endocrinology, and a broken marriage to even start to become aware of the existence of these skills and laws.

The understanding of these laws and techniques is as deep and as profound and not far removed from the understanding of the Creator and discovering how to love the woman in your life can be a way to discover the face of that Creator.

A Powerful Tool for Finding Complete Surrender--What Is Possible with the Level 9 Orgasm

About a year ago, I discussed the idea of female ejaculation and offered a seminar to teach some very esoteric techniques.

I have closed that seminar for now; but I am offering a course that presents many of the techniques in audio and written materials. This is not a course to read and think about. This is an action group with home work assignments.

The goal of the group is that your lover will reach a place of more loving surrender and of female ejaculation. Before you get too excited, be sure to read this.

What This Action Group Cannot Fix:

  • If your woman has the personality to roam--borderline personality disorder, narcissistic personality disorder, and others--then she will roam no matter what. No man will ever satisfy her because she is unable to find satisfaction. But, she will still be obedient to you when she is with you.

  • If you do not do as instructed, then you will not see results. This is an action group, not a study course. You learn to do or else learning does not change your life.

  • If your relationship is damaged, it may take being away from your lover for a time or starting over with another person. Sometimes, you can't un break a glass. But, if you start over, you will increase your chances of a real connection.

The Tools to Teach You the Skills

Week 1: Total Surrender Orgasm with Female Ejaculation Part I (One hour MP3 audio recording).

Week 2: Anytime...for as Long as You Want: Strength, Genius, Libido, & Erection by Integrative Sex Transmutation 15-day course for men to improve sex and life.

Week 3: Total Surrender Orgasm Part II (One hour MP3 audio recording) Explains

Week 4: The Law of Health: 10 Essential Steps to Glorious Health & Miraculous Healing. A 10-Week course to find your best health and your best shot at rejuvenation and healing of your body-temple.

Week 5: Dr. Runels Recipe for Erection Enhancement. How to make your penis larger and healthier. What women really think about penis size. When size matters and when it does not.

Week 6: The #1 Health & Energy Secret Without this one you will have less energy to give.

Week 7: Total Surrender Orgasm with Female Ejaculation Part III (One hour MPE audio recording). Explains

Week 8: The Magic 9 techniques for extending lovemaking for as long as you want making ejaculation like a light switch that you turn on or off at will.

Week 9: Practical Application of Integrative Sex Transmutation: Advanced techniques for transmuting sexual energy into strength, energy, intelligence, creativity, spiritual enlightenment, and into the sexual and physical connection that makes two lovers become one.

For about the price of dinner and a movie, you can learn how to elevate your sex and love-making to a place of which few know exists and even less ever see.

I've been asked by some of my group to extend this price but after one more week, the price goes WAY up (haven't decided how much yet). Most offer discounts to get new clients. I'm offering a discount because you've been reading my stuff already.

Hope to hear from you. I'll be advertising the group and going up on the price in a few days.

(credit card will not show the name of the action group) 100% guaranteed results

Peace & Health,


Charles Runels, MD

The Sex Energy Doctor™

Bookmark and Share