1. Software that helped…

If you prefer to take notes using the SmartNote system, RoamResearch seems to be more useful than Evernote. Here’s where the idea behind the app is explained (click). I admit I tried to use the old-school index card method for the SmartNotes (as per the developer), but the index cards were not being filed, so I swapped to RoamResearch (also recommended by the author of the book). (here’s where to try the app).

2. Helpful research…

During my years as a general internist, I saw frozen shoulder too frequently disrupt the ability of the elderly to recover from stroke. The treatment has been surgery or corticosteroids. The following article showed that PRP injection of the shoulder improved range of motion more than did corticosteroid injections: click.

3. Most important research I read this week —

When COVID was initially blasting through the planet, I once heard Dr. Fauci quote a mortality rate of 4%… BEFORE we knew the incidence in the general population.

The mortality rate eventually turned out to be less than what he quoted; he was looking at the mortality of hospitalized patients and wrongly speculating on the mortality in those infected who did not require hospitalization (this was before widespread testing was available, so he just did not know the incidence rate). Eventually, as a way to think about things with real numbers, I used real numbers available to the public and did the following easy, 5-step calculation…

1. I used mortality as the main marker, thinking that it’s hard to fake or ignore a death and less likely to be misidentified than say who is sick with COVID.
2. Then I postulated that the mortality rate would naturally be directly proportional to population density.
3. Then I calculated a linear regression with population density for each state on the x-axis and mortality rate on the y axis.
4. Not surprisingly, there IS a linear correlation (correlation coefficient of 0.68 at that time).
5. So, then I looked to see if the more restricted states were seeing a mortality rate less than predicted and if the less restricted states saw mortality more than predicted. Such was not the case (you can see those calculations here)<—

I know, it’s a very rough estimate, but the numbers convinced me to stay as healthy as possible and inclined me to feel a little like I was endorsing the Tooth Fairy when practicing social distancing or when wore a mask on the sidewalk or in a store (to me like trying to cage mosquitoes with a rabbit cage).

But, who was I to say? So, I played the game when asked or stayed in my bubble.

This week, however, researchers at Johns Hopkins looked at an initial pool of 18,590 studies, narrowed those down to the 117 eligible by their criterion (one of which was that they also chose morality as the more reliable number), and did a meta-analysis.

Here are the conclusions they reached:

“Overall, our meta-analysis fails to confirm that lockdowns have had a large, significant effect on mortality rates. Studies examining the relationship between lockdown strictness (based on the OxCGRT stringency index) find that the average lockdown in Europe and the United States only reduced COVID-19 mortality by 0.2% compared to a COVID-19 policy based solely on recommendations. Shelter-in-place orders (SIPOs) were also ineffective. They only reduced COVID-19 mortality by 2.9%. Studies looking at specific NPIs (lockdown vs. no lockdown, face masks, closing non-essential businesses, border closures, school closures, and limiting gatherings) also find no broad-based evidence of noticeable effects on COVID-19 mortality.”

And their closing paragraph…

“The use of lockdowns is a unique feature of the COVID-19 pandemic. Lockdowns have not been used to such a large extent during any of the pandemics of the past century. However, lockdowns during the initial phase of the COVID-19 pandemic have had devastating effects. They have contributed to reducing economic activity, raising unemployment, reducing schooling, causing political unrest, contributing to domestic violence, and undermining liberal democracy. These costs to society must be compared to the benefits of lockdowns, which our meta-analysis has shown are marginal at best. Such a standard benefit-cost calculation leads to a strong conclusion: lockdowns should be rejected out of hand as a pandemic policy instrument.”

4. Helpful business book…

So many time management books populate my shelves, yet some days I still feel more like a leaf in a hurricane than a man walking a straight path to intended results.

I’m several weeks into the 12 Week Year method and am finding some fresh ideas. The workbook that goes with the book has been, perhaps more helpful than the book.

5. Quote I’m pondering —

Rachel Corbett’s book, You Must Change Your Life, describes the relationship between Rainer Maria Rilke and Auguste Rodin and relates when Rilke’s Letters to Young Poet were written in relation to the lives of the two men. In one passage in the book, Corbett documents the two men discussed a quote from Beethoven; so, I thought, perhaps it was worth meditating on for me as well:

“No friend have I, I must live with myself alone: but I know well that God is closer to me than to others in my art, I go about with him without fear, I have always recognized and understood Him; I am also not at all afraid for my music, that can have no ill fate; he to whom it makes itself intelligible must become free of all the misery with which other are encumbered.”

And, please give me feedback: hit “reply” and shoot me an email, or on our membership sites, or on our weekly Journal Club with Pearls & Marketing. Which bullet above is your favorite? What do you want more or less of from the CMA? Other suggestions? Please let me know!

Have a great week!

Charles

P.S. The last book I launched could be of help with your patients who suffer with premature ejaculation: Extend Sex: The 30-Second Trick. You’ll notice that my trick makes use of the functional anatomy, even though I did not know the anatomy when I dreamed this up 40 years ago.

Next Hands-On Workshops with Live Models<—

FORWARDED THIS MESSAGE? Learn more about the CMA here<—

References:

Corbett, Rachel. You Must Change Your Life: The Story of Rainer Maria Rilke and Auguste Rodin, 2017.

Shahzad, Hafiz Faisal, Muhammad Taqi, Syed Faraz Ul Hassan Shah Gillani, Faisal Masood, and Munawar Ali. “Comparison of Functional Outcome Between Intra-Articular Injection of Corticosteroid Versus Platelet-Rich Plasma in Frozen Shoulder: A Randomized Controlled Trial.” Cureus, December 21, 2021. https://doi.org/10.7759/cureus.20560.

Ahrens, Sonke. How to Take Smart Notes, 2017.

Moran, Brendan, and Michael Lennington. The 12 Week Year. New Jersey: John Wiley & Sons, 2013.

Hello

Thank you very much for trusting me to help you with your intimate health.

Here’s where to book the first appointment<–

If you have any questions, please text my cell phone at 251-648-7704

best regards,

Charles Runels, MD

Got here by accident or want to share this service with others? Here the details about VaginaLab™

5 Things that Helped Me Last Week (2021August23-29)

For Members of the Cellular Medicine Association

Hello!

Here are 5 things that helped me last week…

1. Idea/business book that helped me last week…

Propaganda, Bernays 1928. I just had to pull this one out again. No one would ever say, “Hey, let’s make a plan where we have our enemy make a circle around us; also, we can let the enemy mix with civilians so if they do something dangerous, we can’t shoot back.”

But, if things went unexpectedly, and that scenario happened, Bernays would have said, let’s reframe it with propaganda: “We have a common interest with our enemy; our enemy who surrounds us is now our “partner” to help keep us safe.”

When in reality, we are safe as long as we do what our “protection” demands.

The word “Propaganda” eventually got a bad reputation (Bernays wrote this book in 1928). But, Bernays (who was Sigmund Freud’s nephew) pioneered the idea and wrote some of the seminal works about influencing public opinion.

We covered another one of his books a few weeks ago (Crystallizing Public Opinion). Read them both if you want to find a good feel for the basics of propaganda.

Like any influence, propaganda can be used for good or bad. Whatever your political disposition, it’s best if you learn to recognize when it’s being used, study it, and then think of ways to use the same techniques to influence people to practice good health practices.

2. Video that encouraged me last week…

I interview or at least converse with other physicians almost daily. But, I found this interview with Brenda Scaggs really snuck up on me and touched me. Brenda worked as a forensic nurse during her ER years to help women who had been raped. Now, she’s come up with a wonderful way of Helping women who have suffered from genital mutilation. The first part of the video is me going over the research; skip that part if you want (the research is listed below the video). But, do not watch the last part of this video unless you want to be touched by Brenda’s story about how she helped a woman who had her clitoris cut off when she was 8 years old (along with her friends).

3. Most important research I read this week —

We’ve been using the P-Shot® to help men who have failed the usual post prostate surgery penile rehabilitation. Not all recover, but many do. The following article interestingly makes a positive case for what we do, and the has the usual and expected criticism that the variety of ways that people isolate PRP makes comparative studies difficult. And, then uses as an argument against the strategy that people are making money doing it. I’m always interested when “commercialization” is used as a criticism. Another way of saying the same thing is “Unless insurance pays for it, then it’s probably not good medicine.” Any physician who struggles to get insurance to pay for needed therapies knows the folly of this attitude; yet, most physicians still use what’s financed by insurance as a guide to what works. Anyway, that’s a side topic—but the following review article about cellular therapies to help after prostate surgery still encouraged me since the discussion has at least begun. Remember, it takes 20 years for a new medical procedure to be widely accepted…so we have another 9 years at least before the P-Shot® will be routine as part of the Penile rehabilitation protocol post-prostatectomy. Here’s a link to the article…Chung, Eric. “Regenerative Technology to Restore and Preserve Erectile Function in Men Following Prostate Cancer Treatment: Evidence for Penile Rehabilitation in the Context of Prostate Cancer Survivorship.” Therapeutic Advances in Urology 13 (January 1, 2021): 17562872211026420. https://doi.org/10.1177/17562872211026421.

4. App I Used Every Day

For the past 5 years at least, I kept my literature searches organized in Mendeley. But, recently, I found FREE software that makes both the importing and the documenting in a written paper both your footnotes and bibliography easier than ever. I love this software: Zotero. If you’re writing in Word, you can literally click and drag into the paper and the references are formatted in whatever format you desire.

5. Quote I’m pondering —

Walt Whitman Speaks, Walt Whitman…

“The woman who has denied the best of herself—the woman who has discredited the animal want, the eager physical hunger, the wish of that which though we will not allow it to be freely spoken of is still the basis of all that makes life worthwhile and advances the horizon of discovery. Sex: sex: sex; whether you sing or make a machine, or go to the North Pole, or love your mother, or build a house, or black shoes, or anything—anything at all—it’s sex, sex, sex: sex is the root of it all: sex—the coming together of men and women: sex: sex.”

And, please give me feedback: hit “reply” and shoot me an email, or on our membership sites.

Have a great week!

Charles

P.S. The last book I launched could be of help to your patients who suffer from premature ejaculation: Extend Sex: The 30-Second Trick. You’ll notice that my trick makes use of the functional anatomy, even though I did not know the anatomy when I dreamed this up 40 years ago.

Next Hands-On Workshops with Live Models<—

FORWARDED THIS MESSAGE? Learn more about the CMA here<—

Hello!

Here are 5 things that helped me last week…

1. Idea/business book that helped me last week…

Thinking with Concepts

In 1979, in college, I took a course in embryology. With great excitement, I thought, “Now, I’ll finally figure out how babies grow!” Two weeks into the course, I felt a deep sense of disappointment: I realized that the course described in great detail what happens in the uterus, but with no explanation of why/how. There’s a great temptation to think that because we name something, or draw a picture of it, that we explained it. But a name, a concept noun, does not explain. Richard Feynman discusses this idea of concepts in a video where he tells how his father encouraged him to think by telling him (when observing a ball) that the name for the occurrence is momentum, but why it occurs is not known.

Those not trained in science usually think that we, as physicians, know and can do more than we can because we know the names of lots of diseases and can draw pictures of what the etiology looks like under the electron microscope.

Thinking with Concepts, the first chapter gives a list of methods to realize when you’re dealing with a fact, like the capital of the US is DC, and when you’re dealing with a concept, like inertia or cell differentiation—and how to think about each.

2. “Health” book that encouraged me last week (and remembering mothers of children with cystic fibrosis)—

Savage Factors, Peak Physical, Mental, & Sexual Performance Through the Practices of Ancient Civilizations.

One of the great medical innovations of mankind has been vaccines. One of the corollary dangers, however, of vaccines has been the false assumption that vaccines can completely compensate for an unhealthy body. Before we had so many antibiotics and antiviral medications, when my father was a child during the days of polio, mothers and grandmothers preached staying very well and practicing health practices so the body could defeat infection.

The fear: hospitalization with severe COVID-19 from which no medication and no ventilator can save you, that fear, that’s what every mother fears for her child with cystic fibrosis—they know a severe life-threatening pneumonia will very likely attack their child. So of course, they get their children vaccinated. But, you know what else they do? If you look here (click), you’ll read what I’ve seen first hand, the first advice of those mothers is “Help your child stay as healthy as possible.”

I don’t mind that Fauci preaches masks and vaccines; I’m puzzled that I never hear him preach, “Stay as healthy as possible,” or warn truthfully that “If you are obese, your chance of dying from COVID is increased one-hundred fold.”

Instead, physicians who talk about staying as healthy as a way to prevent COVID risk being labeled anti-vaccine and losing their license.

Though I’ve often been unkind to my body, I’ve been a Jack Lalanne fan and a Paul Bragg fan most of my life, but after reading this article about hormesis (click) a few years ago, the idea of hormesis seemed important, so I wrote a book for my own reminders about ways to stay healthy. After losing, last week, a dear friend and local cardiologist to COVID, l reread the book to remind me what I should be doing to stay healthy: Savage Factors, Peak Physical, Mental, & Sexual Performance Through the Practices of Ancient Civilizations.

3. Most important research I read this week —

Histopathology and Ultrastructural Findings of Fatal COVID-19 Infections on Testis

We all learned in medical school about mumps causing orchitis and leading to low testosterone or infertility, but we have not thought as much about it as an outcome from COVID. Not only can COVID infect the testes, but there are reports of it causing Peyronie’s.

Knowing this helped me last week while thinking about men who trust me with their health.

4. App I Used Every Day

Evernote. We use it at the office to communicate with each other and to store our company documents. And, I use me personal account to scan research and just about everything.

5. Quote I’m pondering —

Freeman Dyson, in Disturbing the Universe, describing his observations of Bomber Command during World War II (he was a mathematician who was involved in thinking about the war and weapons)…

“The Lancaster a magnificent flying machine, made into a death trap for the boys who flew it. A huge organization dedicated to the purpose of burning cities and killing people, and doing the job badly. A bureaucratic accounting system which failed utterly to distinguish between ends and means, measuring the success of squadrons by the number of sorties flown, no matter why, and by the tonnage of bombs dropped, no matter where. Secrecy pervading the hierarchy from top to bottom, not so much directed against the Germans as against the possibility that the failures and falsehoods of the Command should become known either to the political authorities in London or to the boys in the squadrons. A commander in chief who accepted no criticism either for above or from below, never admitted his mistakes and appeared to be as indifferent to the slaughter of his own airmen as he was to the slaughter of Germans civilians. An Operational Research Section which was suppose to give him independent scientific advice but was too timid to challenge any essential element of his policies.”

Does the news ever seem to you to be “copy and paste” from the history of previous generations? How odd that we are surprised.

And, please give me feedback: hit “reply” and shoot me an email, or on our membership sites, or on our weekly Journal Club with Pearls & Marketing. Which bullet above is your favorite? What do you want more or less of from the CMA? Other suggestions? Please let me know!

Have a great week!

Charles

Charles Runels, MD
1-888-920-5311

P.S. The last book I launched could be of help to your patients who suffer from premature ejaculation: Extend Sex: The 30-Second Trick.
You’ll notice that my trick makes use of the functional anatomy, even though I did not know the anatomy when I dreamed this up 40 years ago.

Next Hands-On Workshops with Live Models<—

FORWARDED THIS MESSAGE? Learn more about the CMA here<—

5 Things that Helped Me Last Week (2021August8-14)

Hello!

Here are 5 things that helped me last week…

1. Business Book that helped…

Good Strategy Bad Strategy: The Difference and Why It Matters

So many people confuse “positive thinking,” or a “goal” with a “strategy.” Even the idea of defining “mission,” “values,” “objectives” usually misses the mark. This is another one of those books that I read or listened to (it’s on audible) every year since it came out in 2011. This past week, when I re-listened, I heard once again his use of our poor strategy in Afghanistan as an example of what a bad strategy looks like and how inept our leaders often are. I can’t do much about Afghanistan, but that’s not why I was reviewing the book. If you at least listen through the end of the first section, you will thank me when you go back to thinking about your business.

2.Reference book that I actually used last week—

When I write, I seldom actually look at it, but when I do want it, nothing else works as well. My Dad gave me a Roget’s International Thesaurus when I was in grade school. I loved it then and still do.

3. Most important research I read this week —

Effect of A Very Low-Calorie Ketogenic Diet on Food and Alcohol Cravings, Physical and Sexual Activity, Sleep Disturbances, and Quality of Life in Obese Patients Since obesity is a HUGE risk factor for COVID, it’s more important than ever that we advise our patients to lose weight. After reading the literature, I was pleased to find that a low-carb diet was shown to improve arousal, lubrication, and orgasm in women.

4. App I Used Every Day

World Clock Pro. Sits on my desktop and helps me easily figure out the corresponding time when I want to speak or schedule with someone in any country.

5. Quote I’m pondering —

“…you will always find those who think they know what is your duty better than you know it. It is easy in the world to live after the world’s opinion; it is easy in solitude to live after our own; but the great man is he who in the midst of the crowd keeps with perfect sweetness the independence of solitude.”

—Ralph Waldo Emerson Essays “Self-Reliance”

And, please give me feedback: hit “reply” and shoot me an email, or on our membership sites, or on our weekly Journal Club with Pearls & Marketing. Which bullet above is your favorite? What do you want more or less of from the CMA? Other suggestions? Please let me know!

Have a great week!

Charles

P.S. My course that uses cycling through low carb in a mostly comfortable way to lose weight, the 3-Day Fat Burn<–

Next Hands-On Workshops with Live Models<—

FORWARDED THIS MESSAGE? Learn more about the CMA here<—

For Members of the Cellular Medicine Association

Hello!

Here are 5 things that helped me last week…

1. Popular Magazine that Helped Explain to Women What We Do —

“Beyond Kegels: The Pelvic Floor Is Finally Getting the Attention It Deserves” Much gratitude to Cindy Barshop (who was interviewed for this article in Vogue) for her brave efforts to help women. The phrase “pelvic floor” has always felt less glamorous than what the muscles deserve (we usually don’t hold the floor of something in the highest of esteem). But, of course, without the pelvic floor functioning properly, neither continence nor sex works as well. Instead of thinking in terms of a general mass of muscles, women seem to find it more helpful to talk about the specific sections of the “floor” that serve the various functions. I’ve started using the terminology “G-spot support muscles” or “GSSM” for those muscle most contributory to sexual arousal. This idea of specific sections of the pelvic floor also help explain why our O-Shot® procedure works (click)<—.

2. Marketing/business/thinking book that helped —

The Lifetime Learner’s Guide to Reading & Learning (Hoover, 2017) This author is a monster…he lives in a 33 room house so that he can keep is library of 57,000 plus books. I think that qualifies him to make some reading suggestions (both books to read, and tips about what to read). He claims that only about 30% of what’s in his books is on the internet. I don’t know what the real number is, but I know that few people are inspired by a thumb drive on a shelf. And quite a bit that lives on the shelves of my home and office cannot be found online.

3. Most important research I read this week —

Materials Selection for the Injection into Vaginal Wall for Treatment of Vaginal Atrophy This very nice review article of most everything that’s been in injected into the vagina to help it work better puts an up-to-date and balanced view on where the science is now. They get a few things confused about our O-Shot® procedure, but still they give it a fair and favorable nod. More up-to-date research about the topic can be found here<—

4. App I Used Every Day

I almost always start any writing project using Ulysses (including this email), then I move whatever I wrote over into where it’s going to be launched or further developed.

5. Quote I’m pondering —

“It’s time to let the secret out: Mathematics is not primarily a matter of plugging numbers into formulas and performing rote computations. It is a way of thinking and questioning that may be unfamiliar to many of us, but is available to almost all of us.”—John Allen Paulos (from his A Mathematician Reads the Newspaper).

I have often been aghast at how many talking heads on the news just blatantly twist the numbers. I suppose that there is the possibility of an honorable lie, but still, when I look at the numbers and know I’m hearing a lie, it somehow makes me feel like something is physically crooked and clouded.

For example, in the early days of COVID, Dr. Fauci was quoting a mortality rate from COVID of 4%, but at the time those numbers were only from people who were hospitalized; no one knew at that time the incidence of COVID in the general population (including the millions not in the hospital). Had he qualified his mortality rate to mean “4% mortality in hospitalized patients,” I would have not felt betrayed—but he did not say that. So, with great disappointment, I knew that he knew what he said was not true (or at least impossible at the time to know to be true), so from then on, I knew he would lie to frighten me.

Here’s an article about how wrong Fauci was about the math early on (nothing of course about how a freshman statistics student could have known he was wrong, or that he’s too smart to not know).

I’m not talking politics, I’m not talking about whether to wear a mask, or get vaccinated—I’m talking math, and how seldom do even smart people remember the ideas behind the math.

Richard Feynman said, “The experts who are leading you may be wrong.” And, “Another of the qualities of science is that it teaches the value of rational thought as well as the importance of freedom of thought; the positive results that come from doubting that the lessons are all true.”

Plugging numbers about COVID into formulas terrified people with wrong conclusions instead of notifying the people who most need to be warned (read this to see<click<).

I still seldom see anyone (Fauci included) point out the huge increase in mortality from COVD with even mild obesity. Looking at the math, dropping BMI from high to normal would be more protective to an individual than wearing a mask.

Hence, my favorite quote for last week (from a Mathematician Reads the Newspaper): “It’s time to let the secret out: Mathematics is not primarily a matter of plugging numbers into formulas and performing rote computations. It is a way of thinking and questioning that may be unfamiliar to many of us, but is available to almost all of us.”

Reminds me of yet another quote that’s haunted me (this one from Thomas Jefferson), “If a nation expects to be ignorant and free, in a state of civilization, it expects what never was and never will be.”

 And, please give me feedback: hit “reply” and shoot me an email, or on our membership sites. Which bullet above is your favorite? What do you want more or less of from the CMA? Other suggestions? Please let me know!

Have a great week!

Charles

P.S. The last book I launched could be of help to your patients who suffer from premature ejaculation: Extend Sex: The 30-Second Trick. You’ll notice that my trick makes use of the functional anatomy, even though I did not know the anatomy when I dreamed this up 40 years ago.

Next Hands-On Workshops with Live Models<—

FORWARDED THIS MESSAGE? Learn more about the CMA here<—

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™<–