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'If you want to last longer, you'll just need to have plenty of practice on your own'

Each week, sex therapist Emily Power Smith answers your sex-related queries

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Each week, sex therapist Emily Power Smith answers your sex-related queries. Image posed by model

Each week, sex therapist Emily Power Smith answers your sex-related queries. Image posed by model

Each week, sex therapist Emily Power Smith answers your sex-related queries. Image posed by model

Q. How do I last longer?

A. As this is literally all you wrote, I don't know how experienced you are, your age, if you're in a relationship, how often you have partner sex, if you've always had this problem, or how long you last currently.

All these elements are important and can influence the solution I'd offer. For example, if you're a young man at the start of your sexual career, there may not be a significant problem and things may settle down with more experience. If you're in a relationship there may be added extra worries around disappointing your partner. Worrying usually makes matters worse. You might also feel extra pressure to attempt penetration even when you don't want to, or you might be avoiding sex, which can have its own impact on the relationship.

If you've had this problem from the start, your age is important. A habit that's been built over 20 or 30 years will usually be harder to crack than a newer one. If you've noticed a change in how long you last over a period of time, we might be able to pinpoint a cause, which could affect the treatment. Some people develop rapid ejaculation due to medication, surgery, injury or a build-up of worry.

Finally, if you last more than four and a half minutes during penetration, you're already lasting above the average (based on statistics from the UK, Australia and France). Some men decide they want to last half an hour or longer because they believe that's what their partners want. It's always worth asking partners rather than assuming. Many women talk about five or ten minutes penetration as being plenty. Unless sex is excellent, the pleasure and arousal can diminish for the person being penetrated and it can become uncomfortable or painful. The idea that women want hard pounding for extended lengths of time often comes from porn.

If you want to last longer, start with yourself. Practise mindful masturbation, where you slow down long enough to recognise when you're getting close to ejaculation. Often, men who ejaculate quicker than they'd like are unaware of their arousal cycle and by the time they realise they need to slow down, they've reached what I call 'the point of no return'. That's the point where not even a gun to the head could stop the release.

The trick is to learn how to get turned on, and then to surf the feeling without getting too close to that point I mentioned. You discover a safe playground where you can enjoy pleasure and arousal without ejaculation.

I suspect many men want to get themselves as turned on as possible, believing that's the ultimate feeling. In doing that, however, they lose their connection to the slow build-up and anticipation that can feel delicious. For detailed help, get yourself a book by Dr Helen Singer Kaplan called Overcoming PE and follow it to the letter.

Q. What do you think about labiaplasty? I'm considering getting it done as I hate the way my vagina looks. I worry it puts men off. I've been dating for a few years now and haven't had a boyfriend that lasted.

A. The rate at which cosmetic surgery such as labiaplasty or vulvoplasty is increasing is astonishing. While I don't have Irish statistics, in Australia, America and the UK, this is the fastest growing plastic surgery. In those countries, some females looking for surgery are as young as 13 and have the support and agreement of their mothers.

Labiaplasty is a procedure where the inner labia are trimmed so that they don't protrude beyond the outer labia, thus creating a very neat, minimalist vulva. While some women have this kind of vulva naturally, it's estimated that at least half of the female population don't. In fact, some argue that when your inner labia (labia minora) hang lower than your outer labia (labia majora) it's a sign of womanhood and is something to be proud of. The idea that labia should be 'tidy' or symmetrical is not based on reality, but rather fantasy.

Of course, it's your decision and your right to do what you wish with your body. It's important to understand the facts before you do, however. The very least you can do is find images of real, untreated vulvas so you can gauge better whether yours is 'abnormal'. You can visit www.dodsonandross.com and see a vulva gallery.

Slow down and think about who you're doing this for. If a man is seriously going to dump you because of the shape of your labia, I'd suggest you've had a narrow escape.

Surgery of this kind carries risks for ongoing nerve damage, pain, lack of sensation, scarring, and lowered lubrication. All of those things are going to massively impact your ability to enjoy sex, possibly for the rest of your life. So what's more important: how you look, or how you feel?