1 in 3 men between the ages of 18 and 59 experiences premature ejaculation at some point.
Premature ejaculation, also know as Premature climax, early ejaculation or rapid ejaculation is when a man has an orgasm and ejaculates earlier during intercourse than he or his partner would like.
It’s a common problem, affecting 30% to 40% of men. Causes include physical problems, chemical imbalances and emotional/psychological factors.
What is Premature Ejaculation (PE) ?
Premature ejaculation is a type of sexual dysfunction that occurs when a man has an orgasm and releases (ejaculates) semen sooner than he or his partner would like. It often happens before or shortly after penetration during intercourse. Premature ejaculation can be a frustrating experience for both you and your sexual partner and makes your sex lives less enjoyable. However, the good news is that it’s usually fixable!
As long as it happens infrequently, it’s not cause for concern. However, you might be diagnosed with premature ejaculation if you:
• Always or nearly always ejaculate within one minute of penetration
• Are unable to delay ejaculation during interourse all or nearly all of the time
• Feel distressed and frustrated, and tend to avoid sexual intimacy as a result
What are the Causes of PE?
There are many possible causes of Premature Ejaculation, and they can include both emotional and physical conditions.
Physical and chemical conditions include:
• An underlying erectile dysfunction diagnosis.
• A hormonal problem with oxytocin levels, which has a role in sexual function in men. Other hormone levels that play a role in sexual function include luteinizing hormone (LH), prolactin and thyroid stimulating hormone (TSH)
• Low serotonin or dopamine levels, chemicals in the brain that are involved in sexual desire and excitement.
• A penis that is extra sensitive to stimulation.
Emotional and Mental health conditions include:
• Poor body image or poor self-esteem
• History of sexual abuse, either as the perpetrator, or as the victim or survivor
Other things that can lead to PE include:
• Worrying about ejaculating too early
• Anxiety about limited sexual experience
• Problems or dissatisfaction in your current relationship
What are the Risk Factors of PE?
Various factors can increase your risk of premature ejaculation, including:
• Erectile dysfunction. You might be at increased risk of premature ejaculation if you occasionally or consistently have trouble getting or maintaining an erection. Fear of losing your erection might cause you to consciously or unconsciously hurry through sexual encounters.
• Stress. Emotional or mental strain in any area of your life can play a role in premature ejaculation, limiting your ability to relax and focus during sexual encounters.
What are the Symptoms of PE?
The main symptom of premature ejaculation is the inability to delay ejaculation for more than one minute after penetration. However, the problem might occur in all sexual situations, even during masturbation.
Premature ejaculation can be classified as:
Lifelong (primary): Lifelong premature ejaculation occurs all or nearly all of the time beginning with your first sexual encounters.
Acquired (secondary): Acquired premature ejaculation develops after you’ve had previous sexual experiences without ejaculatory problems.
Many men feel that they have symptoms of premature ejaculation, but the symptoms don’t meet the diagnostic criteria for premature ejaculation. Instead these men might have natural variable premature ejaculation, which includes periods of rapid ejaculation as well as periods of normal ejaculation.
What’s the difference between erectile dysfunction and premature ejaculation?
If you have erectile dysfunction, you can’t attain or maintain your erection. If you have premature ejaculation, you have an erection but you reach orgasm and ejaculate earlier than you or your partner would have liked.
However, erectile dysfunction can actually lead to the development of premature ejaculation. This happens when a man knows his ability to sustain an erection is poor, so he develops the habit of ejaculating soon after erection before he loses his erection.
Because of this connection between these two conditions, your urology will want to figure out if you have erectile dysfunction and, if so, treat that first.
What are the complications of PE?
Premature ejaculation can cause problems in your personal life, including:
• Stress and relationship problems. A common complication of premature ejaculation is relationship stress.
• Fertility problems. Premature ejaculation can occasionally make fertilization difficult for couples who are trying to have a baby if ejaculation doesn’t occur intravaginally.
How can you prevent PE?
Yes, you likely can! By following the techniques described in this article to delay ejaculation, taking any prescribed medications, and seeking counseling if needed, premature ejaculation can become a problem of your past.
How to Treat Premature Ejaculation ?
There are many different treatments options for premature ejaculation depending on the cause. These include behavioral therapy, counseling and medications. Most causes of premature ejaculation are usually treated first with behavior therapy and/or counseling to help with emotional concerns, performance anxiety or stressors that may be contributing. Often more than one treatment approach may be tried at the same time.
Behavioral therapy involves trying different methods to delay your orgasm. Its goal is to teach you how to control your body and your feelings. Methods include:
Start and stop: With this technique, you or your partner stimulates your penis close to the point of orgasm then stops the stimulation for about 30 seconds until you regain control of your response. Repeat this “start and stop” approach three or four times before allowing yourself to orgasm. Continue practicing this method until you have gained good control.
Distracted thinking: With this technique, the idea is to focus your attention on ordinary nonsexual things while you’re being sexually stimulated. Naming sequences are a good way to focus your attention. For example, visualize naming all the businesses you pass on your drive to the gym, naming all the players on your favorite sports team or naming all the products on the aisles of your favorite store.
If the cause of your premature ejaculation is psychological, emotional, or due to relationship issues – due to performance anxiety, depression, stress, guilt, or a troubled relationship – seek the help of a psychologist, psychiatrist, couples therapist or sex therapist. Your urologist can help direct you to these health professionals.
Several types of medications may be tried.
Antidepressants, especially selective serotonin reuptake inhibitors or the tricyclic antidepressant clomipramine can help delay premature ejaculation. This is an “off-label” use (not approved by the Food and Drug Administration for this use). Be sure to discuss the side effects of this medication with your urologist to be sure it’s appropriate for you.
Anesthetic (numbing) creams and sprays applied to the head and shaft of the penis is another medication option to delay ejaculation. The anesthetic cream or spray is applied to the penis, absorbed for 10 to 30 minutes or until you feel less sensitivity in your penis. It’s important to wash your penis before sex to prevent numbness to your partner’s vagina or loss of your erection.
Erectile dysfunction medications have also been used to treat premature ejaculation, particularly in men with underlying erectile dysfunction.
When to see a doctor
A family doctor is a good place to start when you have erectile problems. See your doctor if:
You have concerns about your erections or you’re experiencing other sexual problems such as premature or delayed ejaculation. You have diabetes, heart disease or another known health condition that might be linked to erectile dysfunction
You have other symptoms along with erectile dysfunction
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Sesan Kareem is a public health advocate and writer. His mission is to use his clinical and leadership skills to democratize healthcare for all Africans