Premature ejaculation is the term used when a man ejaculates sooner than he or his partner would like. It is a frequent complaint among young men in particular and is thought to occur in a third of men at some point in their lifetimes.
Of course, if premature ejaculation occurs occasionally there is no cause for concern. However, if you find that you nearly always achieve orgasm shortly after penetration (the average time to orgasm is 5 minutes), or you are unable to delay ejaculation during intercourse when you would like to, it may be time to see your doctor. When the problem has persisted for more than 6 months it warrants investigation.
Certainly, this particular subject can be embarrassing to talk about. Bear in mind that this is a common and very treatable condition should you find yourself feeling stressed or frustrated and perhaps even avoiding sexual intimacy.
Since both psychological and biological factors can play a role in premature ejaculation you and your physician will likely explore a variety of treatments. These may include medications, counselling and sexual techniques that help to delay ejaculation.
Doctors classify premature ejaculation as either primary or secondary.
Regarding secondary (acquired) premature ejaculation, common causes can include: anxiety, stress, relationship issues, erectile dysfunction and high blood pressure. Alcohol and recreational drug use as well as over-the-counter and prescribed medications can also contribute to the problem.
If you have experienced sexual abuse, depression or have had difficulty with sexual relationships, you may have an ongoing problem with premature ejaculation and worrying about your next sexual encounter. This worry can contribute to a continuing cycle of fear and failure. A qualified sex therapist can explore these issues with both you and your partner. A combination of therapy and medication can be very effective at resolving the issue.
Biological causes of premature ejaculation
Upon consultation with your physician, a history and thorough physical exam can reveal additional clues to any biological cause of premature ejaculation. Testing for hormone levels, vitamin deficiencies and infection may be ordered. However, most commonly your doctor can diagnosis the problem with a few questions about the frequency of the problem, how long it has been an issue and how it is affecting your sexual relationship.
Behavioural therapy can help most men with premature ejaculation. It will require the cooperation of both partners. Keep in mind that premature ejaculation frequently returns warranting additional behavioural therapy.
Psychological couples counselling is one aspect of behavioural therapy that can be explored with a qualified sex therapist. This issue is tackled by delving into any interpersonal issues that may be contributing to the problem.
Behavioural therapy may also include trying a number of physical exercises to help with premature ejaculation. The most commonly recommended is the “squeeze technique”. When a man senses that he is close to premature orgasm, he can interrupt intercourse to squeeze the penis, effectively calming down arousal. This helps to delay ejaculation. After a time, the man will learn to control ejaculation without having to use the squeeze technique.
Keep in mind that although topical aesthetic agents are effective and well tolerated, they do have potential side effects. Some men have reported temporary loss of sensitivity and decreased sexual pleasure. Female partners may also experience these effects.
The topical treatments are aesthetic creams and sprays that contain a short acting agent such as lidocaine. The product is applied to the penis 10 to 15 minutes before sex which reduces sensation delays ejaculation.
All prescription medications that are used to treat this condition are “off-label”. In other words, these are drugs that are usually given to help with other medical problems such as depression, pain or erectile dysfunction and have a side effect of prolonging ejaculation. Such medications may be suggested by your doctor as a trial for premature ejaculation and it is perfectly safe to do so.
Common medications that may help with premature ejaculation include:
There is encouraging research that suggests several additional drugs may be effective in treating premature ejaculation. These include:
More time and research is needed to ensure the safety and efficacy of these medications.
Premature ejaculation can be a frustrating issue when it persists. Rest assured that you are not alone with this condition and that your family doctor is happy to help you navigate the waters of determining the cause and a treatment that will be effective for you and your partner.
For a thorough review of this subject, I recommend you check out the following reliable websites:
The British Association of Urological Surgeons
