Premature Ejaculation

Overview

Premature ejaculation is when a man ejaculates earlier than he or his partner would like during intercourse or ejaculates less than a minute into intercourse. According to research, this condition is common as 1 in 5 men between the ages of 18 – 59 has experienced premature ejaculation. 

It can also result from emotional or relationship problems, which can be addressed by a sex therapist, stress, or even depression. The good news is premature ejaculation is fixable.

Key facts

• Varied factors can cause premature ejaculation. When a man is sexually excited, the nerve muscles in the penis relax and allow blood to flow in to cause an erection. Ejaculation is an automatic action controlled by the central nervous system. It kicks in when sexual stimulation in males reaches a critical stage of excitement.

•  A significant symptom of premature ejaculation is the inability to delay ejaculation for more than one minute from the start of intercourse. Another tell-tale sign is rapid climax during masturbation.

• Some of its leading causes include anxiety, emotional distress, and sexual inexperience. Several biological factors can also cause it. These include abnormal hormone levels, abnormal levels of brain chemicals called neurotransmitters, inflammation and infection of the prostate or urethra, or a sign of erectile dysfunction.

• There are different options for treatments for premature ejaculation ranging from behavioural therapy, counselling, and medications. Your doctor will prescribe the one that best suits your case.

Symptoms

You may have premature ejaculation if you;

• Always or almost always ejaculate within one minute of penetration.
• Are unable to delay ejaculation during intercourse all or nearly all of the time
• Feel frustrated with sexual intercourse and tend to avoid a repeat.

This condition can also be classified into two groups.

• Life long (primary): Primary ejaculation refers to when you’ve had it since the beginning of your first intercourse.

• Acquired (secondary): This develops after you’ve had several sexual intercourses without unsatisfactory ejaculation.

Tell your doctor if this condition has persisted for over three months. A proper diagnosis would be conducted to ascertain if underlying medical conditions and the course of treatment cause your symptoms.

Diagnosis

Testing for premature ejaculation can take different forms. See your doctor if the condition has persisted consistently for up to 3 months and is causing frustration and anxiety.

Your doctor will likely begin the examination by asking about your sexual history. The questions may take these forms:

• How long have you had this problem?
• In what circumstances does it happen?
• How often does it happen?
• Does it happen at every sexual attempt?
• Does it happen with all the sexual partners you’ve had?
• Does premature ejaculation occur when you masturbate?
• Do you find it difficult to maintain an erection?

While these questions may seem invasive, it is essential to answer them correctly and truthfully so your diagnosis can be accurate. You might also be asked about medications you take (prescribed or not), herbal medicines, supplements, or alcohol and drug intake.

Additionally, your doctor might prescribe some lab tests if they suspect an underlying medical problem contributes to premature ejaculation. 

Causes & Prevention

There are several possible causes of premature ejaculation ranging from medical to emotional or psychological factors.

Medical causes include

• Irregular dopamine or serotonin levels in the brain. These chemicals are responsible for sexual excitement and stimulation.
• Undiagnosed Erectile dysfunction
• Abnormal levels of Oxytocin, luteinizing hormone (LH), prolactin, and thyroid-stimulating hormone (THS). These hormones are involved with sexual function.
• Penis that is extra sensitive to stimulation 
• A genetic trait inherited from parents.

Emotional/ psychological causes

• Performance anxiety. This is one of the leading causes of premature ejaculation. Being anxious to please or satisfy your partner, the nervousness of being with a new partner, or abstaining from sex for a long can cause you to ejaculate faster than desired.
• Lack of confidence 
• Stress
• Relationship problems
• Depression
• History of sexual abuse

Because the reason for premature ejaculation is multiple, you will need to see a doctor as soon as possible for a proper diagnosis so your treatment can commence in time. 

Treatment

There are different treatment options for premature ejaculation, depending on the cause. They include the behavioural method, counselling, and medications. However, behavioural methods and counselling are the first approaches to treating premature ejaculation as a rule of thumb. You may need to try multiple treatment options to determine what works best for you.

Behavioural methods

Behavioural methods involve training the mind and body to control and delay orgasm. They include;

• Stop and start method: You or your partner will stimulate your penis and stop for 30 seconds when you are near orgasm to begin again when you have regained control of your response. Repeat this start-and-stop technique three or four times before you ejaculate.

• The squeeze technique: It works almost the same as the stop-and-start method. However, this time, when you’re close to orgasm, you or your partner should gently squeeze the cap of your penis until you lose your erection. Repeat this technique a few times before ejaculating. Continue practising this technique until you gain control of your sexual responses.

• Strengthen weak pelvic muscles. In some cases, weak pelvic floor muscles contribute to premature ejaculation. Find the muscles to tighten by stopping your pee mid-stream from fixing this. Hold them tight for at least three seconds before continuing to pee. Do this at least three times every day for the best results.

• Masturbate before sex: Some men have found masturbating just before sex helps to prevent premature ejaculation during intercourse.

• Wear a condom: Wearing a condom will help reduce the sensitivity of your penis and help you to last longer.

Counselling

Your doctor might refer you to a therapist if your premature ejaculation is linked to anxiety or depression.

If none of these work, then medications will be prescribed. While there are no specific drugs for premature ejaculation, some will help mitigate repeated occurrences. They include; 

• Antidepressants
• Tramadol
• Anaesthetic creams or sprays

Your doctor may also prescribe medications used to treat erectile dysfunction. They include;

• Sildenafil citrate (Viagra)
• Tadalafil (Cialis)
• Vardenafil HCI (Levitra)

Some of these medications may have unpleasant side effects. If you notice any side effects or unwanted changes in your body, speak with your doctor about it.

Conclusion

In many cases, symptoms of premature ejaculation can be easily treated in just a few steps. There are many forms of treatment to handle this condition, and your doctor will prescribe the one that best suits your case. 

While sharing deep private details about your problem might be uncomfortable or embarrassing, remember your doctor only wants you and your partner to have a satisfying sex life. 

This condition is more common than you know, but it is crucial to speak with your doctor sooner than later to identify if they’re any underlying causes and commence your treatment.