Premature Ejaculation: What it is and how to treat it
Many men experience some form of premature ejaculation, or PE, at some point in their lives. In fact, it’s quite a common problem in men who are sexually active, affecting about 20% to 30% of men. Still, experiencing premature ejaculation can be distressing and embarrassing, not only for the man experiencing it but for their sexual partner as well. It can negatively affect self esteem, decrease sexual satisfaction, and disrupt overall quality of life for a man and his partner.
If you have ever experienced premature ejaculation or you’re dealing with it on a consistent basis, you may be looking for some guidance and help. Fortunately, there are several ways to treat and manage this problem.
Read on to learn more about premature ejaculation and all your available treatment options.
What is premature ejaculation?
In medical terms, premature ejaculation refers to the inability of a man to delay ejaculation long enough for his partner to reach orgasm. According to the definition by Masters and Johnson, this inability to delay ejaculation should be present for half of all “intercourse attempts” in order to be defined as premature ejaculation.
The International Society for Sexual Medicine (ISSM) defines premature ejaculation as a type of sexual dysfunction that is characterized by ejaculation that always occurs within one minute of vaginal penetration (lifelong PE). They define acquired premature ejaculation as a reduction in the time period before a man’s usual ejaculation time by around 3 minutes or less. An inability to delay ejaculation is often accompanied by feelings of distress and disappointment, as well as an avoidance of sexual intimacy.
In other words, if you only experience premature ejaculation once in a blue moon, it’s probably not a cause for concern. However, a healthcare professional may diagnose you with premature ejaculation if:
- You almost always ejaculate within one minute of vaginal penetration
- You’re unable to delay ejaculation almost every time you have sex
- You feel frustrated or distressed about your inability to delay ejaculation
There are two main types of premature ejaculation as defined by the ISSM:
Lifelong Premature Ejaculation
This type of premature ejaculation occurs all or nearly all of the time from the time you first start having sexual experiences.
Acquired Premature Ejaculation
This type of premature ejaculation develops over time after you’ve already had sexual experiences without any problems.
The degree and type of premature ejaculation can vary throughout a man’s life. Symptoms of premature ejaculation might not fall within one category of the condition. A sexually active man might experience periods of an inability to delay ejaculation followed by periods of normal ejaculation times. Consult a doctor or healthcare provider if you have concerns about your sexual condition.
Why does premature ejaculation happen?
There’s more than meets the eye when understanding what premature ejaculation means. While the exact cause of premature ejaculation is unknown, there are several risk factors that may come into play. Biological and physical risk factors may include:
- Low serotonin levels
- Abnormal levels of LH, prolactin, TSH and other hormones
- Infection or inflammation of the urethra or prostate
- High blood pressure
- Multiple sclerosis
- Prostate disease
- Underactive thyroid
Risk factors may also be psychological in nature:
- Irrational fears or expectations with new partners
- Self-esteem problems
- Sexual abuse
- Repression of sexual desires
Premature ejaculation may also be associated with erectile dysfunction, also known as impotence. Almost one-third of men complain of experiencing erectile dysfunction with premature ejaculation.
Can premature ejaculation be cured?
There are many available treatment options for premature ejaculation. However, it can’t be cured. There are a number of medications, supplements, and lifestyle changes that can help manage the condition. In most cases, premature ejaculation is psychological. In other cases, a medication like Priligy (dapoxetine) can be prescribed.
Premature ejaculation treatment
Selective serotonin reuptake inhibitors (SSRIs) are antidepressants that are often prescribed to treat premature ejaculation. These medications may include Zoloft (sertraline), Lexapro (escitalopram), and Paxil (paroxetine). If SSRIs are not effective, a doctor may prescribe a tricyclic antidepressant like Anafranil (clomipramine) instead.
One short-acting SSRI called Priligy is specifically marketed for the treatment of premature ejaculation. In two clinical trials that evaluated over 2,500 men aged 18 to 77 years old, dapoxetine was found to be more effective than placebo for increasing ejaculatory latency time. After the trials, men taking dapoxetine said they experienced better control of ejaculation and improved sexual satisfaction.
Other medications like phosphodiesterase-5 (PDE-5) inhibitors may be prescribed, such as Viagra (sildenafil), Cialis (tadalafil), or Levitra (vardenafil). While PDE-5 inhibitors are primarily used to treat erectile dysfunction, they may also be effective for treating premature ejaculation.
Supplements and natural remedies may be useful in some cases. For example, zinc supplements may help improve ejaculation time. Natural Ayurvedic or Chinese herbal medicines may also help improve premature ejaculation although studies are still ongoing. Consult a healthcare provider before trying a natural remedy.
Premature ejaculation may be caused by weak pelvic floor muscles. You may choose to try pelvic floor muscle exercises, also called Kegel exercises, to strengthen these muscles. These exercises involve identifying the pelvic floor muscles and activating them. Strengthening these muscles can help control the muscle contractions responsible for ejaculation.
Behavioral treatment techniques
Behavioral therapy includes the pause-squeeze technique. This method involves engaging in sexual activity and stimulating the penis until you feel the need to ejaculate. Then, your partner squeezes the end of your penis where the head meets the shaft for several seconds until the need to ejaculate passes. Your partner can repeat this process as necessary through the duration of sexual activity. Another variation of this technique is the stop-start technique, which involves stopping sexual stimulation before ejaculation and then starting again. Your doctor may also recommend masterbating an hour or two before sex to delay ejaculation during sex.
Therapy and counseling
Therapy and counseling may be recommended alone or in addition to other treatments for premature ejaculation. Because premature ejaculation is often psychological in nature, sex therapy and counseling can help identify the root causes of the problem. A therapist or provider can help guide a man through their anxieties or other emotions that may be contributing to premature ejaculation. Talking about the problem can be helpful for many men with premature ejaculation.
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