Introduction

Premature Ejaculation (PE) is a common sexual health concern that affects many men worldwide, yet it is often misunderstood. The condition can affect relationships negatively.

In this blog, we shed light on this prevalent concern, exploring its causes, the psychological impact on men and relationships, and the array of available treatments.

Understanding, managing, and ultimately overcoming premature ejaculation begins with awareness, knowledge, and compassionate dialogue.

What is Ejaculation?

Ejaculation is the sudden and pleasurable release of semen through the penis during sexual intercourse. This natural physiological response is an integral part of the reproductive process, as it allows sperm to fertilize the egg to make a baby.

Besides its function in reproduction and providing sexual pleasure, it also adds to the emotional and physical closeness between partners.

However, concerns such as premature ejaculation (PE) can sometimes occur.

What is Premature Ejaculation?

Premature Ejaculation is the inability to control ejaculation, leading to an early ejaculation /orgasm before a man or his partner desires to do so. But it might occur in all sexual encounters, even during masturbation.

It can be classified as

Lifelong Premature Ejaculation: Present since the first sexual experience.

Acquired Premature Ejaculation: Developing after having a period of normal sexual experiences.

And based on the severity, it can be three types: mild, moderate, and severe; depending on the time of ejaculation.

When is a Man’s Ejaculation Considered Medically Premature?

International guidelines define premature ejaculation as consistently ejaculating within 1 to 3 minutes of vaginal penetration.  

However, there isn't a fixed duration within which a man must ejaculate during sex. It's up to you and your partner to decide if you are happy with the time it takes you to ejaculate.

The problem is that you and your partner might feel there isn't enough time to enjoy it if you ejaculate and lose your erection quickly. Your sexual life becomes less enjoyable as a result, which can be frustrating for both of you.

The good news is that PE is a treatable condition. Medications, counseling, and techniques that delay ejaculation can help you and your partner have better sex.

How Common is Premature Ejaculation?

It is the most common type of sexual dysfunction in men. Between 30% to 40% have it at some point throughout their lives. And the least you should do is worry about it if it happens only occasionally.

Premature ejaculation can happen at any adult age, however, it is most commonly reported in men between the ages of 18 and 30 and in men between the ages of 45 and 65 who also have erectile dysfunction.

What are the Causes of Premature Ejaculation?

The exact cause of PE is not known. It was considered to be primarily psychological. However, medical professionals now understand that PE comprises a complex interaction of psychological and biological factors.

Biological Factors

• Men who have low levels of the chemical serotonin in their brains tend to take a shorter time to ejaculate.
• Irregular levels of hormones such as LH, prolactin, and TSH. These hormones have a role in sexual function in men.
• Inflammation or an infection of the prostate or urethra (the tube that runs from the bladder and sends urine out of the body.)
• Erectile dysfunction. This is when the penis doesn’t remain firm enough for sex. Men who have concerns about their ability to sustain an erection might develop a tendency to rush ejaculation. It can be a hard habit to break.
• A penis that is extra sensitive to stimulation.
• Inherited traits from parents.

Psychological Factors

• Depression
• Anxiety
• Stress
• Guilt
• Unrealistic expectations about sexual performance
• Performance anxiety
• History of sexual repression
• History of sexual abuse
• Lack of confidence/poor body image
• Relationship problems

Diagnosis of Premature Ejaculation

If you're experiencing frequent premature ejaculations, or if it's affecting your enjoyment of sex, it's a good idea to consult a doctor. 

Typically, the doctor will start by asking questions about your medical history, your sex life, and relationships. Although the questions may be private, it's important to provide honest answers. This will help your doctor accurately identify the root cause of your issue.

You might also have a check-up with a urologist, a specialist in urinary system issues.

If your doctor believes that emotional factors are behind PE, they might suggest connecting with a mental health professional who specializes in sexual difficulties.

Are lab tests needed to diagnose for premature ejaculation?

Lab tests are only needed if your healthcare provider suspects an underlying health problem that is contributing to the problem during the physical exam.

Psychological Impact of Premature Ejaculation

Premature ejaculation isn’t just a physical issue; it’s linked to a whole range of negative psychological effects. This includes:

• Anxiety
• Depression
• A lack of sexual confidence
• Poor self-esteem
• Poor quality of life
• Relationship issues
• A feeling of guilt and shame
• Isolation and social withdrawal

The effects are quite profound and can put a strain on relationships.

In certain situations, it might even pose challenges for single guys looking to start new relationships. It can lead to feelings of distress not just in men but also in their female partners.

If you are grappling with these difficulties, it is best to seek support from healthcare professionals, therapists, and sexual health experts who can provide guidance and help you manage it properly.

Have open communication with your partner to foster understanding and find solutions together.

Treatment/ Management of Premature Ejaculation

Behavioral therapy, psychotherapy, and medications are the main treatments for premature ejaculation. You and your doctor can work together to find the best method for treating premature ejaculation depending on the cause. A combination of treatments can be done at the same time.

Behavioral Therapy: Techniques like the ‘Stop and Start’ and ‘Squeeze’ methods, along with muscle strengthening exercises (Kegels), can help delay ejaculation. 

Other techniques include using ‘Climax Control’ condoms to enhance erection and prolong performance, taking advantage of the post-ejaculation refractory period through prior masturbation, which naturally delays ejaculation in subsequent intercourse.

Additionally, techniques such as distracted thinking, different sex positions, and extended foreplay can be employed for better control.

Psychotherapy: Seek support for psychological or relationship-related issues contributing to premature ejaculation from professionals like psychologists, psychiatrists, or sex therapists.

Medications: Caution is advised, and medication should only be used under a doctor's supervision. Off-label use of drugs like SSRIs, Tramadol, numbing creams, and even erectile dysfunction medications may be prescribed for certain cases of premature ejaculation.

Complications of Premature Ejaculation

Fertility Problems:

Premature ejaculation can sometimes pose fertility challenges. If ejaculation doesn't take place in the vagina there is no chance for your partner to get pregnant.

Relationship Issues:

Premature ejaculation can have a ripple effect on relationships, leading to stress and difficulties that affect both partners. The frustration and disappointment stemming from unfulfilled sexual experiences can create emotional distance and erode intimacy.

We recommend seeking the expertise of a certified sex therapist or couples counselor who can assist both of you in confronting and finding solutions to your concerns

FAQs

1. Is premature ejaculation purely a psychological issue?

No, premature ejaculation can have both psychological and physical causes. Anxiety, stress, and performance pressure can contribute, but underlying medical factors should also be considered.

2. Can premature ejaculation be treated?

Yes, premature ejaculation is treatable. Behavioral techniques, counseling, medications, and lifestyle adjustments can all play a role in managing and overcoming this condition.

3. Are there medications for premature ejaculation?

Certain medications, such as selective serotonin reuptake inhibitors (SSRIs), can be prescribed by a healthcare professional to help delay ejaculation. However, these should be used under medical guidance.

4. Can a change in lifestyle help with premature ejaculation?

Absolutely, adopting a healthy lifestyle can contribute to better sexual function. Regular exercise, a balanced diet, stress reduction, and open communication with your partner can all make a positive difference.

5. When should I seek professional help?

If premature ejaculation becomes a consistent issue causing distress or dissatisfaction, it's recommended to consult a healthcare provider or a specialist in sexual health. They can help identify the underlying causes and suggest appropriate treatments.

6. Is there hope for improvement?

Yes, many men see significant improvement in their ability to manage premature ejaculation through a combination of strategies, support, and medical interventions. Being patient and persistent in finding what works best for you is important.

Conclusion

Understanding and addressing premature ejaculation is a significant step towards achieving a fulfilling and satisfying sex life.

Prioritize your sexual well-being and overall quality of life by seeking professional help and exploring your options to find effective solutions tailored to your specific needs.

Remember that you're not alone in facing this challenge, and many have successfully overcome premature ejaculation to enjoy healthier, more satisfying sexual experiences.

References

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