Premature Ejaculation

PREMATURE EJACULATION

Premature ejaculation is a common sexual complaint. It occurs when a man ejaculates sooner during sexual intercourse than he or his partner would like.  As long as it happens infrequently, it might not be cause for concern.

However, one might be diagnosed with premature ejaculation if:

SYMPTOMS

• One tends to avoid sexual intimacy as a result feeling distressed and frustrated.
• One always or nearly always ejaculate within a minute of penetration.
• One is unable to delay ejaculation during intercourse all the time or nearly all of the time.

CAUSES

The exact cause of premature ejaculation has not been established. Initially, it was thought to be psychological, however, doctors have established that premature ejaculation involves a complex interaction of psychological and biological factors.

Psychological factors that might play a role will include:

• Sexual abuse
• Guilty feelings
• Depression
• Fear or worrying about premature ejaculation

Other possible factors:

• Erectile dysfunction – many times if a man is anxious about obtaining or maintaining an erection during sexual intercourse, he ends up forming a pattern of rushing to ejaculate. Since it is difficult to change habits after they have been formed, this becomes a problem.
• Anxiety - Many men with problems with anxiety, also suffer from premature ejaculation.
• Relationship problems. If sexual relationships with previous partners have been satisfactory with premature ejaculation not happening or happened infrequently, there is the possibility that interpersonal issues between you and your current partner could be contributing to the problem.

Some biological factors such as under listed might contribute to premature ejaculation:

• Abnormal hormone levels
• Inherited traits
• Infection and or Inflammation of the prostate or urethra
• Abnormal levels of neurotransmitters (brain chemicals)

TREATMENT

The main treatments for Premature Ejaculation are Psychological, behavioral and Medical.

Many times, combined treatments are used.

• Psychological Therapy

This seeks to address the negative feelings and emotions that could lead to problems with sexual relationships. As said earlier, this can be used as the only treatment, or it may be used along with the other therapies. It helps couples learn to grow closer. Psychological therapy helps one to become less nervous about sexual performance. Overall, it can engender greater sexual confidence and understanding to improve partner satisfaction.

• Behavioral Therapy

This therapy uses exercises to help build tolerance and delay ejaculation.  Examples include the squeeze and the stop-start method.

Exercises work well, however they depend upon your partner's help, which is not always possible. They may not be a lasting solution.

The Squeeze Method

The partner stimulates the man’s penis until he is close to ejaculation. Partner then firmly squeezes the penis so the erection partly goes away. The aim is to create awareness of the sensations leading to climax. That way the man can better control and delay climax.

The Stop-Start Method

In this method the partner stimulates the penis until just before ejaculation. Partner then stops until the urge to climax abates. After regaining control, partner resumes penis stimulation. This process is best if repeated 3 times. The man ejaculates on the fourth stimulation. The best is to repeat this method 3 times a week with the partner until the man gains better control.

• Medical Therapy

There are no approved drugs to directly treat Premature Ejaculation. However, there are some drugs and numbing creams or sprays that have positively delayed ejaculation in men with PE.

• Drugs

Doctors noticed that men and women on antidepressants have delayed orgasms. Drugs such as fluoxetine, paroxetine, sertraline and clomipramine affect serotonin levels.

Such drugs can be taken every day or only before sex. Based on your activity level a doctor will decide when will be the best time to take the drug as the best time to take the drug is not clear. Most doctors suggest from 2 to 6 hours before sex.

• Numbing Creams or Sprays

These creams/sprays are applied on the tip of the penis about minutes before sex. If the numbing cream/spray is left on the penis for longer than suggested, one could lose his erection. The numbing cream/spray may cause vaginal numbness if left on the exposed penis during vaginal sex. The direction is to wash the cream off penis minutes before sex.

Wearing a condom can also help dull some sensation.

• Counseling

Premature ejaculation, could lead to the loss of the closeness shared with a sexual partner. One might feel angry, ashamed and upset, and turn away from his partner.

A partner might also be upset with the change in sexual intimacy. Premature ejaculation as a condition can cause partners to feel less connected.

Talking about the problem in honesty is an important step, and relationship counseling or sex therapy might be helpful.