Premature Ejaculation
What is premature ejaculation?
Premature ejaculation (PE) refers to the rapid release of semen during orgasm, occurring faster than desired by either partner. It’s a common sexual dysfunction affecting about one in three men aged 18 to 59 at some point. It is often termed as rapid ejaculation, premature climax, or early ejaculation.
Is premature ejaculation a type of sexual dysfunction?
Premature ejaculation (PE) is classified as a sexual dysfunction, encompassing various issues that hinder couples from fully enjoying sexual activity. It’s distinct from erectile dysfunction (ED), which specifically involves the inability to achieve and sustain an erection sufficient for satisfactory sexual intercourse. Individuals can experience both PE and ED concurrently, although they are separate conditions with different impacts on sexual performance and satisfaction.
What are the symptoms of premature ejaculation?
Occasional instances of premature ejaculation (PE) are typically not cause for concern. However, treatment may be necessary if PE happens frequently or persists over time. The primary symptom of PE is the consistent inability to delay ejaculation for more than a minute after penetration during sexual intercourse. Some individuals may also experience rapid climax during masturbation.
PE can be categorised into different types:
- Natural Variable Premature Ejaculation: This occurs when a person experiences premature ejaculation sometimes and normal ejaculation at other times.
- Lifelong (Primary) PE: This type indicates that a person has consistently experienced PE since their first sexual encounter.
- Acquired (Secondary) PE: In this case, a person previously had longer-lasting ejaculations but has developed PE later in life.
What causes premature ejaculation?
Psychological and emotional factors contribute to premature ejaculation (PE), alongside various other causes. Some psychological aspects may be temporary; for instance, individuals may have initially experienced PE during early sexual experiences but learned strategies over time to delay ejaculation as they gained sexual experience. PE can also arise later in life, often coinciding with difficulties in maintaining an erection as individuals age. Additionally, underlying conditions and mental health issues may contribute to PE, including poor body image, low self-esteem, depression, and a history of sexual abuse, either as a perpetrator, victim, or survivor.
Feelings of guilt can also lead to rushed sexual encounters, exacerbating PE. Other factors contributing to PE may include anxiety related to ejaculating too early, concerns about limited sexual experience, relationship problems or dissatisfaction, and stress. Furthermore, physical causes play a significant role in PE; for example, difficulty maintaining an erection due to erectile dysfunction (ED) may prompt individuals to rush through intercourse to avoid losing their erection. Abnormal levels of hormones like testosterone and neurotransmitters produced by nerve cells can also contribute to PE. Inflammation of the prostate or urethra is another potential cause of symptoms like PE and ED.
When do you seek help with premature ejaculation?
If you’re experiencing premature ejaculation (PE) and it’s impacting your life, it’s important to consider speaking with a doctor, especially if:
- PE is occurring frequently enough to cause relationship issues or conflicts.
- PE makes you feel self-conscious or affects your self-esteem.
- PE is hindering your ability to pursue or maintain intimate relationships.
A doctor can provide a thorough evaluation to understand the underlying causes of your PE and recommend appropriate treatment options. Depending on your specific situation and needs, they may suggest lifestyle changes, behavioural techniques, therapy, or medications.
How is premature ejaculation treated?
In some cases, making adjustments to your sexual routine can help address premature ejaculation (PE). Here are some strategies that may be recommended:
- Masturbate before intercourse: Masturbating an hour or so before engaging in sexual activity with your partner may help delay ejaculation during intercourse.
- Start-and-stop method: This technique involves your partner stimulating your penis until you’re near ejaculation, then stopping until you regain control. Repeat this process a few times before allowing ejaculation.
- Squeeze method: With this approach, your partner stimulates your penis until you’re close to climax, then firmly squeezes the head of the penis until the urge to ejaculate subsides. This helps you recognise the sensation before ejaculation and gain better control.
- Pelvic floor exercises (Kegels): Strengthening the pelvic floor muscles can improve ejaculatory control. To perform Kegel exercises, tighten the pelvic floor muscles for a few seconds, then relax them. Repeat this several times a day, gradually increasing repetitions.
- Decreasing sensitivity: Using condoms, particularly those designed for “climax control” that contain numbing agents like benzocaine, can reduce penile sensitivity and delay ejaculation.
- Numbing agents: Applying numbing creams or sprays to the penis before intercourse can reduce sensitivity. Consult with your doctor before using these products to ensure they are safe and effective for you.
- ED medications: If erectile dysfunction (ED) contributes to premature ejaculation, medications like tadalafil (Cialis) or sildenafil (Viagra) may help maintain erection firmness, potentially aiding in delaying ejaculation.
These methods may take time and practice to be effective, and their success can vary depending on individual circumstances. Discussing these options with a healthcare provider to determine the most appropriate treatment plan for your situation is advisable.
