Premature Ejaculation

Premature ejaculation: what is it?

When someone has an orgasm and ejaculates earlier than they or their partner would like, it’s known as premature ejaculation (PE), a kind of sexual dysfunction. During intercourse, it often occurs before to or soon after penetration. Both you and your sexual partner may find premature ejaculation annoying, and it may also make your sex life less pleasurable.

Since your first sexual encounter, you may have had PE for the rest of your life. Additionally, it may be acquired, meaning that you have had intercourse in the past when PE wasn’t a problem.

How long does it typically take to ejaculate prematurely?

Premature ejaculation, according to many medical professionals, is defined as ejaculating within a minute after starting sexual activity. Premature ejaculation may occur at any time, and only your healthcare practitioner can diagnose it.

Ejaculation is deemed “premature” by the majority of healthcare organisations if it:

occurs earlier than either you or your significant other would want.
makes one or both partners unhappy.
occurs during most or all sexual activity.
occurs one minute after insertion.
has been going on for more than half a year or more.

To what extent does premature ejaculation occur?

Premature ejaculation affects between 30% and 40% of persons at some time in their life. Premature ejaculation is the most prevalent kind of sexual dysfunction among penile individuals, with around 1 in 5 individuals aged 18 to 59 experiencing it.

Causes and Symptoms

What leads to early ejaculation?

Premature ejaculation is often caused by psychological or anxiety-related reasons. Another frequent reason is very sensitive penile skin.

Among the psychological or emotional reasons are:

anxiousness related to performance. It might be caused by being too enthusiastic, being apprehensive about having sex again after a long time of abstinence, being with a new partner, or other factors.
Stress. Work, other relationships, life transitions, or other life events may all cause stress.
issues in relationships. This might include aggressive attitudes towards your spouse or a history of sexual abuse.
thoughts of depression. These could include overwhelming feelings of guilt.
low self-esteem. This involves insecurities or problems with body image.

Among the chemical and physical reasons are:

The inability to erect
Oxytocin levels are a hormonal issue that affects sexual function; additional hormone levels that affect sexual performance include thyroid stimulating hormone (TSH), prolactin, and luteinizing hormone (LH).
Low levels of dopamine or serotonin, two brain chemicals linked to excitation and sexual desire
An very sensitive penis to stimulation
A prostate that is inflamed

It’s important to remember that an underlying penile dysfunction, illness, infection, or issue with your reproductive organs is seldom the cause of premature ejaculation. Most of the time, everything is operating as it should, and tension, worry, and uneasiness are the cause of the issue.

Does premature ejaculation provide any symptoms?

No. Ejaculating too quickly is the sole sign of premature ejaculation.

What are this condition’s complications?

The consequences of premature ejaculation are psychological rather than physical, and they may have a big impact on your connection with your spouse. It’s possible that you’ll feel ashamed or that you can’t please your lover. This might affect your relationship overall and cause intimate problems. People with PE often suffer frustration and sadness.

It is crucial to get assistance for PE because of this. Many individuals find this common ailment frustrating. Depending on what caused your early ejaculation, your healthcare practitioner may assist you choose the best course of action.

Testing and Diagnosis

How can the reasons of early ejaculation be identified?

Make an appointment to visit a urologist if you often ejaculate too soon or if it’s harming your relationships and making you feel anxious or depressed.

Before starting an examination, a urologist will enquire about your sexual history. They could enquire:

How long has this been an issue for you?
In what conditions has it occurred?
How often does it occur?
Does every sexual encounter result in premature ejaculation?
Does that occur with every partner?
Does masturbating cause premature ejaculation?
Do you find it difficult to keep your erection going?

Even though the questions are private, it’s crucial that you give your urologist honest answers so they can determine the cause of your issue.

Additionally, your urologist will enquire about any prescriptions you are taking, including over-the-counter drugs, vitamins, and herbal items, as well as any other health issues you may have. They will also enquire about your usage of drugs and alcohol.

Does the diagnosis of premature ejaculation need laboratory testing?

Unless your doctor believes that an underlying medical condition is causing the issue, lab testing is often not required.

Handling and Therapy

What is the treatment for premature ejaculation?

Depending on the reason, premature ejaculation might have a wide range of therapy options. These include of counselling, behavioural treatment, and prescription drugs. Behavioural therapy and/or counselling are often used to address emotional issues, performance anxiety, or pressures that may be significant factors in the majority of premature ejaculation causes. You may experiment with many treatment modalities simultaneously, and in fact, combinational therapy could work better than any one of them alone.

Therapy involving behavioural modification

Behavioural treatment entails experimenting with several useful techniques to postpone your orgasm. Teaching you to regulate your body and emotions is the aim. Techniques consist of:

Start and stop. This method involves stimulating your penis till it approaches climax, then stopping the stimulation for about 30 seconds until you or your partner can regulate your reaction again. Before letting yourself climax, use this “start and stop” method three or four times. Until you have adequate control, keep using this technique.
treatment by squeeze. In order to cause you to lose your erection, you or your partner will gently squeeze the head of your penis for around 30 seconds after stimulating it almost to the point of orgasm. Before letting yourself have an orgasm, repeat this approach a few times. Keep using this method until you’ve mastered the ability to postpone your orgasm.
thinking when distracted. The objective behind this approach is to concentrate on everyday, nonsexual objects while engaging in sexual activity. Using naming sequences might help you concentrate. Imagine, for instance, identifying every company you see on your way to the gym or every member of your preferred sports team.

Guidance

Seek the assistance of a psychologist, psychiatrist, or sex therapist if your early ejaculation is psychological, emotional, or related to relationship problems, such as performance anxiety, sadness, stress, guilt, or a problematic relationship. You may get referrals to these medical specialists from your urologist.

Drugs

Your doctor could suggest certain drugs to treat PE.

Since they may help postpone ejaculation, antidepressants are among the first-line treatments for PE. The Food and Drug Administration has not authorised this usage, which is known as “off-label.” To ensure that this drug is suitable for you, be sure to talk to your urologist about its adverse effects.

The tricyclic antidepressant clomipramine (Anafranil®) and selective serotonin reuptake inhibitors (SSRIs) are two examples of antidepressants that your doctor may recommend.
Celexa® (citalopram)
Escitalopram (brand name Lexapro)
The drug fluoxetine (Prozac)
(Paxil®) Paroxetine
The drug sertraline (Zoloft)
Another possible first-line medicine option to postpone ejaculation is to use anaesthetic (numbing) lotions and sprays to the head and shaft of your penis. In ten to thirty minutes, the anaesthetic cream or spray is absorbed by your penis. It results in your penis becoming less sensitive. To avoid making your partner’s genitalia numb, it’s crucial to cleanse your penis before having intercourse.
Premature ejaculation may be treated with erectile dysfunction drugs, such as vardenafil (Levitra®), tadalafil (Cialis®), sildenafil (Viagra®), and avanafil (Stendra®), especially in those who have underlying erectile dysfunction.
Your doctor could sometimes recommend the opiate drug tramadol.