Premature Ejaculation

An overview of Premature Ejaculation

Having trouble enjoying sex with your partner?? Is she complaining about incomplete sexual pleasure!! Premature Ejaculation might be the cause….Premature Ejaculation is a sexual disorder when a man climaxes and ejaculates (releases semen) sooner than he or his partner would like during sex. Between 30% to 40% men experience premature ejaculation during their lifetime as witnessed in one such study. Though it is considered to be the most common sexual complaint among male population, it is treatable with medications, counselling and techniques that delay ejaculation improving sex between two partners. Irregular hormone levels, depression, erectile dysfunction, stress and relationship problems contribute to premature ejaculation. Popular oral medicines to delay ejaculation as prescribed by doctors are tadalafil (Cialis) and sildenafil (Viagra). On the other hand, doctors also prescribe applying numbing creams and sprays on the head of the penis before sex to delay ejaculation. Other common treatments offered by health care provider are psychological therapy and behavioural therapy. An urologist or a healthcare provider may offer medications and other therapies to delay ejaculation but remaining stress-free, intake of healthy food and performing regular exercise can help stay away not only from such diseases but also helps an individual lead a happy and healthy life.

Causes of Premature Ejaculation

Though the exact cause of premature ejaculation in men has not yet been identified, research has shown that it involves a complex interaction of biological, chemical or emotional factors.

Serotonin: This is a natural substance available in human body made by nerves. It helps control the way the brain manages mood, emotion, sleep and sexual desire. Studies have shown that high amounts of serotonin in the brain increase the time to ejaculation while low amounts can shorten the time to ejaculation leading to premature ejaculation.

Psychological Causes of Premature Ejaculation

Psychological or mental health issue can cause premature ejaculation and may include:

  • Depression
  • Anxiety
  • Poor body image
  • Stress
  • Lack of confidence
  • Guilt
  • Sexual abuse
  • Unrealistic desires around sex

Other factors playing a role in premature ejaculation may include:

Erectile dysfunction: Sometimes men worry about getting and maintaining an erection, which leads to a rush to ejaculation, which leads to premature ejaculation. This pattern is difficult to change.

Relationship Problem: With premature ejaculation, men often feel less connected with their partner. This might lead to feeling angry, ashamed or upset, and turn away from the sexual partner. This not only affects the patient but the partner too and both feel less connected or hurt.

Biological Causes of Premature Ejaculation

A number of biological factors may contribute to premature ejaculation and this may include:

  • Irregular hormone levels
  • Irregular levels of brain chemicals
  • A penis that’s especially delicate to stimulation
  • Swelling and infection of the prostate or urethra
  • Inherited traits

Symptoms of Premature Ejaculation

The primary symptom of premature ejaculation is the regular inability to delay ejaculation for more than a minute after penetration during sexual activity. But it might happen in all sexual circumstances, indeed amid masturbation.

Premature ejaculation can be broadly divided into two categories:

Lifelong (primary): This type of ejaculation occurs all or nearly all the time beginning with the first sexual experience.

Acquired (secondary): This type of ejaculation develops after having previous sexual experiences without problems with ejaculation.

Treatment for Premature Ejaculation

Untimely ejaculation could be a upsetting issue but can be treated with a combination of therapeutic, behavioral, and mental treatments. It is important to treat the underlying medical conditions, for instance erectile dysfunction (impotence), infections (orchitis, prostatitis). It is also advisable to include the female partner in the treatment for a satisfying sexual life.

Nonpharmacologic therapy

Some of the therapeutic strategies are given below:

Behavioral techniques: Some behavioural techniques advised by healthcare providers include masturbating an hour or two before the actual sexual activity, trying another erection shortly after an episode of premature ejaculation. These techniques help build tolerance to delay ejaculation. 

Pelvic floor exercises: Premature ejaculation treatment may include pelvic floor exercises (kegel) which help strengthen muscles and improve control at ejaculation.

Sex therapy: Masters and Johnson proposed two sex techniques to control premature ejaculation- The Squeeze Method & The Stop-Start Method.

The Squeeze Method: In this method, an individual or his partner stimulates his penis until he is close to ejaculation. When the individual is close to ejaculation, he or his partner firmly squeezes his penis so that his erection partly goes away. The objective is for the individual is to become aware of the sensations leading to climax. 

The Stop-Start Method: With this method, an individual or his partner stimulates his penis until just before ejaculation. When the individual is about to climax, the individual or his partner stops until the urge to climax lets up. As he regains control, he and his partner start stimulating his penis again. This process must be repeated three times. The individual ejaculate on the fourth time. Doctors advise to repeat this method three times a week until the individual has gained more control.

Distracted thinking: In this technique, patients are advised to focus their attention on ordinary nonsexual things while they are being sexually stimulated. Naming sequences are a good way to focus attention on ordinary nonsexual things. 

Counselling: Psychologist, psychiatrist, couples therapist or sex therapist conduct counselling sessions for any underlying performance anxiety or depression, for relationship problems, for past traumatic events, etc. to recover from premature ejaculation.

Condoms: Doctors treating premature ejaculation suggest using thick condoms or condoms with numbing agents to improve control at ejaculation.


Pharmacologic therapy

Oral medications: Antidepressants, especially certain serotonin inhibitors such as citalopram (Celexa®), escitalopram (Lexapro®), fluoxetine (Prozac®), paroxetine (Paxil®), and sertraline (Zoloft®) or the tricyclic upper clomipramine (Anafranil®), delay. premature ejaculation Other solutions include sildenafil (Viagra®), tadalafil (Cialis®), vardenafil (Levitra®) and avanafil (Stendra®).Tramadol, a strong painkiller with a side impact of deferred ejaculation can offer assistance with untimely ejaculation. But it also has additional adverse effects like nausea, vertigo, addiction, etc.

Topical desensitizing agents: Some numbing medicines, namely, lidocaine and prilocaine when applied 10-15 minutes before the sexual activity to the head and shaft of the penis delay ejaculation. They might, however, lessen sensitivity and pleasure.

Latest advancement in medical science has come up with many treatment options for premature ejaculation.  It’s common to feel embarrassed about discussing sexual health concerns with healthcare providers. Remember that you are not alone, if you love your partner and want to enjoy a stress free and loving relation, visit your nearest doctor soon and lead a happy sexual life.

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