Premature ejaculation is a type of sexual dysfunction that occurs when a man experiences orgasm and releases (ejaculates) semen earlier than he or his partner would like. Premature ejaculation affects between 25 % and 43 % of men at some point in their lives. Premature ejaculation is the most common type of sexual dysfunction in men, according to the American Urological Association. Premature ejaculation affects about one in every five men between the ages of 18 and 60.

The American Psychiatric Association categorizes ejaculation into three levels of severity (mild, moderate, and severe), with mild being less than one minute. Many doctors define prematurity as ejaculation within a minute of beginning intercourse if given a time limit.

Premature ejaculation can lead to secondary symptoms such as distress, embarrassment, anxiety, and depression.

 

 

 

How Does Ejaculation Work?

The central nervous system regulates ejaculation. Signals are sent to your spinal cord and brain when men are sexually stimulated. Signals are sent from your brain to your reproductive organs when men reach a certain level of excitement. As a result, semen is ejected through the penis (ejaculation).

 

 

Causes and Diagnosis

The majority of the time, there is a psychological cause, and the prognosis is favorable. The exact cause is unknown. However, your brain chemistry could be at least partially responsible. Men who have low levels of the chemical serotonin in their brains ejaculate more quickly.

Emotional factors may be involved:

• Stress

• Depression

• Anxiety

• Guilt/Performance Issue

• Erectile Dysfunction

Consult your doctor if premature ejaculation is interfering with your sexual life. They will conduct a physical examination and asks some question from you. If your doctor suspects that emotional issues are causing your PE, he or she may refer you to a mental health professional who works with people who have sex problems. If a physical problem is causing it, they may refer you to a urologist, a doctor who specialises in conditions affecting the urinary system.

 

 

 

 

Treatment Options Available

 

Behavioral therapy

Behavioral therapy involves trying different methods to delay your orgasm. Its goal is to teach you how to control your body and your feelings. Methods include:

Start and stop: With this technique, you or your partner stimulates your penis close to the point of orgasm then stops the stimulation for about 30 seconds until you regain control of your response. Repeat this “start and stop” approach three or four times before allowing yourself to orgasm. Continue practicing this method until you have gained good control.

Squeeze therapy: With this technique, you or your partner stimulates your penis close to the point of orgasm then gently squeezes the head of your penis for about 30 seconds so that you begin to lose your erection. Repeat this technique a few times before allowing yourself to orgasm. Continue practicing this technique until you have gained control in delaying your orgasm.

Wear condoms decrease the over-sensation and prolong the time of the ejection

Some men find that masturbating a few hours before sex helps them stay in control during intercourse.

Strengthen your muscles: Weak pelvic floor muscles sometimes contribute to PE. Kegel exercises may help strengthen them.

 

 

Medication:

Although no medications are officially approved for the treatment of PE in the United States, some antidepressants have been found to help some men delay ejaculation.

Topical numbing agents

Creams, gels, and sprays that contain a numbing agent — such as benzocaine, lidocaine, or prilocaine — are sometimes used to treat premature ejaculation. They're applied to the penis 10 to 15 minutes before sex to reduce sensation and help delay ejaculation. They're available without a prescription. However, a cream containing both lidocaine and prilocaine (EMLA) is available by prescription.

Although topical numbing agents are effective and well tolerated, they have potential side effects. They may cause decreased feelings and sexual pleasure in both partners.

 

Oral Medication:

Several types of medications may be tried.

Antidepressants, especially selective serotonin reuptake inhibitors like citalopram (Celexa®), escitalopram (Lexapro®), fluoxetine (Prozac®), paroxetine (Paxil®) and sertraline (Zoloft®) or the tricyclic antidepressant clomipramine (Anafranil®), can help delay premature ejaculation. This is an “off-label” use (not approved by the Food and Drug Administration for this use). Be sure to discuss the side effects of this medication with your urologist to be sure it’s appropriate for you.

 

 

 

References

American Urological Association. Urology Care Foundation. Premature Ejaculation. (https://www.urologyhealth.org/educational-materials/premature-ejaculation-x2949) Accessed 8/4/2020.

Sexual Medicine Society of North America. Conditions: Premature Ejaculation. (https://www.sexhealthmatters.org/premature-ejaculation) Accessed 8/4/2020.

 

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