PREMATURE EJACULATION

Premature ejaculation is described as the condition where a man ejaculates during intercourse earlier than he or his partner would like. Literature states, although estimates vary across studies, that 1 out of 3 men report that they experience this problem at some point of time.

A person is said to be diagnosed with PREMATURE EJACULATION if they:

• Always or nearly always ejaculate within one minute of penetration
• Are unable to delay ejaculation during intercourse all or nearly all of the time
• Feel distressed and frustrated, and tend to avoid sexual intimacy as a result

SYMPTOMS

Classification of premature ejaculation can be as follows:

Lifelong (primary): lifelong premature ejaculation occurs all or nearly all of the time beginning with your first sexual encounters.

Acquired (secondary): Acquired premature ejaculation develops after you’ve had previous sexual experiences without ejaculatory problems.

CAUSES/RISK FACTORS

• Early sexual experiences
• Sexual abuse
• Poor body image
• Depression
• Worrying about premature ejaculation
• Guilty feeling that increases your tendency to rush through sexual encounters
• Anxiety
• Relationship problems

COMPLICATIONS

Premature ejaculation can cause problems in your personal life, including:

SRESS AND RELATIONSHIP PROBLEMS: Relationship stress is a common complication of premature ejaculation.

FERTILITY PROBLEMS: Fertilization may prove difficult for couples who are trying to conceive particularly if ejaculation doesn’t occur intravaginally.

DIAGNOSIS

In addition to asking about your sex life, your doctor will ask your heath history and might do physical examination. Its advisable to consult an urologist or psychiatrist/mental health professional who specializes in sexual dysfunction.

TREATMENT

General advice

• More frequent sex (or masturbation): premature ejaculation is more likely if there is a longer gap between sexual intercourse.
• Using a condom may decrease sensation.
• Sex with the woman on top reduces the likelihood of premature ejaculation.
• Squeeze and stop-go techniques: stimulating the penis almost to the point of ejaculation and then stopping. These techniques are often effective but may take few months to produce any benefit.
• Behavioral treatments are useful for secondary premature ejaculation but are not recommended first-line for lifelong premature ejaculation. They are time-intensive and require commitment from the partner.
• Pelvic floor exercises: weak pelvic floor muscles might impair your ability to delay ejaculation. Pelvic floor exercise (Kegel exercises) can help strengthen these muscles.
• Condoms: might decrease penis sensitivity, which can help delay ejaculation.

MEDICATIONS:

• TOPICAL ANESTHETICS: Anesthetic creams and sprays that contain a numbing agent.
• ORAL MEDICATIONS: many medications might delay orgasm. These medications might be prescribed for either on-demand or daily use, and might be prescribed alone or in combination with other treatments.