Premature ejaculation is a form of sexual dysfunction that adversely affects men’s quality of sexual life.
Premature ejaculation is a very common ejaculation problem affecting 30-40% of men. It occurs when a man ejaculates earlier during intercourse. Premature ejaculation is always not a cause for concern. However, it might be a concern if it often happens when the patient cannot delay ejaculation or feel distressed.
There is no set time for a man to ejaculate during sex. Still, premature ejaculation is when a man has an orgasm (peak of sexual arousal) before intercourse or less than a minute after intercourse, i.e. ejaculate and lose erection soon.
What Are The Causes?
There is no specific cause, but brain chemistry could be a reason. Low serotonin levels in the brain could cause men to take a shorter time to ejaculate.
There are two types of premature ejaculation-
- Primary (lifelong)
- Secondary (acquired)
Causes of primary premature ejaculation- Psychological, such as having a traumatic sexual experience at an early age
Causes of secondary premature ejaculation- Psychological and physical factors like drinking too much alcohol and inflammation of the prostate gland (prostatitis)
Risk Factors
Emotional factors: Stress, Depression, Anxiety, Guilt, Lack of confidence, Sexual repression
Physical factors:
- Hormonal imbalance
- Irregular levels of neurotransmitters in the brain (an imbalance in chemicals that pass messages to the rest of the body)
- Inflammation or infection in prostate or urethra
- Genetics
- Chronic pelvic pain syndrome (long-term pain and cramping in the pelvic area plus long-term urinary tract symptoms and sexual dysfunction)
- Thyroid Disorders
- Recreational drug use
Sometimes premature ejaculation can be a problem in men with erectile dysfunction, where men develop a pattern of rushing to ejaculate.
How Can Premature Ejaculation Be Investigated?
Consult a doctor when premature ejaculation gets in the way of your sexual intercourse.
The doctor will perform a physical exam and ask specific questions to conclude whether ejaculation occurs early or late.
Labs may also be ordered if the doctor finds something during your physical exam.
Treatment and Management of Premature Ejaculation
Different treatment options depend on the cause, including behavioural therapy, counselling, and medications.
Mostly premature ejaculation is treated with behaviour therapy or counselling to help with emotional issues, anxiety, or stress.
Behavioural therapy– Behavioral therapy involves trying different methods (how to control body and feelings) to delay orgasm.
- Start and stop therapy
- Squeeze therapy
- Distracted thinking
Counselling– If the cause of premature ejaculation is psychological or emotional issues that may be due to performance anxiety, depression, stress, guilt, or a troubled relationship– seek the help of a doctor.
Medications-
- Antidepressants can help delay premature ejaculation
- Anaesthetic (numbing) creams and sprays are another option to delay ejaculation
- Erectile dysfunction medications can also be used to treat premature ejaculation, particularly in men with underlying erectile dysfunction
Make sure to discuss with a sexologist which treatment is appropriate for you.
Self-help to Treat Premature Ejaculation
Self-help techniques to try before getting medical help:
- Strengthen your muscles (pelvic floor exercises)
- Masturbating 1-2 hours before sex
- Using a thick condom
- Taking breaks during sex and distracting yourself
- Adding Zinc and Magnesium to your diet
