Premature Ejaculation

It is not uncommon for men to sometimes ejaculate much sooner during sexual intercourse than either they or their partner would prefer them to. It is not anything to be concerned about if this is an infrequent occasion. However, if this happens on a regular basis, such as shortly after or before intercourse begins, there is a chance that premature ejaculation is to blame.

It is possible that as many as one out of every three men are effected by premature ejaculation at some time.

Both biological and psychological factors can contribute to the development of premature ejaculation, and many men are usually too embarrassed to admit that they suffer it, though it is a treatable and common problem.

There are medications, sexual techniques and psychological counseling that can help delay ejaculation so that both partners can enjoy sex more. Many men find that combining treatment works well.

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Symptoms

The most obvious symptom of premature ejaculation is when ejaculation occurs prior to when both partners wish for it to occur, which causes distress or concern. However, this problem may be present in any sexual situation, including during attempts to masturbate.

Doctors usually classify this condition as either lifelong (primary) or acquired (secondary).

Primary premature ejaculation is usually characterized by:

• An inability to delay ejaculation during vaginal penetration.
• Ejaculation that nearly always happens within a minute of vaginal penetration.
• Frustration, distress or avoiding sexual intimacy.

Secondary premature ejaculation is usually characterized by:

• Causing relationship problems or personal distress.
• Recurrent ejaculation before it is wished and with minimal stimulation prior to penetration.
• The development after having previous sexual relationship without any problems with ejaculation.

When to See a Doctor

When most sexual encounters result in ejaculated sooner than either partner prefers, it is time to discuss it with a doctor. Even though a man may feel as if though he needs to fix the issue himself, treatment may still be required in order to achieve a satisfying sex life.

Some men may find that a conversation with the doctor results in the revelation that not only is the occasional premature ejaculation considered normal, but it may not even be premature. The range of what is considered normal from the start of intercourse to ejaculation is typically considered to be between two and ten minutes.

Causes

It is not known what the precise cause of premature ejaculation is. Though once upon a time, it was believed that the problem was purely psychological, it is now known that the condition is much more complicated than that in that it involves a less simple interaction, including biological factors as well as psychological.

• Psychological Causes. There are some doctors who feel that developing patterns from early sexual experiences make it difficult to change later on in life, including:
  • Situations where a man may needed to have rushed climax before he was discovered;
  • Feelings of guilt that may increase a man’s likelihood to hurry through a sexual encounter.
• Other possible reasons for premature ejaculation to occur may also include:
  • Anxiety. Several men who suffer from premature ejaculation also have issues dealing with anxiety, whether it is only geared towards sexual performance or for other reasons.
  • Erectile dysfunction. Men who have issues or worries about obtaining and keeping their erection throughout intercourse may develop of a pattern of hurrying towards ejaculation, which is a difficult process to change.
  • Relationship problems. If a man has previously had a sexually satisfying relationship without any or with minimal premature ejaculation, then the odds are that an interpersonal issue with a current partner might be to place for the premature ejaculation.
• Biological Causes. There are some factors with regards to biology that might contribute to the condition, as well, such as:
  • Abnormal hormone levels;
  • Abnormal levels of neurotransmitters, which are brain chemicals;
  • Abnormal activity with regards to the reflex of the ejaculatory system;
  • Some thyroid problems;
  • Inherited traits; or
  • Inflammation or infection of the urethra or prostate.
• It is possible, but rare, for premature to be caused by:
  • Withdrawal from narcotics or trifluoperazine (Stelazine), which is a drug that is used to treat anxiety; or
  • Damage of the nervous system that may have resulted from trauma or surgery.

Even though it is possible for both psychological factors and biological factors to play a role in the majority of instances of premature ejaculation, most experts believe that only the instance of primary premature ejaculation has traces of a primarily biological cause.

Risk Factors

There are several different factors that might increase the risk of developing premature ejaculation, such as:

• Erectile dysfunction;
• Health problems;
• Stress; or
• Certain medications;

Tests and Diagnosis

Not only will the doctor wish to obtain a detail interview about the man’s sex life, but he or she will wish to know about the history of his health and will probably wish to conduct a general physical examination. The doctor may refer the patient to a urologist whose specialty lies within sexual dysfunction or, alternatively, to a professional in the mental health field in order to help determine a diagnosis.

If a man has premature ejaculation and also has difficulty either obtaining or maintaining an erection, the doctor will likely order a blood test to see if his testosterone levels are up to speed.

Treatments and Drugs

Options for treating premature ejaculation may include medications, sexual therapy and psychotherapy. Many men find that combining these treatments work best for them.

Sexual Therapy

Sexual therapy, in some instances, might involve several steps.

For instance, the man may wish to masturbate an hour or two prior to engaging in intercourse in order to be capable of delaying ejaculation while having sex.

The doctor might also recommend that he do not have sex for awhile, focusing on other kinds of sexual play in its stead so that there is no more pressure involved with his sexual encounters.

The Squeeze Technique

The doctor may suggest that a man and his partner use a certain method referred to as the “squeeze” technique, and it is performed as follows:

1. Begin the sexual activity as normal, which includes any stimulation of the man’s penis, until he feels that he is about to ejaculate.
2. When this happens, his partner should squeeze the penis where the head (glans) meets with the shaft, keeping a hold of the squeeze for several seconds, by which time the urge to ejaculate should pass.
3. Once the squeeze has been released, he should wait another 30 seconds before continuing on with foreplay. This step may cause the penis to become less erect than it was before, but upon the resuming of sexual stimulation, it will again return to its full erection.
4. If the need to ejaculate occurs again, the partner should repeat the process of squeezing.

This process should be repeated as often as necessary so that the man has reached a point of entering his partner without immediately ejaculating. After performing this for a few times, he should recognize the feeling of how to delay his ejaculating and the habit should develop without having to squeeze any longer.

Medications

There are some topical anesthetic creams and antidepressants that can be applied in order to treat premature ejaculation. Some are used for this purposes, although none of these drugs are specifically approved by the FDA to treat this condition. A man may have to try several medications before finding one that works best for him.

Antidepressants

One of the side effects of antidepressants is the delay of orgasm. For this reason, it is suggested that men who suffer from premature ejaculation may benefit from this particular side effect. However, other side effects may also include dry mouth, nausea, drowsiness and decreased libido.

Topical Anesthetic Creams

When a topic anesthetic cream has prilocaine or lidocaine in them, it may dull the sensation that a penis feels, which should effectively delay orgasm. It should be applied for a short while before intercourse and promptly removed once the penis has lost enough of its sensation in order to delay ejaculation.

Some studies have reported that some men felt less sexual pleasure because the sensitivity was lessened. Additionally, even though the cream is wiped off prior to intercourse, studies show some female partners feeling less sexual pleasure due to a reduced genital sensitivity themselves. In rare instances, prilocaine or lidocaine may cause allergic reactions.

Psychotherapy

This method of treatment involves talking to a professional of mental health about past relationships and past experiences. The purpose of the sessions is the reduce anxiety about performance or to find a better, more effective way to deal with stress and solving problems. Many couples may find that going to therapy together produces the best results for their relationship.

Alternative Medicine

Studies in recent times aimed to compare how effective yoga was versus fluoxetine (Prozac) when used for the treatment of premature ejaculation. The results of the study revealed that both treatments offered a similar improvement on how long the participants were able to have sex before they ejaculated. However, more research on this is needed.

Coping and Support

Many men who suffer from premature ejaculation often feel frustrated or even ashamed of their condition. It may help them when they discover that the problem is a common one and that treatment is generally very effective. Talk to a doctor if this is causing any distress with or without a partner.

While there are other treatment options to be explored, there are ways to lift the pressure on the sexual side of a relationship. Many doctors recommend that a man avoid having intercourse entirely for a short while and instead sharing other ways of physical pleasure and affection in its stead.

By connecting with a partner in this way, a physical and satisfying bond between partners can be re-established by removing the emphasis off intercourse, which should effectively cancel the concern with premature ejaculation, laying the foundation for a sexual relationship that is more fulfilling.

Prevention

It is possible for premature ejaculation to be caused by a lack of communication between two partners or not fully understanding how the sexual functioning of a man and a woman differ.

Women often need more stimulation for prolonged periods of time than men normally do, and it is this difference that is capable of causing some sexual resentment between a couple, not to mention adding more pressure to future sexual encounters. Many men experience premature ejaculation when they feel pressured during sexual intercourse.