Premature Ejaculation

1 What is Premature Ejaculation?

When a man ejaculates sooner during sexual intercourse than he or his partner would like, it is called premature ejaculation which a common sexual compliant.

It is not cause for concern as long as it happens infrequently but as many as 1 out 3 men say that they experience this problem.

There is a diagnostic criterion for premature ejaculation. It includes:

  • are unable to delay ejaculation during intercourse all or nearly all of the time;
  • always or nearly always ejaculate within one minute of penetration;
  • feel frustrated and distressed and will tend to avoid sexual intimacy as a result.

Both biological and psychological factors might be the cause of premature ejaculation.

This is a common and treatable condition even if some men are embarrassed to talk about it. Treatments are medications, sexual techniques and counseling.

2 Symptoms

The inability to delay ejaculation for more than one minute after penetration is the primary symptom of premature ejaculation, but sometimes they even occur in masturbation.

This condition can be lifelong (primary) that occurs all or nearly all of the time beginning with your first sexual encounters or acquired (secondary) that develops after you have previous sexual experiences without ejaculatory problems.

Some men thought that they have premature ejaculation but it did not meet the criteria, it might be because of natural variable premature ejaculation which has periods of rapid ejaculation and periods of normal ejaculation.

Consult your doctor if you think you have premature ejaculation. Since it is common and treatable condition, do not feel embarrassed talking about it.

Your doctor might say that the average time form the beginning of sexual intercourse to ejaculation is about five minutes and it is normal to have occasional premature ejaculation.

3 Causes

There is no known cause of premature ejaculation.

Doctors believed that both biological and psychological factors may play a role in premature ejaculation.

The biological causes include:

  • abnormal levels of brain chemicals called neurotransmitters;
  • abnormal hormone levels;
  • certain thyroid problems;
  • abnormal reflex activity of the ejaculatory system;
  • inherited traits;
  • inflammation and infection of the prostate or urethra;
  • nerve damage from trauma or surgery but very rare.

The psychological factors include:

  • guilty feelings that makes you rush through sexual encounters;
  • situations that you may have hurried to reach climax in order to avoid being discovered;
  • anxiety because of sexual performance or related issues;
  • erectile dysfunction – men may form a pattern of rushing to ejaculate because they want to maintain an erection during sexual intercourse;
  • relationship problems – sometimes because you have interpersonal issues with your partner.

4 Making a Diagnosis

Since premature ejaculation can occur due to a number of factors, speak with your doctor to receive a proper diagnosis.

Talk to your doctor and do not feel embarrassed when you are going to talk about sexual problems because premature ejaculation is common and is a treatable condition.

Before the visit, make a list of the symptoms that you are having such as how do you often ejaculate after the beginning of the sexual intercourse. You can also write down medical history such as if yiu are diagnosed with medical problems and all the supplements and medications that you are taking every day. Write down your sexual history like if you had this before.

Some of the possible questions that you can ask your doctor include

  • What is causing my premature ejaculation?
  • What tests do you recommend?
  • What treatments do you recommend?
  • How soon can I see the improvement?
  • Is this a recurring condition?
  • What websites do you recommend visiting?

Your doctor will likely ask you very personal questions such as

  • How often do you have premature ejaculation?
  • Did it develop gradually or suddenly?
  • Do you have premature ejaculation with a specific partner or partners?
  • Do you also experience this during masturbation?
  • Are you experiencing this every time you have sex?
  • How often do you have sex?
  • Is your partner bothered by this?
  • Are you bothered by this?
  • Are you having erectile dysfunction?
  • Do you use recreational drugs?

You and your partner should consider exploring other ways in which both of you can connect while waiting for the appointment. Your doctor may perform physical exam and will ask you about your health history.

You may undergo a urine test to check for infection or blood tests to check for testosterone levels if you are having both premature ejaculation and trouble maintaining an erection.

He may also refer you to a mental health professional or urologist who specializes in sexual dysfunction. 

5 Treatment

The treatments for premature ejaculation include

  • topical anesthetics,
  • behavioral techniques,
  • counseling
  • and oral medications.

For topical anesthetics

Sprays and creams that have prilocaine or lidocaine that will be applied to the penis a short time before sex to reduce the sensation which can lead to delay in the ejaculation, but these have side effects such as allergic reaction.

For behavioral techniques

Your doctor may suggest that you should avoid intercourse for a period of time and focus on other types of sexual play to remove the pressure from your sexual encounters.

Your doctor may also recommend pause-squeeze technique: after the beginning of the sexual activity, let your partner squeeze the end of your penis up to the point where the head (glans) joins the shaft for several seconds until the urge to ejaculate passes, released the squeeze then wait for 30 seconds and then you can go back to foreplay, if you feel that you are going to ejaculate again ask your partner to do the process again.

You will notice that squeezing can cause it to less erect but it will soon regains full erection once sexual stimulation resumed.

For oral medications

Such as antidepressants, analgesics and phosphodiesterase-5 inhibitors can be used but are not approved by the Food and Drug Administration to treat premature ejaculation.

Antidepressants such as sertraline (Zoloft), fluoxetine (Prozac) or paroxetine (Paxil) may be use for the delay of the ejaculation.

Your doctor may also prescribed clomipramine (Anafranil), but these have side effects such as

Analgesics such as Tramadol (Ultram) may be used to treat pain and delay ejaculation but have side effects such

Phosphodiesterase-5 inhibitors such as sildenafil (Viagra), vardenafil (Levitra, Staxyn) or tadalafil (Adcirca, Cialis) may be used to treat erectile dysfunction but have side effects such as temporary visual changes, nasal congestion, headache and facial flushing.

Your doctor may recommend talk therapy with a mental health provider regarding your experiences and relationships, this can help you find better ways of coping with stress and reduce performance anxiety.

6 Prevention

Here are some of strategies to help you prevent premature ejaculation:

  • reducing your anxiety by talking to your partner to stop pressuring you intentionally or not, and by relaxing your mind,
  • think nonsexual thought and avoid thinking of a topic that will make you stress,
  • change positions,
  • take it slow especially if you find yourself getting too close to orgasm,
  • focus on foreplay.

7 Alternative and Homeopathic Remedies

There are research studies about alternative remedies such as yoga and surgical treatments but it is not yet known if they are effective and safe.

8 Lifestyle and Coping

To best cope with premature ejaculation, it's best to speak with your doctor to ensure you are making correct lifestyle choices.

Some of the things that you can do to delay ejaculation are as follows:

  • use condoms if you think your penis is too sensitive;
  • focus on other sexual pleasures to decrease the anxiety and help you gain better control over ejaculation;
  • do not hesitate to talk to your doctor so he can help you.

9 Risks and Complications

There are several risks and complications associated with premature ejaculation.

The risk factors for premature ejaculation include:

  • erectile dysfunction – you may be at risk if you are having a hard time maintaining an erection because the fear of losing your erection may lead to consciously or unconsciously hurry through sexual intercourse,
  • health problems – you may feel anxious during sex if you chronic or serious conditions such as heart disease,
  • stress – mental or emotional strain that will limit your ability to relax and focus during sexual encounters.

Premature ejaculation can cause problems in your personal life such as:

  • fertility problems – this will be hard for couple who are trying to have a baby,
  • stress and relationship problems.
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