What is Premature Ejaculation?
When ejaculation occurs during intercourse sooner than a man or his partner would prefer, usually within two to three minutes, this is known as premature ejaculation (PE). Other names for occasional PE include early ejaculation, premature climax, and fast ejaculation. PE may not be a reason for concern. However, if it affects relationships and makes sex less pleasurable, it can be annoying. Your healthcare professional can offer assistance if it occurs frequently and causes issues.
Premature Ejaculation and Erectile Dysfunction (ED)
For men who struggle with erection issues like erectile dysfunction (ED), PE can occasionally be an issue. Men experience this when they are unable to achieve or maintain an erection that is sufficiently firm for intercourse. It can be challenging to determine whether the issue is PE or ED because an erection disappears after ejaculation. Since PE might not be an issue after ED is treated, it is advisable to treat ED first.
What Causes Premature Ejaculation?
Although the precise origin of PE is unknown, there are numerous potential causes for men to develop PE. There could be emotional, chemical, or biological causes. Here are a few more particular reasons.
Serotonin
Your body naturally produces serotonin through the production of nerves. It aids in regulating how the brain controls emotions, mood, sleep, and sexual desire. The brain’s high serotonin levels lengthen the time it takes to ejaculate. Low levels can cause PE and reduce the time to ejaculation.
Psychological Issues
Psychological, or mental health, issues can be involved with PE and may include:
• Depression
• Anxiety
• Stress
• Guilt
• Unrealistic expectations about sex
• Lack of confidence
• History of sexual repression (blocked or bottled-up sexual feelings)
• Relationship problems
Taking care of emotional problems often helps.
Other Issues
PE and Age
Any age can experience PE. PE is not directly caused by aging. However, as people age, ED may become more prevalent, which could be related to decreased serum testosterone levels. Erections may not be as big or firm for some elderly guys. The duration of erections may be shorter than before ejaculation. There may be a brief sensation that ejaculation is imminent. An older guy may ejaculate early as a result of these changes.
PE and Your Partner
You can feel less connected to your sexual partner if you have PE. You may turn away from your sexual partner because of feelings of anger, embarrassment, or distress. Both you and your spouse may be impacted by premature ejaculation. PE may make partners feel hurt or less connected. Discussing the issue is a crucial first step. Sex therapy or couples counseling may be beneficial. You and your partner may find that exercises like the squeeze technique assist to prolong an erection (for more information, see the therapy section). Above all, a pair should learn how to unwind. Performance anxiety and other worries might exacerbate physical education.
GET DIAGNOSED
Men usually have some degree of control over whether and when they ejaculate during partner masturbation and intercourse. PE might be present if a guy or his sexual partner(s) are concerned about his inability to regulate when he ejaculates. You should consult a healthcare professional if PE interferes with your ability to enjoy sexual activity. Whether ejaculation happens early, late, or not at all determines the diagnosis. Your doctor will typically diagnose PE following a physical examination and consultation with you. He or she might inquire about the following:
• How often does the PE happen?
• Has the PE been present lifelong, or started recently?
• Does this happen with just one partner, or all partners?
• Does PE happen with each attempt at sex?
• What type of sexual activity (i.e., foreplay, masturbation, intercourse, use of visual cues, etc.) do you take part in and how often?
• How has PE changed your sexual activity?
• How are your personal relationships?
• Is there anything that makes PE worse or better (i.e., drugs, alcohol, etc.)?
GET TREATED
Psychological Therapy
The feelings and emotions that could cause issues in sexual relationships can be worked out through psychological treatment. Finding solutions that could benefit PE and identifying the cause of issues are the objectives of this kind of therapy. Additionally, it can teach couples how to get closer. You can reduce your anxiety about performing sexually with the aid of psychological counseling. Additionally, it might assist you understand how to improve your partner’s enjoyment through increased sexual confidence. This kind of therapy can be used in conjunction with behavioral or medical therapy, or it can be utilized as the sole treatment.
Behavioral Therapy
Exercises that can increase tolerance to postpone ejaculation are used in behavioral therapy. Helping you teach your body to avoid PE is the aim. The stop-start method and the squeeze method are two options. Exercises are effective, but they might not be a long-term solution and might now be suitable for everyone.
The Squeeze Method
This technique involves stimulating your penis until you are almost ready to ejaculate, either by yourself or with your partner. Your erection partially disappears when you or your spouse tightly squeezes your penis when you are close. The intention is for you to become conscious of the feelings that precede climax. You might be able to better control and postpone climax on your own by using the squeeze method.
The Stop-Start Method
This technique involves stimulating your penis till right before ejaculation, either by you or your partner. When you or your partner are on the verge of climaxing, you both pause until the urge subsides. You and your partner resume stimulating your penis as you regain control. Three times, this procedure is carried out. The fourth time you ejaculate. Until you have better control, you use this technique three times per week.
Medical Therapy
Drugs
Physicians have observed that delayed orgasms occur in both men and women on antidepressants. Serotonin levels are impacted by medications like tramadol, fluoxetine, paroxetine, sertraline, and clomipramine. These medications are sometimes used “off-label”—that is, for purposes other than the original prescription—by certain medical professionals to treat PE. Your doctor might advise you to try a different medication if the first one doesn’t work. α1-Adrenoceptor antagonists are an additional pharmacological therapy option for some. Retrograde ejaculation and/or failure of emission are examples of ejaculatory dysfunction that these medications may cause. PE medications can be given daily or just before intercourse. Depending on your degree of exercise, your doctor will advise when to take a medication. It’s unclear when the medicine is best taken. Two to six hours prior to intercourse is what most doctors advise. If you stop taking these medications, PE may recur. These medications must be used continuously by the majority of men with PE.
Numbing Creams or Sprays
About 20 to 30 minutes prior to sex, numbing lotions and sprays can be applied to the penis’ head. Your erection can disappear if you apply the numbing cream or spray to your penis for longer than is advised. Additionally, because it may result in vaginal numbness, the numbing cream or spray shouldn’t be kept on the exposed penis during vaginal sex. Five to ten minutes before having sex, wash the lotion off your penis. Another way to lessen sensation is to wear a condom. In addition to protecting against illness and pregnancy, condoms may stop medications from numbing the vagina.
