Premature Ejaculation

Premature ejaculation (PE) is a sexual condition where a man consistently ejaculates sooner than he would like to. It is the most common ejaculation problem. Most men will experience PE from time to time, but it becomes a sexual disorder if it happens repeatedly over a prolonged period of time. Although PE is often associated with penetrative vaginal sex, it can happen during any kind of sexual stimulation, including foreplay, oral sex, anal sex, or masturbation. Although it can be embarrassing or frustrating, this condition is a common problem which can be successfully treated.

One study timed hundreds of men with a stopwatch to determine the average length of ejaculation time during intercourse (also known as intravaginal ejaculation latency time, or IELT).

In the study, the average time of intercourse before ejaculating was five minutes.

The majority of men who experienced premature ejaculation lasted less than a minute.

How is premature ejaculation diagnosed?

While the average time until ejaculation is about five minutes, there is no set amount of time for how long sex should last. A diagnosis will be influenced by you and your partner's personal experiences and expectations.

You may be diagnosed with premature ejaculation if you:

• often ejaculate within one to two minutes of penetration
• find it difficult to delay ejaculation after penetration most of the time
• are avoiding sex due to frustration with your sex life

If you are concerned about your sexual performance, speak to your doctor, who will be able to suggest different treatment methods. In certain cases, they may refer you to a urologist or a sex therapist, a mental health professional who specializes in sexual dysfunction.

What are the symptoms of premature ejaculation?

The 'correct' length for sexual intercourse is subjective, but those who experience this condition will usually find that ejaculation frequently occurs within less than two minutes. You may also find that your performance time has significantly decreased from what it was.

Most men will experience early ejaculation at some point, but for it to be classified as premature ejaculation, it should be a persistent symptom which occurs regularly.

Premature ejaculation is classified as either lifelong (primary) premature ejaculation or acquired (secondary) premature ejaculation.

Lifelong premature ejaculation

Primary, or lifelong premature ejaculation, usually shows up in your first sexual experiences. It can be due to various psychological and physical factors, including:

• having a more sensitive penis
• a traumatic sexual experience, such as abuse or being caught masturbating
• being raised in a strict environment where sex is frowned upon
• masturbating too quickly as a teenager to avoid being caught

These feelings and behaviours can continue into adulthood, negatively affecting your sex life.

Secondary premature ejaculation

This type is usually temporary, typically developing later in life after having had healthy, functional sexual relationships before. Like primary PE, it can be due to a variety of psychological or physical reasons, including:

• a medical condition
• use of recreational drugs
• relationship problems or worrying about being intimate with a new partner
• stress or anxiety
• side effects of a medication

If you think you are experiencing premature ejaculation, consult your doctor. They will be able to help you determine the cause of your condition and provide the best treatment for you.

Other types of ejaculation problems:

While premature ejaculation is the most common type of ejaculation problem, there are other types of ejaculation problems, such as retarded ejaculation and retrograde ejaculation.

Retarded ejaculation: Those experiencing this condition will still experience feelings of arousal and a normal and strong erection, but will not be able to climax and ejaculate.

Retrograde ejaculation: Retrograde ejaculation is very rare and not often diagnosed. With this condition, men are able to have sexual intercourse, but when they ejaculate, the sperm moves backwards through the urethra, rather than moving up the posterior urethra and out of the tip of the penis. This condition isn't painful, but can cause problems when trying to conceive.

Premature ejaculation can be caused by a variety of psychological and physical causes, but it can be due to a combination of causes that have developed over time.

Psychological

Psychological causes can include:

• stress
• anxiety
• confidence issues
• fear
• depression
• guilt

If a man feels under pressure to perform quickly during his first sexual experiences, it may condition him to orgasm very quickly. Traumatic childhood experiences, such as sexual abuse, can also cause rapid ejaculation. A man may also experience performance anxiety if he has experienced issues before or if he is with a new partner.

Psychological causes of premature ejaculation can be treated with therapy and communication. It is important to communicate openly with your partner and voice any mental, emotional and psychological concerns when speaking to a doctor.

Physical

Physical causes can include medical conditions as well as side effects from certain medications and recreational drug use.

Medical conditions that can lead to premature ejaculation include:

• diabetes
• high blood pressure
• spinal cord injuries
• multiple sclerosis
• thyroid problems, such as hypothyroidism or hyperthyroidism
• inflammation of the prostate gland (chronic prostatitis)

Medications, such as those used for Parkinson's disease, can also cause premature ejaculation. Recreational drugs like alcohol, as well as illicit drugs such as cocaine and amphetamines can lead to ejaculation problems as well.

There are many different ways you can prevent premature ejaculation, from strengthening exercises to techniques used during sex. Some men find that masturbating before sex or trying different sex positions can help them last longer . Whatever method you use, being open and communicating with your partner is key.

Below you will find some information on some of the most common methods used to prevent premature ejaculation.

The stop-start technique

This method can be practiced during sex or while masturbating. As you feel your arousal build, stop stimulating the penis just before you are about to ejaculate, letting your arousal level fall before starting again. You can do this throughout the sexual encounter until you are ready to orgasm.

The squeeze technique

As with the stop-start technique, when you feel you are coming close to ejaculating, stop stimulating the penis and hold the tip of the penis between your thumb and forefinger for approximately 30 seconds.

Topical creams and condoms

Topical creams and sprays containing the anaesthetics lidocaine or prilocaine decrease sensitivity by numbing the area, helping to delay ejaculation. Thick condoms, as well as preventing STIs , can also decrease sensitivity and lengthen the time it takes to ejaculate. Some condoms also contain anaesthetics like benzocaine or lidocaine, which can help to further delay ejaculation.

Pelvic floor exercises

Your pelvic floor, a group of muscles that support your bladder and bowels, can also affect sexual function. You can perform simple exercises, called kegels, to strengthen them. First, find your pelvic floor muscles by contracting the same muscles you would use to stop urinating. Contract these muscles for one second, relaxing for another second, for fast kegels. For slow kegels, do the same exercise but hold and rest for five seconds.

From therapy to prescription medication, there are a few different treatment options used for premature ejaculation.

Prescription treatments

Delayed orgasm is a common side effect of selective serotonin reuptake inhibitors, or SSRIs, a type of antidepressant used to treat anxiety and depression. Antidepressants prescribed off-label for this purpose include paroxetine, clomipramine, sertraline, and fluoxetine.

Another type of SSRI, dapoxetine, is manufactured specifically for the treatment of premature ejaculation. Taken a few hours before sexual activity, it works faster than the other SSRIs. Dapoxetine is sold under the brand name Priligy.

Phosphodiesterase-5 (PDE-5) inhibitors, a type of treatment typically used for erectile dysfunction, can also help with premature ejaculation. Sildenafil, known by the brand-name Viagra, is a well-known PDE-5 inhibitor prescribed for this reason.

Therapy

If the causes of your premature ejaculation are psychological, couples counselling or speaking to a sex therapist could help. In some cases, a doctor may recommend prescription treatment in conjunction with therapy.

No treatment for PE is going to be a short-term fix. For any method to be effective, you will need to practice it consistently over the long term.

You can order Priligy online from euroClinix. Our service includes a completely free and confidential consultation service. Your consultation will then be reviewed by one of our doctors to make sure it is suitable for you. Our doctors will issue a prescription before sending it off to our pharmacy. Your order will be dispatched directly from our pharmacy with free next-day delivery.