Premature ejaculation

Additional information

What is premature ejaculation?

Premature ejaculation (PE) is a common sexual condition where a man ejaculates sooner than desired during sexual activity, often with minimal stimulation. This can lead to feelings of frustration and embarrassment, and it can impact the sexual satisfaction of both partners. While occasional episodes of premature ejaculation are normal, when it occurs frequently, it may be classified as a medical condition. PE is one of the most prevalent sexual issues in men, affecting around 1 in 3 men at some point in their lives.

What causes premature ejaculation?

The causes of premature ejaculation can be multifactorial, involving both psychological and biological factors. Some of the common causes include:

Psychological causes:

• Performance Anxiety: Fear of poor performance, especially in new relationships or after past sexual difficulties.
• Stress and Depression: Mental health issues can contribute to sexual performance problems, including PE.
• Relationship Problems: Unresolved sexual or emotional issues can manifest as premature ejaculation.

Physical causes:

• High Blood Pressure
• Excessive Alcohol Consumption
• Recreational Drug Use
• Diabetes
• Prostate Issues
• Hormonal Imbalances
• Abnormal levels of neurotransmitters
• Inflammation or infection of the prostate and urethra
• Overactive or Underactive Thyroid

Primary and secondary premature ejaculation

Primary Premature Ejaculation and Secondary Premature Ejaculation are two distinct forms of the condition, differing mainly in their onset and underlying causes.

Primary premature ejaculation:

• Onset: Primary PE is a lifelong condition that typically begins with a man’s first sexual experience. Men with primary PE have always had difficulty controlling ejaculation during sexual activity.
• Causes: The causes of primary PE are often rooted in genetic, biological, or psychological factors. For instance, it may be linked to inherited traits, changes in nerve sensitivity, or early sexual conditioning, such as the habit of rushing during masturbation to avoid getting caught. Additionally, upbringing and psychological factors like strict or religious environments can contribute to feelings of guilt or anxiety around sex, further exacerbating the condition.
• Characteristics: Men with primary PE consistently experience ejaculation very quickly (often within one to two minutes of penetration) across all or nearly all sexual encounters.

Secondary premature ejaculation:

• Onset: Secondary PE, on the other hand, develops later in life after a period of normal sexual performance. Men who previously had control over their ejaculation may suddenly or gradually begin experiencing difficulties.
• Causes: The causes of secondary PE are often associated with physical health issues, psychological factors, or a combination of both. Physical causes might include conditions like prostate disease, diabetes, high blood pressure, or the effects of certain medications. Psychological factors such as stress, depression, or anxiety about sexual performance can also trigger secondary PE. Additionally, lifestyle factors like excessive alcohol consumption or drug use may contribute to the condition.
• Characteristics: Secondary PE is characterized by a noticeable change from a previously normal sexual function to a sudden inability to control ejaculation, which can cause distress and impact sexual satisfaction.

In summary, primary PE is a lifelong condition present from a man’s first sexual experiences, often linked to genetic or psychological factors, while secondary PE develops after a period of normal sexual function and is typically triggered by physical or psychological changes later in life.

What are the symptoms of premature ejaculation?

The primary symptom of premature ejaculation is the inability to delay ejaculation for more than a minute or two after penetration or even before penetration. Other associated symptoms may include:

• Low Sexual Satisfaction: Both the individual and their partner may experience dissatisfaction with their sexual experiences.
• Emotional Distress: Feelings of embarrassment, guilt, or frustration are common and can affect overall well-being and relationships.
• Avoidance of Intimacy: Men with PE may avoid sexual intimacy due to fear of repeated experiences.

How to treat premature ejaculation

Treatment for premature ejaculation often involves a combination of psychological, behavioural, and medical approaches:

Behavioural techniques

These include methods like the “stop-start” technique or the “squeeze” technique, which aims to help men control the timing of ejaculation.

Counselling and therapy

Sex therapy or psychological counselling can be effective, particularly when the condition is linked to anxiety, stress, or relationship issues.

Medications

• Topical Anesthetics: Creams or sprays containing a numbing agent, such as lidocaine or prilocaine, can reduce sensitivity and help delay ejaculation.
• Oral Medications: Certain antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), are commonly prescribed for premature ejaculation due to their side effect of delaying ejaculation.
• PDE5 Inhibitors: Medications like sildenafil (Viagra) can also help some men, especially if they experience erectile dysfunction in addition to premature ejaculation.

How to prevent premature ejaculation

While not all cases of premature ejaculation can be prevented, there are several strategies that may help reduce the risk:

• Manage Stress and Anxiety: Techniques such as meditation, relaxation exercises, and therapy can help manage anxiety and stress, which are common triggers of PE.
• Strengthen Pelvic Floor Muscles: Regular pelvic floor exercises (Kegel exercises) can strengthen the muscles involved in ejaculation and improve control.
• Communicate with Your Partner: Open communication with your partner about your sexual concerns can reduce pressure and improve sexual experiences.
• Healthy Lifestyle: Maintaining a healthy lifestyle, including regular exercise, a balanced diet, and adequate sleep, can contribute to overall sexual health.

When to seek medical attention

If premature ejaculation is causing significant distress or impacting your relationship, it is important to seek medical advice. You should also see a doctor if:

• The condition occurs frequently and is persistent.
• You experience other symptoms, such as erectile dysfunction or a decrease in sexual desire.
• Over-the-counter treatments and behavioural techniques are not effective.

A healthcare professional can help determine the underlying cause and recommend appropriate treatment options.

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