What is premature ejaculation? – This refers to a man having orgasm leading to ejaculation (release of semen) earlier than desired. This may occur before or within one to three minutes of sexual intercourse
How common is premature ejaculation?
Premature ejaculation is relatively common as it may affect 30-70% of the population. Majority of men occasionally experience premature ejaculation. If it is not recurrent often, it is usually not something to worry about.
What are the causes of premature ejaculation?
The exact cause of premature ejaculation is unknown but some factors have been associated with it. They include:
1. Psychological issues – These are possibly the commonest factors responsible for premature ejaculation. They may be any or a combination of the following:
- Anxiety about sex
- Depression or low mood
- Psychological and physical stress
- Feeling of guilt towards sex or negative feeling about sex
- Poor body image and fear of poor sexual performance
2. Relationship difficulties
3. Genetic predisposition
Is premature ejaculation related to erectile dysfunction?
The fear of losing erection soon may make those affected with erectile dysfunction (inability to sustain erection during sexual intercourse) to develop a habit of rushing through sex in order to reach orgasm quickly and ejaculate before losing erection.
What are the treatment options for premature ejaculation?
The following can be applied as treatment for premature ejaculation:
1. Sexual behavioural techniques – These are non-medical means of prolonging the time to ejaculation. These include:
- Intermittent penile stimulation – Stimulate the penis until you are about to have orgasm; then stop the stimulation until the orgasm feeling gradually disappears. Then start the stimulation again. This stimulation may be done by your partner as well while you indicate when to stop. The cycle can be repeated as many times as possible before ejaculation.
- Squeezing the glans penis – Start by stimulating the penis as described earlier. When you are about to reach orgasm, squeeze the glans (head of) penis until erection is lost. This is then repeated as many times as possible before ejaculation. It works in similar ways to intermittent penile stimulation.
- Use of condom – Condom reduces the sensation on the penis, especially the glans penis, as it rubs against the vagina during sex. This reduction of sensation helps prolong the time to orgasm and thus allows sex to go on for a longer time.
2. Counselling by psychologist / psychiatrist – This may help those having issues like depression, anxiety, psychological stress etc get through it.
Treatment of erectile dysfunction
Treating erectile dysfunction may solve the problem of premature ejaculation for those whose problem is due to erectile dysfunction. Drugs for this purpose include: sidenafil (Viagra), vardenafil or tadalafil. As these drugs may have effects on the heart, they should be used with caution.
- Drugs – There is no specific drug for treating premature ejaculation. However, drugs used for other purposes have been found to have positive effects (as side effects) on premature ejaculation. These include: antidepressants, tramadol etc.
- Anaesthetic cream or spray – This agent, when applied to the glans penis, helps desensitize the glans and therefore prolongs the time to orgasm. After application to the glans, it is left for about 30 minutes and washed away before sex. It is very important to wash it off before sex as leaving it could lead to early loss of erection and loss of sensation by the partner, thus making sex unsatisfactory for either or both partners.
