Premature ejaculation (PE) is a  sexual issue which is more common than you might think. Premature ejaculation is a form of sexual dysfunction that occurs when ejaculation happens sooner than a man or his partner would like during sex. PE is also known as rapid ejaculation, premature climax or early ejaculation. Many doctors would define prematurity as ejaculation within a minute of beginning intercourse. Despite professional opinions, your feelings as to what is premature are also considered. PE might not be a cause for worry. It can be frustrating if it makes sex less enjoyable and impacts relationships but it’s a common issue for men. Between 30% to 40% have it at some time in their life. So, bear in mind – it’s not something to worry about if it happens only occasionally. However, the good news is that it’s usually fixable!

Causes of Premature Ejaculation

Although the exact cause of PE is not known, a number of factors  may be involved.

  1. Psychological Factors

Most cases of PE are not linked to any disease and are instead due to psychological factors. These include:

  • Sexual inexperience
  • Performance anxiety. Could be due to the nervousness of being with a new partner, anxiousness of having sex again after a long period of abstinence, being overly excited or stimulated or other reasons.
  • Issues with body image or lack of confidence
  • Novelty of a relationship
  • Guilt may also cause you to rush through sexual encounters, which can lead to PE.
  • worrying about ejaculating too early
  • problems or dissatisfaction in your current relationship
  • stress
  • unrealistic expectations about sexual performance
  • Depression
  • relationship problems
  • Negative feelings about the idea of sex (sexual repression)
  • Early sexual experiences
  • Sexual abuse

These common psychological factors can affect men who have previously had normal ejaculation. These cases are usually called secondary, or acquired, PE.

  1. Physical and Biological or Chemical Factors

Physical causes can also play a major role in PE. If you have difficulty maintaining an erection because of ED, you may rush through intercourse so that you complete it before losing the erection. Others include;

  • A hormonal problem with oxytocin levels, which has a role in sexual function in men. Other hormone levels that play a role in sexual function include luteinizing hormone (LH), prolactin and thyroid stimulating hormone (TSH)
  • Low serotonin or dopamine levels, chemicals in the brain that are involved in sexual desire and excitement.
  • A penis that is extra sensitive to stimulation.
  • Inflammation and infection of the prostate or urethra
  • Inherited traits
  1. Medical Factors

More rarely, there may be a biological cause. The following are possible medical causes of PE:

  • Diabetes
  • Multiple sclerosis
  • Prostate disease
  • Thyroid problems
  • Illicit drug use
  • Excessive alcohol consumption

Symptoms Of Premature Ejaculation

The only symptom of premature ejaculation is the condition itself, that is, the inability to delay ejaculation for more than one minute after penetration. However, the problem might occur in all sexual situations, even during masturbation.


Types Of Premature Ejaculation

Premature ejaculation can be classified as:

  1. Primary premature ejaculation – where you have always had the problem
  2. Secondary premature ejaculation (or “acquired premature ejaculation”) – where you recently developed the problem

Many men feel that they have symptoms of premature ejaculation, but the symptoms don’t meet the diagnostic criteria for premature ejaculation. Instead these men might have natural variable premature ejaculation, which includes periods of rapid ejaculation as well as periods of normal ejaculation.


Treatment of Premature Ejaculation

There are many different treatments options for premature ejaculation depending on the cause. These include behavioral therapy, counseling and medications. Most causes of premature ejaculation are usually treated first with behavior therapy and/or counseling to help with emotional concerns, performance anxiety or stressors that may be contributing. Often more than one treatment approach may be tried at the same time.


Behavioral Therapy

Behavioral therapy involves trying different methods to delay your orgasm.  These include

  • Stop and start: You or your partner stimulate your penis until you feel like you’re going to have an orgasm. Stop the arousal for about 30 seconds or until the feeling passes. Start the stimulation again and repeat three or four more times before you ejaculate.
  • The Squeeze Method: With this method, you or your partner stimulates your penis until you are close to ejaculation. When you are close, you or your partner firmly squeezes your penis so your erection partly goes away. The goal is for you to become aware of the sensations leading to climax. The squeeze method may help you better control and delay climax on your own.
  • Distracted thinking: With this technique, the idea is to focus your attention on ordinary nonsexual things while you’re being sexually stimulated. Naming sequences are a good way to focus your attention. For example, visualize naming all the businesses you pass on your drive to the gym, naming all the players on your favorite sports team or naming all the products on the aisles of your favorite store.
  • Exercises: Researchers have found that Kegel exercises, which aim to strengthen the pelvic floor muscles, can help men with lifelong PE.

Others include:

  • Masturbating 1 to 2 hours before having sex
  • Using a thick condom to help decrease sensation
  • Having sex with your partner on top (to allow them to pull away when you’re close to ejaculating)
  • Taking a deep breath to briefly shut down the ejaculatory reflex (an automatic reflex of the body, during which you ejaculate)


Psychological ( Counselling) Therapy

Psychological therapy is a way to work through the feelings and emotions that may lead to problems with sexual relationships.  A  psychologist or psychiatrist can help you work through problems like depression, anxiety, or stress that may be contributing to your PE.


Medical Therapy

Several types of medications may be tried.

  • AntidepressantsA side effect of some selective serotonin reuptake inhibitors (SSRIs) is delayed orgasm. But these medications also have side effects that include nausea and drowsiness. They also can throw a wet blanket on your desire to have sex. So, it’s possible you’re trading one problem for another. You and your doctor will decide what’s right for you.
  • Tramadol: This is a pain reliever that can delay ejaculation. It may be prescribed if antidepressants don’t help. This medicine is addictive, so it may not be an option for you.
  • Anesthetic Creams Or Sprays:You put these on the head of your penis to make it less sensitive. Leave it on for about 30 minutes. It must be washed off before sex so you don’t lose your erection or cause loss of sensation for your partner.
  • Medications For Erectile Dysfunction: These drugs may also help men maintain an erection. They include sildenafil citrate (Viagra), tadalafil (Cialis), or vardenafil HCI (Levitra).

You may be able to overcome PE after trying a combination of therapy, home strategies, or medication.

You and your partner may also be able to enjoy a sexually fulfilling and intimate relationship with less emphasis on intercourse.  Focus on oral sex  or look for ways to enhance your emotional intimacy through nonsexual activities.



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