What is Premature Ejaculation?
Ejaculation is the expulsion of semen from a man’s body. Premature ejaculation is a type of sexual dysfunction that occurs when a man ejaculates sooner than a man or his partner would like during sexual intercourse. Premature ejaculation will make most men and their partner’s sex lives less enjoyable and affects their relationship. Premature ejaculation is the most common type of sexual dysfunction in men. About 1 in 5 men between ages of 18-60 have premature ejaculation.
What is the time frame medically defining a man have Premature Ejaculation?
Ejaculation is defined as premature if it occurs sooner than desired, either before or shortly after penetration. It also can be defined as ejaculation that happened within a minute of the beginning of penetration. However, the time of ejaculation should be based on the satisfaction of the couple during sexual intercourse.
Type of Premature Ejaculation
Primary: occurs during the time of beginning with first sexual intercourse
Secondary: develops after having previous sexual experiences without ejaculation problem
Causes of Premature Ejaculation
The exact cause of premature ejaculation is not well known yet. However, most of the patient with premature ejaculation is because of psychological or biological factor.
Psychological Factors:
- Performance anxiety
- Stressful life
- Relationship problem
- Depression
- Poor body image
Biological Factors:
- Underlying erectile dysfunction
- Low serotonin or dopamine level
- Abnormal hormonal level
- Extra penis sensitivity
Are there any blood test needed to be done to be diagnosed with Premature Ejaculation?
A blood test usually is not needed unless there is a suspicion of an underlying disease. Usually, premature ejaculation can be diagnosed based on the history of patient.
What is the treatment for Premature Ejaculation?
Premature ejaculation needs to be treated with combination therapy. The treatment available are behavioral therapy, medications and counselling.
- Behavioral therapy: this involves different type of methods to delay ejaculation. The goal of this therapy is to teach a man how to control the feelings for ejaculation.
- A man can masturbate before sexual intercourse, this can reduce the sensitivity of penis.
- Start and Stop technique: A man can practice this method with his partner by stimulates penis until close to the point of orgasm then stop the stimulation for about 30 seconds until the urge go away. Repeat this start and stop method up to 3 or 4 times before ejaculate.
- Squeeze therapy: This therapy can practice with partner as well by stimulates the penis until close to the point of orgasm then gently squeeze the head of penis for about 30 seconds until the urge go away or lose erection. Repeat this technique 3-4 times before ejaculation.
- Pelvic floor exercises: To identify the pelvic floor muscle, try to stop urination midstream. This is the feeling of muscle that we want to train. Tighten the pelvic floor muscles for at least 10 times a set and for 3 sets a day.
- Medications:
– Topical medications:
Anesthetic creams or spray that contain a numbing agent can be used. This help to reduce the sensitivity of the penis. This need to be applied 30 minutes before sexual intercourse to help delay ejaculation.
– Oral medication:
a) Antidepressant: The side effects of antidepressants is delayed ejaculation which can be used to improve premature ejaculation
b) Phosphodiesterase-5 inhibitors: These medications might help to delay ejaculation. Thus, these medications will be more effective if use together with antidepressant. - Condom:
– By using condom, it will help to reduce the sensitivity of penis which will lead to delay ejaculation.
