- Premature ejaculation (31%) is more prevalent than erectile dysfunction(20%).
- Men with premature ejaculation have:
- 90% Poor control over ejaculation
- 75% has personal distress
- 78% has dissatisfaction
- 50% has interpersonal difficult
- Only 38% of partners with premature ejaculation felt satisfied with their intimate relationship.
Premature ejaculation (PE) is a condition where a man ejaculates earlier than his partner would like to. Various definitions have been used worldwide.
- American Psychiatry Association defines PE as persistent or recurrent ejaculation with minimal sexual stimulation prior to or shortly after penetration and before a person wishes it.
- WHO defined PE as the inability to delay ejaculation sufficiently to enjoy lovemaking, which is demonstrated by either an occurrence of ejaculation before or shortly after the beginning of intercourse or ejaculation that occurs in the absence of a sufficient erection to make ejaculation possible.
- International Society for Sexual Medicine defines PE as a male sexual dysfunction characterised by ejaculation which always or nearly occurs prior to or within about one minute of vaginal penetration and inability to delay ejaculation on all or nearly vagina penetrations and negative personal consequences such as distress, bother, frustration and/or the avoidance of sexual intimacy.
Based on these definitions, there are 3 important points: time to ejaculate, inability to control or delay ejaculation and negative consequences like bother or distress from PE.
Aetiology Of PE
It is estimated around 20-30% of men have PE and it is widely considered as the most common male sexual dysfunction. However, the causes behind PE is still obscure.
Some conditions have been associated with PE, for example:
- Psychological problem: anxiety, poor body image, relationship problem, depression
- Biological problem: reduction of certain hormone level, proctitis, metabolic syndrome
- Neurological problem
Most of the time, psychological issues are the most relatable cause for PE. With proper treatment, patients may be able to overcome PE and thus experience normal sexual pleasure.
How do I know if I have PE?
As mentioned previously, there are 3 important factors that need to be considered in order to understand the problem.
- Time to ejaculate: always or frequently ejaculate within one minute of penetration.
- Inability to prolong ejaculation during intercourse
- You and your partner felt distressed about this issue.
While seeing your doctor, he or she may want to ask further history regarding your sexual intimacy and it is always recommended if you can be open and share your problem with the doctor. Apart from that, the doctor may need to examine you and look for specific signs that may point towards the causes of PE.
There are also questionnaires that can be used by the doctor. For example, Premature Ejaculation Diagnostic Tool (PEDT) which is a self-administered questionnaire to help doctors to screen and assess PE and its treatment.
Treatment Options: P Shot as the way forward?
Previous articles have mentioned biological and psychological treatment of PE.
Essentially, psychological treatment involves start-stop technique and squeeze technique. Masturbation prior to intercourse has been practiced by some and its efficacy ranges from 50 to 60%.
Biological treatment involves using local anaesthetic agents and Selective Serotonin Reuptake Inhibitor (SSRI). Phosphodiesterase 5 inhibitors (PDE5) may also be used to improve patient satisfaction and reduce anxiety.
Is there any novel approach of treating PE? Yes, there is.
This article will focus more on the use of P Shot or Plasma Rich Platelet (PRP) for male sexual enhancement. P shot is an innovative approach which is commonly used to treat various medical conditions such as hair loss, joint and tendon injuries, erectile dysfunction and to certain extent, ejaculation problems as well. It involves the use of platelet rich plasma, a substance that is thought to promote wound healing. Among the benefits that patients may realise after taking the P Shot are increase in size and sensitivity of the penis, erection becomes firmer hence premature ejaculation will be less likely and importantly, you will have more stamina in the bedroom hence last longer.
How is the P Shot administered?
The procedure involves taking a blood sample from the body which is usually from the arm. The blood sample will be stored in centrifuge to isolate the platelet rich plasma. This procedure may take up to 15 minutes before PRP can be separated from the blood sample. This PRP will then be injected into multiple areas of the penis. Prior to injection, the area involved is numbed with local anaesthetic cream hence patients may not feel the pain during injection.
This procedure is normally done in multiple sessions in order to get the best result, which is the case for most people. Review will be conducted after 3-4 weeks of the first injection before continuing the next treatment.
What about the side effects of P Shot?
Almost every medical procedure carries certain side effects. For P Shot treatment, among the common side effects are bruising, inflammation and swelling at the side of injection, which normally subside in a few days. Others like infection and allergic reaction may also happen but are very rare in this setting. This is because we are using your own blood product to inject back into the body.
In conclusion, PE is a very much treatable condition in most cases. Various treatments are available and can be used to improve sexual intimacy and men’s health in general. If you would prefer a more innovative approach to treat PE issues, P-Shot is one of the treatments that we offer in our clinic. It is a relatively safe procedure with minimal adverse effects. Book your appointment with us if you have any queries and concerns about the treatment.