Premature ejaculation occurs when a man ejaculates sooner during sexual intercourse than he or his partner would like. It may result in an unsatisfactory sexual experience for both partners. This can increase the anxiety that may contribute to the problem. Premature ejaculation is one of the most common forms of male sexual dysfunction and has probably affected every man at some point in his life. Estimates vary, but as many as 1 out of 3 men say they experience this problem at some time. As long as it happens infrequently, it's not cause for concern.
However, you may meet the diagnostic criteria for premature ejaculation if you:
· Always or nearly always ejaculate within one minute of penetration
· Are unable to delay ejaculation during intercourse all or nearly all of the time
· Feel distressed and frustrated, and tend to avoid sexual intimacy as a result
Both psychological and biological factors can play a role in premature ejaculation. Although many men feel embarrassed to talk about it, premature ejaculation is a common and treatable condition. Medications, counselling and sexual techniques that delay ejaculation — or a combination of these — can help improve sex for you and your partner.
The main symptom of premature ejaculation is an uncontrolled ejaculation either before or shortly after intercourse begins. Ejaculation occurs before the person wishes it, with minimal sexual stimulation, where the man is unable to delay ejaculation for more than one minute after penetration. However, the problem may occur in all sexual situations, even during masturbation.
Premature ejaculation can be classified as lifelong (primary) or acquired (secondary). Lifelong premature ejaculation occurs all or nearly all of the time beginning with your first sexual encounters. Acquired premature ejaculation has the same symptoms but develops after you've had previous sexual experiences without ejaculatory problems.
Many men feel that they have symptoms of premature ejaculation, but the symptoms do not meet the diagnostic criteria for premature ejaculation. Instead these may have natural variable premature ejaculation, which is characterized by periods of rapid ejaculation as well as periods of normal ejaculation.
Some key factors that can play a role in causing premature ejaculation include:
· Erectile dysfunction. Men who are anxious about obtaining or maintaining an erection during sexual intercourse may form a pattern of rushing to ejaculate, which can be difficult to change.
· Anxiety. Many men with premature ejaculation also have problems with anxiety — either specifically about sexual performance or related to other issues.
· Relationship problems. If you have had satisfying sexual relationships with other partners in which premature ejaculation happened infrequently or not at all, it's possible that interpersonal issues between you and your current partner are contributing to the problem.
A number of biological factors may contribute to premature ejaculation, including:
· Abnormal hormone levels
· Abnormal levels of brain chemicals called neurotransmitters
· Abnormal reflex activity of the ejaculatory system
· Certain thyroid problems
· Inflammation and infection of the prostate or urethra
· Inherited traits
· Nerve damage from surgery or trauma (rare)
In many cases premature ejaculation resolves on its own over time without the need for medical treatment. Practicing relaxation techniques or using distraction methods may help you delay ejaculation. For some men, stopping or cutting down on the use of alcohol, tobacco, or illegal drugs may improve their ability to control ejaculation.
Your doctor may recommend that you and your partner practice specific techniques to help delay ejaculation. These techniques may involve identifying and controlling the sensations that lead up to ejaculation and communicating to slow or stop stimulation. Other options include using a condom to reduce sensation to the penis or trying a different position (such as lying on your back) during intercourse. Counselling or behavioural therapy may help reduce anxiety related to premature ejaculation.
Mild Premature Ejaculation Conditions
If you have mild PE – for instance, you can last five minutes but would like to last 10 – there's probably no point in going to a doctor.
Why? Because you should be able to improve matters by simple distraction techniques.
This means turning your mind to something else when you sense that climax is near. For example, you can think about something totally unconcerned with sex or pinch yourself.
Practice and relaxation should help you deal with the problem. Some men try to distract themselves by thinking nonsexual thoughts (such as naming baseball players and records) to avoid getting excited too fast.
There are several helpful techniques you can try.
Kegel exercises are designed to strengthen the pelvic floor. To identify the muscles of your pelvic floor, stop yourself from urinating in midstream. This is the action you need to practice when your bladder is empty. Tightly contract the muscles and hold for 10 seconds. Repeat 10 times, three times a day.
The "stop and start" method:
This technique involves sexually stimulating the man until he feels like he is about to reach orgasm. Stop the stimulation for about 30 seconds and then start it again. Repeat this pattern until the man wants to ejaculate. The last time, continue stimulation until the man reaches orgasm.
The "squeeze" method:
This technique involves sexually stimulating the man until he recognizes that he is about to ejaculate. At that point, the man or his partner gently squeezes the end of the penis (where the glans meets the shaft) for several seconds. Stop sexual stimulation for about 30 seconds, and then start it again. The person or couple may repeat this pattern until the man wants to ejaculate. The last time, continue stimulation until the man reaches orgasm.
Local anaesthetic gel
Some men try to treat themselves with a local anaesthetic gel that's applied to the shaft of the penis shortly before intercourse.
This product is advertised to the public as a good way to 'damp down' sexual sensation in the penis.
We do not advise using this gel because the local anaesthetic can 'dull' the sex sensation for your partner.
It can also cause a distressing skin reaction in either partner, with intense itching, redness and soreness.
'Long love' condoms
German scientists have come up with a slightly different approach that won't cause vaginal irritation. It's called the 'long love condom’ and it contains a local anaesthetic (benzocaine or lidocaine) inside it. Long love condoms are now being sold in many countries, under a variety of brand names.