Medically Reviewed by Dr. Veena Shinde
, MD, DGO, PG & ART, Reviewed on 25th January 2021
All you need to know about Premature Ejaculation
What is Premature Ejaculation?
Premature ejaculation is a male sexual dysfunction characterized by male orgasm or ejaculation which occurs prior to or within one minute of vaginal penetration leading to a lack of sexual satisfaction for the man and/or his partner.On average, time till orgasm after penetration can range from 5 to 10 minutes.
If the male is unable to delay or control ejaculations during most sexual encounters or ejaculation happens within a minute of penetration during most sexual experiences, then it can be diagnosed as Premature Ejaculation.
It is NOT Premature Ejaculation if it occurs only occasionally.
Premature Ejaculation is most common in men below the age of 40years. Almost one in five men experience difficulty with uncontrolled or early ejaculation at some point in life. When premature ejaculation happens so frequently that it interferes with the sexual pleasure of a man or his partner, it becomes a medical problem.
Premature Ejaculation:Causes and treatments
Men prone to psychological stressors and having an anxious personality can be more predisposed to PE.
Sometimes, premature ejaculation can occur with a new partner, due to nervousness. If a man has not had sex for a long time, he may also experience premature ejaculation when he becomes sexually active again. Attitude towards sex can also be a major factor in contributing to PE when a man places excess emphasis on penetration and his performance as a measure of his success as a sexual partner.
Several factors may contribute to premature ejaculation:
Psychological problems such as stress, depression, poor body image, early sexual experiences, sexual abuse and other factors that affect mental and emotional health can aggravate this condition. Relationship problems with the partner can also lead to PE. Biological factors can make some men more prone to experience premature ejaculation. Rarely, premature ejaculation is caused by a specific physical problem, such as inflammation of the prostate gland or a spinal cord problem.
The key symptoms of premature ejaculation include:
- Ejaculation that routinely occurs with little sexual stimulation and with little control
- Decreased sexual pleasure because of poor control over ejaculation
- Feelings of guilt, embarrassment or frustration and lack of confidence which can impact other areas of functioning in life.
- The tendency to avoid sexual intimacy due to persisting problem.
- Treatment for Premature Ejaculation is usually successful and may take anywhere between 4 to 12 weeks for full benefit depending on the severity and duration of symptoms.
- Therapy and medication in combination serve as the best treatment option for PE
There are certain sexual techniques that can help in relieving PE if followed regularly.
Pelvic floor exercises
Weak pelvic floor muscles might impair the ability to delay ejaculation. Pelvic floor exercises (Kegel exercises) can help strengthen these muscles.
To perform these exercises:
1. Find the right muscles – To identify your pelvic floor muscles, stop urination in midstream or tighten the muscles that keep you from passing gas. These maneuvers use your pelvic floor muscles. Once you’ve identified your pelvic floor muscles, you can do the exercises in any position.
2. Perfect your technique – Tighten your pelvic floor muscles, hold the contraction for three seconds, and then relax for three seconds. Try it a few times in a row. When your muscles get stronger, try doing Kegel exercises while sitting, standing or walking.
3. Maintain your focus – For best results, focus on tightening only your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks. During this exercise, it is advisable to not hold your breath. Instead, breathe freely during the exercises.
4. Repeat 3 times a day – Aim for at least three sets of 10 repetitions a day.
The pause-squeeze technique
Your doctor might instruct you and your partner in the use of a method called the pause-squeeze technique. This method works as follows:
1. Begin sexual activity as usual, including stimulation of the penis, until you feel almost ready to ejaculate.
2. Have your partner squeeze the end of your penis, at the point where the head (glans) joins the shaft, and maintain the squeeze for several seconds, until the urge to ejaculate passes.
3. Have your partner repeat the squeeze process as necessary.
By repeating as many times as necessary, you can reach the point of entering your partner without ejaculating. After some practice sessions, the feeling of knowing how to delay ejaculation might become a habit that no longer requires the pause-squeeze technique.
If the pause-squeeze technique causes pain or discomfort, another technique is to stop sexual stimulation just prior to ejaculation, wait until the level of arousal has diminished and then start again. This approach is known as the stop-start technique.
Treatments and Medications for Premature Ejaculation :
Medications for Premature Ejaculation are used in combination with the above techniques.
1. Local anaesthetic creams or sprays that contain a numbing agent like lidocaine or prilocaine are used prior to intercourse. These products are applied to the penis 10 to 15 minutes before sex to reduce sensation and help delay ejaculation. Condoms containing numbing agents are also available. The downside of these agents could be reduced sexual pleasure for both partners.
2. Prescription medications used for treating depression like paroxetine have proven to be the most effective. This medication usually takes five to 10 days to begin working. But it might take two to three weeks of treatment before one sees the full effect. Unwanted side effects of antidepressants might include nausea, dry mouth, drowsiness and decreased libido.
3. Dapoxetine is an oral medication that works within 30mins to an hour of consuming it by delaying ejaculation. It must be used as and when required prior to sexual intercourse.
In addition, counselling/therapy sessions with and without the partner can help improve your relationships and sexual experiences. Sessions can help you reduce performance anxiety and find better ways of coping with stress.