PREMATURE EJACULATION

 Basic information

description

Premature ejaculation (PE) involves ejaculating shortly before intercourse begins or shortly afterward, lack of control of ejaculation, and concern or distress about the situation. PE is a common problem in males ages 18 to 59. PE may be lifelong (called primary). It may be acquired (called secondary) if a male was previously able to have ejaculatory control. If acquired, it may occur with specific partners or situations or it may occur in all situations and partners.

FREQUENT SIGNS & SYMPTOMS

• Difficulty in delaying ejaculation.
• Ejaculating before you or your partner wishes or with little stimulation. It is sometimes described as taking place 1 to 2 minutes before or after vaginal penetration.
• Frustration about the premature ejaculation.
• Concerns about partner being sexually unfulfilled.

causes

The exact cause is unknown. In most cases, the male is healthy. PE involves psychological (mental or emotional) factors. Biologic factors may play a role (e.g., an oversensitive glans penis [head of the penis]).

risk increases with

• Erectile dysfunction.
• Lack of sexual experience, infrequent sexual intercourse, stress, fear, anxiety, sexual performance pressure, social phobia, and lack of sexual education have all been mentioned as risk factors.

PREVENTIVE MEASURES

No specific preventive measures.

expected outcomes

Treatment can help in many cases and the man is able to learn ejaculatory control.

possible complications

• The problem can recur after successful treatment.
• Relationship difficulties with sexual partner. PE may cause stress, feelings of guilt, and resentment.
• Can cause difficulty in achieving a pregnancy.

 diagnosis & treatment

general measures

• Your health care provider may do a physical exam and ask questions about your symptoms and sexual history. You may be asked to fill out a questionnaire. Medical tests may be done, but they are usually normal.
• Treatment may include sexual therapy or behavior therapy for patient and partner, and/or drug therapy. Most often, the couple (not just the man) needs to work on the problem together.
• Sexual therapy techniques may be recommended. These can include:
  • Sensate-focus exercises, in which each partner caresses the other's body without intercourse to learn relaxed, pleasurable aspects of touching.
  • Start and stop technique, which delays ejaculation by withdrawing the penis or stopping the thrusts.
  • Masturbating 1 or 2 hours before intercourse so you can delay ejaculation during sex.
  • Squeeze technique, in which the woman squeezes her partner's penis with her thumb and forefinger when he feels an impending ejaculation.
• Counseling from a mental health provider or qualified sex therapist may be recommended if other methods are not successful.
• Work on ways to improve communication with your partner and try to reduce your performance anxiety.

medications

• There is no specific drug to treat the problem. Antidepressants or other drugs help some men and may be prescribed. The drug may be used as a single dose prior to sexual intercourse or taken on a daily basis.
• A topical anesthetic agent (gel, spray, or cream) may be recommended. It may help to reduce penile sensitivity and delay ejaculation. An example is lidocaine. It can be applied to the penis under a condom about 30 minutes before intercourse. Follow instructions provided with the product.

activity

No limits.

diet

No special diet.

 notify our office if

• You or a family member has repeated episodes of premature ejaculation.
• Problem continues despite treatment.

Special Notes: