Premature Ejaculation

premature ejaculation

What is Premature Ejaculation?

Your romantic evening always ends the same way.

Every. Single. Time.

You both feel underwhelmed. Mutual satisfaction is still a long way away. You imagine what you could achieve if you could last the distance. Sometimes you can’t even get your pants off in time.

Thats because, like 1 in 3 men, you suffer from premature ejaculation or PE for short.

Premature Ejaculation (PE) refers to a sexual problem caused due to the release of semen from the penis before the man has achieved an orgasm. In most cases, ejaculation or the release of semen is expected to occur at climax or orgasm. This allows the man to derive optimum sexual satisfaction.

When ejaculation occurs before the climax preventing him from attaining orgasms, the man can be said to be suffering from premature ejaculation.

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PREMATURE EJACULATION?

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PE is sometimes referred to as:

  • Premature climax
  • Early ejaculation
  • Rapid ejaculation

Is premature ejaculation a form of sexual dysfunction?

Yes, Premature Ejaculation (PE) is considered a form of sexual dysfunction because it interferes with the normal physiological processes involved in intercourse resulting in an early release of semen. 

Also, sexual dysfunctions include all problems that can prevent a man or a woman from fully enjoying sexual activity. Since PE is known to reduce the sexual satisfaction of men by inhibiting climax, it is considered a sexual dysfunction. 

The other common sexual problems include erectile dysfunction that occurs due to the inability of men to get or maintain an erection and a low libido or sex drive.

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How common is premature ejaculation?

The incidence of Premature Ejaculation (PE) is rising across the world. Several factors can be contributed to the increasing prevalence of sexual difficulties. PE is considered the second most common sexual problem affecting men, the first one being Erectile Dysfunction. 

It is common for men to suffer from both Premature Ejaculaiton and Erectile Dysfunction. In most cases, men experience PE, which worsens over a period of time, leading to the development of erectile dysfunction and vice versa. 

The incidence of Premature Ejaculation is as common as about 1 in 3 men including young and older men from the age of 18 to 59 years. It is estimated that more than 50% of men experience PE at some point during their lifetime [1].

What are the common signs and symptoms of premature ejaculation?

As stated earlier, it is common for men to experience an early release of semen occasionally. However, the infrequent episodes of early ejaculation are best to be ignored as it may occur without any apparent cause or underlying illness. 

When men experience premature ejaculation on rare occasions and are able to attain climax during most sexual interactions, it can be considered a natural variation of premature ejaculation.

Men need to consult a doctor for the treatment of Premature Ejaculation only if the early ejaculation occurs too frequently or persists for a longer period.

The primary symptom of PE is a frequent inability to hold the erection and delay the ejaculation for more than one minute after penetration during sexual intercourse. Rapid orgasms during masturbation can also be a sign of premature ejaculation in some men.

The primary symptoms may be accompanied by other signs such as:

  • An inability to get an erection
  • Anxiety
  • Nervousness
  • Decreased confidence in the relationship
  • Embarrassment

Based on the symptoms, PE can be categorized as acquired and lifelong.

  • When men have experienced longer-lasting erections and ejaculations in their earlier life, but have developed PE later, it can be considered acquired PE, also called secondary PE.
  • Lifelong or primary PE, on the other hand, refers to cases where men have been experiencing early ejaculation before climax always or nearly always since their first sexual experience.

Classifying Premature Ejaculation based on these parameters can help a physician to determine the possible cause of the condition so that appropriate treatment can be recommended. 

Doctors at the Men’s Health Clinic Australia have expertise in evaluating the exact symptoms experienced by patients based on various parameters such as onset, duration, intensity, and related issues. This can help them to offer customised treatment suitable for the specific set of symptoms the man is suffering from thereby improving the chances of successful outcomes.

What are the causes of premature ejaculation?

PE is known to occur due to an interplay of several physical, psychological, emotional, and external factors. Here is a brief discussion about how various factors interfere with the physiological processes involved in sexual intercourse and cause PE.

Psychological and emotional causes of PE

In most cases, the emotional and psychological components tend to interfere with the sexual act only temporarily. For example, it is common for men to experience PE during their initial sexual experiences. However, as they grow older and have sexual encounters more frequently, they learn the strategies to delay ejaculation. 

Similarly, stress about the minor problems linked to their routine life can also prevent a man from holding the erection from longer resulting in early ejaculation occasionally. In most cases, these factors affect men’s sexual performance only when their mind is stressed. They are able to get erections and maintain them until orgasm on other occasions when they are in a positive state of mind.

However, if stress persists, the impact of poor mental health can have a long-term negative impact on the sexual functions leading to PE.

The emotional and psychological causes of PE may include:

  • Stress
  • Anxiety, particularly about sexual performance
  • Depression
  • Overexcitement and too much stimulation
  • Feelings of inadequacy and guilt
  • Feeling anxious about not satisfying or rejection by the sexual partner
  • Fear of expected failure
  • History of physical or sexual abuse in childhood
  • Religious beliefs including strict upbringing and sexual teaching
  • Conditioning when the teenager has learned to ejaculate faster to avoid being found masturbating
  • Poor body image
  • Loss of self-confidence or self-esteem
  • Strained personal relationships

These factors affect sexual intercourse by creating an imbalance in the levels of certain hormones in the brain. Research studies have suggested that mental stress, depression, and anxiety can lead to an increase in the levels of cortisol in the brain. This hormone, in turn, affects the functions of the nerves, and the dilation and contraction of the blood vessels of the penis resulting in PE [2]. 

Psychological factors responsible for PE often create a vicious cycle. Once a man experiences early ejaculation, it creates fear and anxiety about repeated failures. Due to this, he feels more stressed during the next sexual intercourse. The hormonal imbalance caused due to stress and anxiety can again prevent a man from delaying the ejaculation thereby creating a vicious cycle of stress and PE.

Physical causes of PE

The risk of PE increases with advancing age. It is estimated that as the age of the man increases, his ability to get and maintain an erection and delay ejaculation is reduced [3].

The factors responsible for the decline in the ejaculatory or sexual health in aging men include:

  • The weakness of the muscles in the pelvic floor
  • Reduced sex drive
  • Mental stress due to poor physical health
  • Development of other age-related diseases that interfere with erections and ejaculation such as diabetes, and hypertension

PE can also occur due to the underlying physical conditions such as:

  • Diabetes
  • Hypertension
  • Thyroid diseases such as hyperthyroidism or hypothyroidism
  • Reduced production of the male sex hormone called testosterone
  • Neurological disorders such as peripheral neuropathy
  • Inflammation of the prostate or prostatitis
  • Cancer or benign enlargement of the prostate gland
  • Degenerative brain disorders such as Parkinson’s disease

These physical causes of PE affect the ability of men to delay ejaculation until climax by inhibiting the efficient functioning of the local tissues involved in intercourse such as the muscles, nerves, and blood vessels of the penis. 

These factors also influence sexual intercourse negatively by creating unfavorable conditions for the body to sustain the erection. For example, degenerative disorders of the brain and thyroid diseases cause an imbalance of hormones that play a role in sexual intercourse thereby causing PE.

What are the risk factors for premature ejaculation?

The risk factors for PE include the physical and psychological factors that can increase their chances of developing PE at an earlier age or in a more severe form. 

Here are the common risk factors that can make men more prone to develop PE:

  • Advancing age
  • Unhealthy dietary habits such as eating junk foods and lack of essential vitamins and mineral in the diet
  • A sedentary lifestyle and lack of adequate physical activities 
  • Other sexual problems such as a low sex drive and erectile dysfunctions
  • Diabetes
  • Hypertension  
  • Obesity 
  • High cholesterol and triglycerides 
  • Smoking
  • Excessive alcohol intake
  • History of addiction to recreational drugs
  • Depression
  • Anxiety disorders

Men who suffer from these disorders can contact the Men’s Health Clinic to find out the best treatments that can help in the prevention of PE in the future. The doctors at the Australian Men’s Health Clinic can help assess your overall health and your risk of developing PE. They can recommend effective strategies to prevent the development of PE and enhance your sexual health.

What are the complications of premature ejaculation?

If not managed properly, PE can continue to worsen the sexual health of men. It can also affect their mental and physical health resulting in complications such as:

  • Erectile dysfunction 
  • Reduced libido 
  • Stress 
  • Depression
  • Anxiety
  • Strained personal relations
  • Reduced fertility as PE may prevent the man from making fertilization possible, especially when the ejaculation and penetration does not occur intravaginally.

Diagnosis

The diagnosis of PE can be made depending on the specific symptoms experienced by men. The recurring inability to delay ejaculation and the resulting lack of orgasms and sexual pleasure could help to confirm the diagnosis of PE when the specific symptoms are present as given below:

  • Ejaculation always and nearly always occurs before vaginal penetration has been achieved or within one minute of the penetration.
  • Inability to delay ejaculation nearly or almost every time the penetration occurs.
  • Occurrence of negative consequences such as distress, embarrassment, frustration, and avoidance of sexual intimacy.

The physician will perform a complete physical examination to assess the general health of the patient and detect the possible causes of PE. The physical examination of the patient may include: 

  • Weight and abdominal girth to detect obesity 
  • Measurement of blood pressure to diagnose hypertension
  • Reflexes and sensory and motor functions to assess the neurological health
  • Muscle strength to assess the weakness of muscles and lack of muscle tone
  • Palpation of the prostate gland through the anus to detect prostate enlargement
  • Examination of the next to detect thyroid enlargement

The physician may recommend additional laboratory and imaging tests to diagnose the underlying factors responsible for PE as discussed beneath:

  • Fasting and postprandial Blood sugar levels to detect diabetes
  • Serum cholesterol and triglyceride levels
  • Thyroid hormones
  • Imaging tests such as CT scan and MRI of the brain to detect degenerative changes

The results of these tests can help a physician arrive at the correct diagnosis of the condition and identify the causes responsible for PE. This can help in recommending the most appropriate treatment aimed at eliminating the causes in order to restore sexual functions in a safe and effective manner.

How is premature ejaculation treated?

The prognosis is usually good when premature ejaculation has occurred due to a psychological cause.

When PE occurs due to anxiety during the initial sexual experience or at the beginning of a new relationship, the symptoms may resolve over a period of time as the man gains experience or as the relationship continues.

However, if the problem persists, the doctor may recommend active treatment coupled with counceling from a therapist specialised in sexual diseases as discussed beneath:

Medications for PE

There are no medications specifically recommended for the management of PE. However, the doctor may prescribe antidepressant drugs when the primary causes are psychological in nature. 

For example; the use of Dapoxetine is common for the management of primary and secondary PE in several countries. It is a rapid-acting antidepressant that belongs to the class of drugs called selective serotonin reuptake inhibitors or SSRIs [4]. 

Medications are also prescribed to correct the underlying physical causes such as diabetes, hypertension, high cholesterol and triglycerides, thyroid abnormalities, prostate enlargement, and so on.

Topical drugs

A physician may recommend the use of some topical medications that need to be applied to the penis before intercourse, with or without a condom. These topical agents include local anesthetic creams containing lidocaine or prilocaine that can prevent PE and increase the time before ejaculation by inhibiting overstimulation.

However, longer or more frequent use of local anesthetic creams may result in the loss of erection or numbness. The reduced sensation caused by these creams may also interfere with the sexual pleasure of men as well as women, which is why they are not considered a feasible option in most cases.

Exercises for PE

Premature ejaculation can be controlled effectively by working out the muscles in the pelvic floor. Some of the most effective exercises recommended for men with PE include:

Squeeze method

The squeeze method can help men to prolong the duration of erections and help them delay ejaculation by building their sexual stamina. 

To practice this exercise, the intercourse needs to be stopped when the urge for orgasm is felt. Then, the partner can wrap her hand around the base of the penis and squeeze it firmly. This would reduce the flow of blood into or away from the organ thereby delaying ejaculation.

Kegel exercises

Kegel exercises can improve the strength of the muscles in the pelvic floor and thus, prevent PE.

Men can practice Kegel exercises by simply squeezing the muscles that usually contract when they want to control or stop the flow of urine. They should hold the contraction for 5 to 6 seconds and then, release the muscles. This exercise can be repeated about 10 to15 times during one session.

Stress-relieving exercises

Stress-busting exercises such as meditation can relieve stress and anxiety and reduce PE. Aerobic exercises including simple walking, jogging, and swimming are recommended to reduce weight and control obesity, which is a common cause of PE. It can also help to reduce stress and anxiety. 

Regular exercises such as cardio and weights training can also improve men’s sexual health by preventing diabetes, hypertension, and high cholesterol and restore their ability to delay ejaculation [5].

Other treatments for PE include:

  • Psychological Therapy to address the negative emotions and identify the source of the problem. 
  • Behavioral Therapy to build tolerance and train the body to control the release of semen.

What are the best ways to prevent PE?

Men who are at risk of PE can follow prevention strategies mentioned below to reduce the risk of this condition:

  • Perform routine health check-ups
  • Exercise regularly
  • Follow healthy dietary habits
  • Avoid a sedentary lifestyle
  • Quit smoking
  • Limit alcohol intake
  • Avoid the use of recreational drugs
  • Build trust and affection in personal relations
  • Communicate with the partner openly and regularly about both the positive and negative issues you are experiencing 
  • Avoid mental stress by planning a vacation occasionally and spending quality time with family
  • Pursue hobbies

How the UK Men’s Health Clinic can help.

At Men’s Health Clinic Australia, we have helped thousands of men of all age groups from different parts of the world to overcome the symptoms of Premature Ejaculation. The comprehensive, customised treatment offered by the Men’s Health Clinic can also help men to hold their erections until climax thereby enhancing their satisfaction and pleasure. 

At the Men’s Health Clinic, the treatment is entirely based on the root cause of your PE. We customize the treatment after detecting the factors responsible for PE in a particular patient. This can help men overcome their sexual difficulties in a shorter duration while deriving rapid results that are effective and long-lasting.

So, now there is no need to ignore your PE and suffer in silence. Our treatment is designed to ignite the spark in your sex life such that you will once again be able to enjoy the thrilling experience of intense sex for years after years.

If you are unsure of whether you are suffering from Premature Ejaculation, complete our FREE quiz to find out.

References:

  1. Urology Care Foundation. What is Premature Ejaculation?. Urology Care Foundation. http://www.urologyhealth.org/urologic-conditions/premature-ejaculation
  2. McMahon, C. G., Jannini, E. A., Serefoglu, E. C., & Hellstrom, W. J. (2016). The pathophysiology of acquired premature ejaculation. Translational andrology and urology, 5(4), 434–449. doi:10.21037/tau.2016.07.06. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5001985/. 
  3. Saitz, T. R., & Serefoglu, E. C. (2016). The epidemiology of premature ejaculation. Translational andrology and urology, 5(4), 409–415. doi:10.21037/tau.2016.05.11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5001986/. 
  4. McMahon C. G. (2012). Dapoxetine: a new option in the medical management of premature ejaculation. Therapeutic advances in urology, 4(5), 233–251. doi:10.1177/1756287212453866. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3441133/. 
  5. Yildiz, Y., Kilinc, M.F., & Doluoglu, O.G. (2018, September). Is There Any Association Between Regular Physical Activity and Ejaculation Time?. Urology Journal. https://www.ncbi.nlm.nih.gov/pubmed/29681052.

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Premature Ejaculation FAQ

The symptoms of Premature Ejaculation are relatively easy to determine: if your ability to have satisfactory intercourse is interrupted by an inability to control your orgasm beyond 1-3 minutes, you have a problem with Premature Ejaculation. The severity may be partially determined by the happiness of yourself and your partner with your sexual activity. Take the MHC Premature Ejaculation quiz to see if you are suffering from PE.

Yes. Statistics and research estimates show that PE is under reported, and the actual frequency of occurrence may be as high as 1-in-3 men. Having PE is nothing to be ashamed of. Having PE and ignoring the solution is. To find your customised treatment solution click .

Yes. Natural ageing can have a physical impact on your ability to perform, and changes in your life that effect your emotional health, including stress, can also lead to problems with Premature Ejaculation. Both of these causes of late-onset Premature Ejaculation can be overcome with treatment.

Premature Ejaculation (PE) and Erectile Dysfunction (ED) are very often linked together and there are many cases of men who suffer from both problems simultaneously. In cases where both PE and ED are a problem, treatment typically follows a course that resolves the Erectile Dysfunction first, then moves on to the Premature Ejaculation, because successful treatment of the first may also resolve the second.

Premature Ejaculation (PE) that is not confronted can destroy relationships and seriously diminish your happiness and quality of life. It can also provoke serious health problems, including depression and stress-related illnesses and conditions. Premature Ejaculation should always be treated to ensure that it does not impact your life and health with more serious consequences. Take this assessment to see if treatment can help you.