What is premature ejaculation?
Premature ejaculation is a treatable medical condition that occurs when a man ejaculates (comes) too soon. This can happen during penetrative sex, or even before penetration occurs. There is a popular misconception that premature ejaculation only happens to inexperienced and over excited young men and teenagers. In fact, it can happen to men of any age group and background. It is believed to be the most common sexual problem in men under the age of 40.
There is no set time for how long it takes a man to ejaculate during sex and most men will find that their endurance varies all the time. One study estimated that the average duration of sexual intercourse is around 5 ½ minutes. This can change according to your level of arousal, tiredness, stress, alcohol use, or whether you are wearing a condom or having unprotected sex. Many men ejaculate sooner than either partner would prefer, but this usually doesn’t meet the medical definition of premature ejaculation.
If you find that you ejaculate too soon (either immediately before or shortly after penetration) at least 50% of the time, it is likely that you are suffering from genuine premature ejaculation and should seek medical help.
What are the causes of premature ejaculation?
There are several possible causes of premature ejaculation. They can be divided into physical causes and psychological causes, but some men may suffer from both.
Physical causes of premature ejaculation can include the use of certain recreational drugs such as cocaine or amphetamines. If you are using these drugs and experience premature ejaculation, stop taking them and see if there is any improvement. If there is no improvement or you struggle to stop your drug use, seek immediate medical advice.
Chronic inflammation of the prostate gland may also cause premature ejaculation, as can thyroid problems.
Most cases of premature ejaculation are psychological and are usually treatable. Dealing with the underlying issues may improve your quality of life on a wider level. The most common psychological issues are stress, relationship problems, depression, and anxiety about sexual performance. Deeper issues may include childhood traumas (such as sexual abuse, humiliation, or being punished for masturbating). An overly strict or repressive upbringing can lead to a furtive and tense attitude to sex, while some men suffer from a negative attitude towards their own bodies and personal appearance.
Symptoms of premature ejaculation
The symptoms of premature ejaculation are very simple. If you find that either of the following occurs at least 50% of the time when you have sex, you probably meet the medical criteria for a diagnosis of premature ejaculation.
- You experience an unwelcome ejaculation during initial sexual activity but before penetration.
- You experience an unwelcome ejaculation shortly after penetration.
If you experience premature ejaculation, the psychological symptoms can have a serious effect on your general well being, and can have a further negative effect on your sexual performance.
- Feelings of humiliation
- Loss of self confidence
- Anxiety and self-doubt
- Feelings of powerlessness
- Anger and frustration
- Relationship difficulties
- Avoidance of sex
N.B. Many men find that they ejaculate sooner than either partner would prefer, but this is not premature ejaculation that requires medical treatment.
Diagnosis of premature ejaculation
If you are experiencing premature ejaculation, at least 50% of the time when you have sex, a doctor may regard your situation as a medical condition that requires treatment. You may find it difficult, or even humiliating, to seek medical help, but it is important that you do. Your premature ejaculation may be a side effect of an underlying physical problem (chronically inflamed prostate or a poorly functioning thyroid) that requires treatment.
If a medical checkup rules out any physical causes for your premature ejaculation, the causes are likely to be psychological. Whatever the case, you may be prescribed medication such as Priligy tablets or Emla Cream. This may be a sole treatment or may be used in conjunction with counselling, cognitive behaviour therapy (CBT), or another medication.
A diagnosis of premature ejaculation is nothing to be ashamed of, nor is it a personal crisis or a sign of inadequacy. For many men, it can be an opportunity to deal with wider personal problems and improve their overall quality of life.
Treatments for premature ejaculation
Treatments for premature ejaculation (PE) depend on the causes of the condition. If you are experiencing PE as a side effect of an existing medical condition such as an enlarged prostate, malfunctioning thyroid, or recreational drug use, the primary emphasis may be on managing these conditions. You may also require direct treatment for your premature ejaculation as an interim measure, or even on an ongoing basis. These can include the use of a prescription medication like Priligy or a topical remedy like Emla Cream, used in conjunction with psychosexual treatment.
If there is a psychological cause for your premature ejaculation (or you are developing psychological problems as a result of PE) you may benefit from some form of psychosexual treatment in conjunction with prescription medication. There are many forms of counselling and therapy available, as well as self-help guides. Your GP might refer you to a specialist counsellor, which may help you confront wider personal issues and achieve a better quality of life generally.
As part of a holistic approach to treating premature ejaculation, you may be advised to try various sexual techniques to reduce sensitivity and delay the natural ejaculation reflex. These can further enhance the effectiveness of medications like Priligy and Emla Cream and improve your ‘staying power’.
How to prevent premature ejaculation
There is no single way to prevent premature ejaculation. It will happen at some point to around a third of men, either as isolated incidents or as an ongoing problem. There are some basic steps that you can take, which may help to prevent premature ejaculation.
Be with the right sexual partner
If you’re with the wrong sexual partner, you may be setting yourself up for premature ejaculation, impotence, or various emotional and psychological problems. Choose a partner who you love (or at least like), who you find arousing, and who you genuinely enjoy being with. If you feel obliged to have sex, or feel guilt, resentment, or stress, premature ejaculation may occur.
Don’t use recreational drugs
Cocaine, and amphetamine based drugs might feel as though they are enhancing your mood, sensations, or physical performance, but they are also sometimes known to cause premature ejaculation. Avoiding these drugs could reduce your chances of experiencing premature ejaculation, as well as other health problems.
Get checked out
Regular medical checks can identify problems such as thyroid malfunction and inflammation of the prostate gland. If these are treated, side effects like premature ejaculation are less likely to occur.
Look after your mental health
Identifying and dealing with problems like stress, depression, anxiety, and anger is probably the single best way to prevent premature ejaculation from occurring. If you feel that you have deep rooted issues with shame, guilt or sexual inhibition, it is worth trying therapy or seeking other counselling.