Premature Ejaculation: Causes, Symptoms & Treatments

What is premature ejaculation?

Ejaculation is the release of semen from the penis. This usually happens during an orgasm. A man is said to have premature ejaculation when he ejaculates faster than normal.

Premature ejaculation is very common. According to the Urology Care Foundation, at least 1 in 3 men between 18 and 59 years of age have this condition.

Premature ejaculation may also be referred to as:

• Early ejaculation
• Premature climax
• Rapid ejaculation

Premature ejaculation is considered to be a form of sexual dysfunction. Sexual dysfunction refers to those issues that hinder the full enjoyment of sexual activity between couples.

Premature ejaculation should not be confused with erectile dysfunction (ED). In Erectile dysfunction, the man is unable to achieve an erection or to sustain it. In some cases, one may experience both premature ejaculation and erectile dysfunction.

Causes of premature ejaculation

The precise cause of premature ejaculation is not known. However, clinicians and medical researchers believe is involves  both biological (physical) factors and psychological factors.

Biological factors

Several biological factors are involved in the occurrence of this condition. These include:

• Genetics or inherited traits. This means that if there’s a history of premature ejaculation in your family, you may also be at risk.
• If your prostate gland or your urethra is inflamed, this may put you at risk of a premature ejaculation. Your prostate gland is a gland the size of a walnut. It is located between the bladder and the penis. Your prostate is important for reproduction.it produces fluid that forms part of your semen. The urethra on the other hand is a small tube that transports urine from the bladder out of the body.
• Abnormal levels of neurotransmitters. A neurotransmitter is simply a chemical messenger that transports, boosts, and balances signals between nerve cells and target cells in the body.
• Abnormal levels of hormones. Hormones are your body’s chemical messengers. They are produced in the endocrine glands. They travel around your bloodstream and instruct your tissues and organs on what to do.

Psychological factors

Psychological factors may contribute to the onset of this condition. For instance, a man may experience premature ejaculation just when he is beginning to have sex, but as he gets older and more experienced, he learns strategies that help him to delay the ejaculation.

Psychological factors that may contribute to premature ejaculation include:

• Sexual abuse
• Early sexual experiences
• Depression
• Low self-esteem or poor body image
• Having fears or thoughts about premature ejaculation
• Harbouring guilty feelings that cause you to rush through sexual activity

Abnormal levels of some hormones, like testosterone or certain chemical messengers, may also cause premature ejaculation. Inflammation of the urethra or prostate may also contribute to premature ejaculation.

Symptoms of premature ejaculation

One may experience premature ejaculation occasionally. This is nothing to worry about. However, you may need to see your doctor if you experience this frequently or if it has occurred over a prolonged period.

The primary symptom of premature ejaculation is “fast release” or being unable to delay ejaculation for at least a minute after penetration during sexual intercourse. Some people may also experience rapid climax during masturbation.

If you ejaculate normally sometimes, and prematurely at other times, then you may be having natural variable premature ejaculation.

There are two classes of PE

• Lifelong premature ejaculation is also known as primary premature ejaculation. It means you’ve ejaculated prematurely since your first sexual encounter.
• Acquired premature ejaculation, or secondary premature ejaculation means you’ve had normal ejaculations in your life but then, developed premature ejaculation.

When should you see a doctor?

You should consult your doctor if premature ejaculation:

• has occurred several times that it now threatens your relationship
• gives you a self-conscious feeling
• prevents you from having or maintaining intimate relationships

If you experience these problems, you can consult your doctor. A urologist is a doctor who treats diseases of the urinary system. He or she also specialises in the treatment of male sexual function.

You can also discuss confidentially with one of our doctors. At Access Doctor, we have a team of specialists who can assist you. Also, you don’t have to worry about the stress or awkwardness of a face-to-face consultation as we support online consultation service. Our doctors can also speak to you over the phone if need be.

When you are going for a consultation, go with the following information:

• how long you’ve been involved in sexual activities
• when you started having premature ejaculation
• how often it occurs
• do you experience quick ejaculation during intercourse or masturbation?
• Do you use performance drugs during sex?
• Do you have normal ejaculation during sex? And if yes, how frequent is it?

Available treatments for premature ejaculation

Available treatments for premature ejaculation include topical medications (creams), tablets, self-help techniques, and psychological assistance. One needs to find the treatment or therapy that is most suitable for one’s condition.

Creams: Anaesthetic sprays and creams can be used to treat premature ejaculation. These creams contain a numbing agent like prilocaine, lidocaine, or benzocaine. You will apply the product to your penis at least 10 minutes before sex. These products help to minimise sensation and delay ejaculation.

AccessDoctor has in stock a lidocaine-prilocaine topical medication called EMLA. It is available by prescription.

It is important to note that topical creams are well-tolerated and very effective. But they also have some side effects. For instance, some people may experience decreased pleasure during sex or loss of sensitivity.

Oral medications (tablets): some medications can help delay orgasm. Some include analgesics, antidepressants, and phosphodiesterase-5 inhibitors. Your doctor might prescribe these medications for daily use or on-demand. The drugs may also be prescribed alone or along with other medications. Examples of antidepressants that help to delay ejaculation include:

• Escitalopram
• Fluoxetine
• Paroxetine
• Sertraline

These are all selective serotonin reuptake inhibitors.

Phosphodiesterase-5 inhibitors that treat erectile dysfunction may also be useful in premature ejaculation. Drugs in this category include:

• Vardenalfil (Staxyn and Levitra)
• Sildenafil (Viagra)
• Tadalafil (Adcirca and Cialis)

Psychological: This involves consulting a mental health professional. You can discuss with him/her about your experiences and relationship. Counselling sessions can reduce performance anxiety and help you to cope better with stress. Counselling works best when combined with drug therapy.

Self-help techniques: These include pelvic floor exercises, the pause-squeeze technique, and the use of condoms.

The weakness of the pelvic floor muscles impairs a person’s ability to delay ejaculation. These muscles can be strengthened with Kegel exercises.

In the pause-squeeze technique, you and your partner will engage in sexual acts. Your partner will stimulate your penis until you are on the verge of ejaculating, then you or your partner will squeeze the head of your penis until you no longer feel the urge to ejaculate. You can repeat this process as necessary. By repeating this process, you can penetrate your partner without ejaculating.

Condoms make your penis less sensitive. This helps to delay ejaculation. You can get control condoms over the counter. They contain lidocaine and benzocaine (both are numbing agents) and are produced with thicker latex to delay ejaculation.

Takeaway

Premature ejaculation is a common condition affecting at least 1 in 3 men. Needless to say, it is common. However, it can be contained with the help of a qualified doctor.

AccessDoctor offers a range of prescription only medications for the treatment of premature ejaculation, such as:

• EMLA ™ 5% (without dressing for topical anaesthesia)
• Priligy 30 mg film-coated tablets

Our service is 100% confidential and served by qualified UK doctors.