Premature ejaculation (PE) is a common sexual dysfunction in men, characterized by ejaculation that occurs sooner than desired during sexual activity. Symptoms may include a lack of control over ejaculation, usually occurring in less than two to three minutes of vaginal penetration, and difficulty achieving sexual satisfaction. Premature ejaculation can be classified as lifelong (present from the onset of sexual activity) or acquired (developing later in life).
Causes of Premature Ejaculation
Premature ejaculation can result from a combination of physical and psychological factors, including:
- Psychological Factors: Performance anxiety or stress about sexual performance can lead to premature ejaculation. Mental health issues, including depression, can contribute to PE, as well as communication problems or dissatisfaction in a relationship.
- Physical Factors: Low levels of serotonin, a neurotransmitter that helps regulate sexual desire, can lead to PE. Conditions like multiple sclerosis or spinal cord injury can impact ejaculatory control, while infections or inflammation in the prostate, urethra, or other parts of the reproductive system may contribute. In some cases, a family history of PE can increase the likelihood of developing the condition. Conditions like diabetes, high blood pressure, or thyroid problems can also increase the risk of PE.
Diagnosis
To diagnose premature ejaculation, healthcare providers may utilize:
- Medical History: Discuss sexual history, frequency of premature ejaculation, and any contributing psychological or physical factors.
- Physical Exam: A physical exam to check for underlying health conditions that may affect sexual function.
- Lab Testing: In most cases, additional testing for PE is not necessary unless your doctor needs more information to evaluate contributing risk factors.
Treatment Options
Treatment for premature ejaculation depends on the severity of the condition and the underlying causes, and may include:
- Start-Stop Technique: This involves pausing during sexual activity when ejaculation is imminent to reduce sensitivity and delay ejaculation.
- Squeeze Technique: A method where pressure is applied to the penis near the head to delay ejaculation. With this approach, the patient can eventually better control climax.
- Medications: There are several off-label medication options available for treatment of PE. There are numbing creams and sprays that can be used before sexual activity to reduce sensation.Antidepressants such as fluoxetine or sertraline can delay ejaculation by increasing serotonin levels. Phosphodiesterase-5 inhibitors, such as Viagra and Cialis, may also help to delay ejaculation in some patients.
- Therapies: Working with a therapist can help patients with issues that are impacting sexual satisfaction.
Next Steps
If you are experiencing symptoms of premature ejaculation, it is important to seek an evaluation from a provider specializing in male sexual health. Early diagnosis and treatment can help manage the condition and improve sexual satisfaction. There are various treatment options available, from behavioral techniques to medications, that can significantly reduce the frequency of premature ejaculation and enhance sexual experiences.