Premature ejaculation (PE) is characterized by ejaculation that occurs sooner than desired, either before or shortly after penetration, causing distress to one or both partners.
It is the most common male sexual dysfunction. It is estimated that approximately 20-30% of men experience PE at some point in their lives. Cultural, social, and psychological factors can influence the prevalence and reporting of PE.
PE can be classified into two categories namely:
Lifelong (Primary) PE is typically caused by genetic or neurobiological factors and has been present since a man's first sexual experience; and
Acquired (Secondary) PE develops later in life and is often associated with psychological issues, relationship problems, or medical conditions such as prostatitis.
Premature ejaculation (PE) can affect sexual relationships in several ways, including:
Emotional Stress: It can lead to feelings of frustration, inadequacy, or embarrassment for the person experiencing it, which can impact his self-esteem and confidence.
Communication Issues: If not openly discussed, PE can lead to misunderstandings and miscommunications between partners, potentially creating emotional distance.
Relationship Strain: Persistent issues with PE may cause stress or tension in the relationship, potentially leading to conflicts or decreased overall relationship satisfaction.
Lack of Sexual Satisfaction: It may affect both partners' sexual satisfaction, leading to dissatisfaction or reduced intimacy.
Impact on Partner: The partner may feel neglected or frustrated, which can affect their emotional well-being and the dynamics of the relationship.
Fortunately, there are several approaches to treating premature ejaculation (PE), depending on the underlying causes and the individual's preferences. Some of the more common treatments are:
Pharmaceutical Interventions
Selective Serotonin Reuptake Inhibitors (SSRIs): Medications like fluoxetine or paroxetine, often used to treat depression, can also help delay ejaculation. Some of the more common side effects of SSRIs include nausea, diarrhea, or constipation, decreased libido, difficulty achieving orgasm, or erectile dysfunction, insomnia or abnormal dreams, weight gain or loss, dry mouth, lethargy, drowsiness, fatigue, night sweats and persistent headaches or migraine. More serious, but less common side effects include Serotonin Syndrome, a potentially life-threatening condition characterized by agitation, confusion, rapid heart rate, and high blood pressure; Suicidal thoughts more particularly in young people or those with a history of mental health issues; and Mania in individuals with bipolar disorder. Dapoxetine is a PE specific SSRI that can be used on an as-needed basis in order to prevent frequent recurrence of the aforesaid side effects.
Topical Anesthetics: Creams or sprays containing numbing agents can reduce sensation and help delay ejaculation. Common side effects of these include reduced sensitivity or excessive numbness in the genital area, which can affect sexual pleasure for both partners; redness, itching, or a rash at the application site; allergic reactions causing swelling and/or severe itching; and numbness or irritation for the sexual partner due to transfer of anesthetic to their sexual organs.
Behavioral Techniques:
Stop-Start Technique involves stopping sexual activity just before ejaculation and starting again after a brief pause. This requires clear communication with a partner in order to ensure that they are comfortable with, and understand the process to avoid them becoming frustrated and losing interest.
Squeeze Technique involves applying pressure to the penis just before ejaculation to delay climax. This also requires clear communication with a partner in order to ensure that they are comfortable with, and understand the process to avoid them becoming frustrated and losing interest.
Counseling and Therapy:
Sex therapy or sex coaching can address any psychological factors involved, such as performance anxiety or relationship issues as well as help manage stress and anxiety related to PE using various learnt tools and skills.
Exercise
Regular physical activity can help reduce stress and improve overall sexual function.
Pelvic Floor Exercises (Kegel exercises) can help to strengthen the pelvic floor muscles and improve control over ejaculation.
Diet & Nutrition
A diet rich in fruits, vegetables, whole grains, and lean proteins can support overall health and improve sexual function. Foods high in antioxidants, such as berries and dark chocolate, as well as those rich in omega-3 fatty acids, like fish and flaxseeds, are particularly beneficial.
Alternative Therapies
Acupuncture is a traditional Chinese medicine technique which involves inserting thin needles into specific points on the body to improve energy flow and blood circulation. Some studies suggest acupuncture helps to alleviate symptoms of PE by reducing stress and improving overall health.
Herbal Supplements such as St. John's wort and kava may help reduce anxiety and improve sexual performance. It is important to consult with a healthcare provider to determine the most appropriate treatment based on individual needs and medical history before using herbal supplements, as they can interact with certain medications and have unpleasant and/or dangerous side effects.
Men experiencing PE conditions should seek medical advice to determine the most appropriate and effective treatment plan tailored to their specific needs. With the right approach, most men can manage or overcome this condition and improve their sexual health and overall well-being.
If you or someone you know is concerned or seeking help, speak to a healthcare professional who can provide guidance and support tailored to your specific needs.
