Definition and Overview
Premature ejaculation is a medical condition where the male experiences uncontrolled ejaculation despite minimal penile stimulation either before or shortly after sexual penetration. Also known as premature climax and rapid ejaculation, this condition affects 20% of men ages 18 to 59. The problem is often assumed to be both physiological and biological. Based on studies, premature ejaculation isn’t just an embarrassing and frustrating problem for the male population, but it also harms relationships and affects the quality of life. Although occasional instances of this condition are considered normal, men who regularly experience the symptoms are encouraged to seek treatment.
The exact causes of this condition are still unknown. Experts recognized that this condition, which is once thought to be just psychological, involves a complex interaction of both biological and psychological factors. These include relationship stress, sexual inexperience, too much stimulation, anxiety, depression, novelty of a relationship, and issues related to control and intimacy. Other factors include upbringing, traumatic sex experiences, and conditioning.
Aside from biological and psychological factors, premature ejaculation can also be the result of the following medical conditions: diabetes, prostate disease, multiple sclerosis, high blood pressure, and thyroid problems. It can also be because of illicit drug use and excessive alcohol consumption.
Premature ejaculation is characterized by uncontrolled ejaculation with little sexual stimulation as well as decreased sexual pleasure. It also leads to frustration, guilt, and, more often than not, embarrassment.
Who to See and Types of Treatments Available
Diagnosing premature ejaculation starts with a thorough discussion with your doctor and is based on typical symptoms mentioned above. Patients are encouraged to be open and frank despite embarrassment over the problem. The more information supplied to the doctor, the higher the chances of identifying the problem and formulating the best treatment plan.
Tests may also be required if sexual history is ruled out as the main contributor to the condition. These tests, which may include prostrate and neurological tests, are designed to determine if the cause of premature ejaculation is physical, mental, or psychological. Urine test may also be ordered to rule out possible infection. If premature ejaculation is experienced in combination of erectile dysfunction, the doctor will order blood tests to check the testosterone level.
Patients who experience key symptoms mentioned above are encouraged to consult a urologist, a medical professional who specializes in conditions affecting both the male and female urinary tract and male reproductive organ. Although urology is generally classified as a surgical specialty, urologists handle a wide range of clinical problems. Thus, they require knowledge and skills on other specialties such as internal medicine and gynecology.
Urologists provide treatment plans for men who suffer from premature ejaculation. Common treatment options include counseling, behavioral techniques, oral medications, as well as topical anesthetics.
The most common behavioral techniques are squeeze and stop-start. While the first one involves squeezing the penis to reduce the urge to ejaculate, the second technique is about stopping sex or reducing the amount of stimulation to achieve the same goal. Practicing delaying ejaculation may prove to be challenging for many, but over time, you should be able to build control during sex without stopping. However, men suffering from premature ejaculation who did not experience significant success using behavioral technique, typically combine this method with medical treatment. Many medications can be used to delay orgasm. These include antidepressants, analgesics, and phosphodiesterase-5 inhibitors.
Topical anesthetics may also help with the symptoms. Creams and sprays that contain prilocaine, lidocaine, and other numbing agents are applied to the penis before sexual intercourse to reduce the sensation.
Currently, there is no recommended surgical treatment for this condition.