What Is Premature Ejaculation?
Premature ejaculation is a form of sexual dysfunction where a man experiences an orgasm and releases semen earlier than desired, often occurring before or shortly after penetration during intercourse. It can be a frustrating experience for both you and your sexual partner, making your sexual encounters less enjoyable. However, the good news is that it is usually treatable. Let’s explore the causes, symptoms, and treatment options for overcoming premature ejaculation in Riyadh, and take the first step towards a happier and healthier sex life.
How Common Is Premature Ejaculation?
Between 30% and 40% of men experience premature ejaculation at some point in their lives. According to the Specialist, premature ejaculation is the most common type of sexual dysfunction in men. Approximately one in five men between the ages of 18 and 59 report occurrences of premature ejaculation.
What Time Frame Medically Defines Premature Ejaculation?
Although the definition of premature ejaculation varies, if it occurs sooner than desired, either before or shortly after penetration, causing distress for either one or both partners. Three levels of severity (mild, moderate, severe) based on time to ejaculation, with mild being less than one minute. When pressed for a specific time frame, many experts would define premature ejaculation as ejaculation within a minute of starting intercourse. However, your feelings about what is premature are also taken into consideration.
Symptoms and Causes
What Causes Premature Ejaculation?
Premature ejaculation is caused by physical, chemical, and psychological factors.
Physical and chemical issues include:
1. An underlying diagnosis of erectile dysfunction.
2. Hormonal problems, such as oxytocin levels, which play a role in sexual function in men. Other hormone levels involved in sexual function include luteinizing hormone (LH), prolactin, and thyroid-stimulating hormone (TSH).
3. Low serotonin or dopamine levels, chemicals in the brain associated with sexual desire and excitement.
4. Increased penile sensitivity to stimulation.
Deep or psychological causes include:
1. Performance anxiety, which may result from the fear of being with a new partner, anxiety about engaging in sexual activity after a long period of abstinence, lack of confidence, commitment issues, excessive excitement, or other reasons.
2. Stress.
3. Relationship problems.
4. Depression.
Are There Other Symptoms of Premature Ejaculation?
No, the primary symptom of premature ejaculation is the condition itself.
Diagnosis and Tests
How Are the Causes of Premature Ejaculation Diagnosed?
If you experience frequent premature ejaculations or if premature ejaculation causes you anxiety, distress, and impacts your relationship, consider seeing a urologist.
Your urologist will initiate an examination by asking about your sexual experiences. You are likely to be asked:
1. How long have you had this issue?
2. Under what circumstances does it occur?
3. How often does it occur?
4. Does premature ejaculation happen in every sexual attempt?
5. Does it happen with all partners?
6. Does premature ejaculation occur when you masturbate?
7. Do you have difficulty maintaining an erection?
While these questions are private, it's important to answer them honestly so that your urologist can accurately diagnose the source of your concern.
Your urologist will also inquire about any other medical conditions you might have and any medications, including over-the-counter drugs, supplements, and herbal products that you are taking. They will also ask about alcohol and illegal drug use.
Are Lab Tests Required for Diagnosing Premature Ejaculation?
Lab tests are generally not required unless your healthcare provider suspects that an underlying medical condition contributes to the problem.
Management and Treatment
How Is Premature Ejaculation Treated?
There are various treatment options for premature ejaculation depending on the cause. These include behavioral therapy, counseling, and medications. Most cases of premature ejaculation are initially treated with behavioral therapy and counseling to address personal concerns, performance anxiety, or stressors that may contribute. Often, multiple treatment approaches may be attempted simultaneously.
Behavioral Therapy
Behavioral therapy involves trying different techniques to delay your ejaculation. Its goal is to teach you how to control your body and emotions. Techniques include:
1. Start and stop: In this method, you or your partner stimulates your penis close to the point of climax, then stops the stimulation for about 30 seconds until you regain control of your response. Repeat this "start and stop" approach three or more times before allowing yourself to climax. Keep practicing until you have gained good control.
2. Squeeze technique: With this approach, you or your partner stimulates your penis close to the point of climax and then gently squeezes the top of your penis for about 30 seconds to make you lose your erection. Repeat this technique several times before allowing yourself to climax. Continue practicing until you have gained control in delaying your ejaculation.
3. Distraction: In this technique, the idea is to focus on non-sexual things while you are physically stimulated. Naming objects or sequences is an effective way of focusing. For example, imagine naming all the companies you pass on your way to the gym, naming all the players on your favorite sports team, or naming all the products on the aisles of your favorite store.
Counseling
If the cause of your premature ejaculation is psychological, personal, or related to relationship issues – such as performance anxiety, depression, stress, guilt, or a strained relationship – seek the help of a psychologist, therapist, couples therapist, or sex therapist. Your urologist can assist in referring you to these healthcare professionals.
Medications
Several types of medications may be tried:
1. Antidepressants, especially selective serotonin reuptake inhibitors like citalopram (Celera®), escitalopram (Lexapro®), fluoxetine (Prozac®), paroxetine (Paxil®), and sertraline (Zoloft®), or the tricyclic antidepressant clomipramine (Anafranil®), can help delay premature ejaculation. This is an "off-label" use (not approved by the Food and Drug Administration for this use). Be sure to discuss the side effects of this medication with your urologist to ensure it is suitable for you.
2. Topical (numbing) creams and sprays applied to the head and shaft of the penis are another medication option to delay ejaculation. The numbing cream or spray is applied to the penis, allowed to absorb for 10 to 30 minutes or until you feel reduced sensitivity in your penis. It is important to wash your penis before intercourse to prevent numbness to your partner's vagina or loss of your erection.
3. Erectile dysfunction medications, including sildenafil (Viagra®), tadalafil (Cialis®), vardenafil (Levitra®), and avanafil (Standard®), have also been used to treat premature ejaculation, especially in men with underlying erectile dysfunction.
Are Lab Tests Required to Make the Diagnosis of Premature Ejaculation?
Lab tests are usually not necessary unless your healthcare provider suspects that an underlying medical condition is contributing to the issue.
Prevention
Can Premature Ejaculation Be Prevented?
Yes, it can be prevented! By following the strategies described in this article to delay ejaculation, taking any prescribed medications, and seeking counseling if necessary, premature ejaculation can become a thing of the past.
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