Scribd Logo
Upload

Welcome to Scribd!

  • 154 views

    31 Premature Ejaculation

    Uploaded by

    Wàrìs Ràfìqùé ßàlòçh
    This document discusses premature ejaculation (PE), including what it is, types, symptoms, causes, diagnosis, and treatment options. PE is defined as ejaculating sooner than desired during sexual intercourse. There are two types - lifelong PE existing from first becoming sexually active, and acquired PE developing later in life. PE is commonly caused by psychological factors like anxiety but can also have biological causes. Treatment involves psychotherapy, behavioral techniques, oral medications, and topical anesthetics to delay ejaculation.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    31 Premature Ejaculation

    Uploaded by

    Wàrìs Ràfìqùé ßàlòçh
    154 views4 pages
    This document discusses premature ejaculation (PE), including what it is, types, symptoms, causes, diagnosis, and treatment options. PE is defined as ejaculating sooner than desired during sexual intercourse. There are two types - lifelong PE existing from first becoming sexually active, and acquired PE developing later in life. PE is commonly caused by psychological factors like anxiety but can also have biological causes. Treatment involves psychotherapy, behavioral techniques, oral medications, and topical anesthetics to delay ejaculation.

    Original Description:

    pathology

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    This document discusses premature ejaculation (PE), including what it is, types, symptoms, causes, diagnosis, and treatment options. PE is defined as ejaculating sooner than desired during sexual intercourse. There are two types - lifelong PE existing from first becoming sexually active, and acquired PE developing later in life. PE is commonly caused by psychological factors like anxiety but can also have biological causes. Treatment involves psychotherapy, behavioral techniques, oral medications, and topical anesthetics to delay ejaculation.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    154 views4 pages

    31 Premature Ejaculation

    Uploaded by

    Wàrìs Ràfìqùé ßàlòçh
    This document discusses premature ejaculation (PE), including what it is, types, symptoms, causes, diagnosis, and treatment options. PE is defined as ejaculating sooner than desired during sexual intercourse. There are two types - lifelong PE existing from first becoming sexually active, and acquired PE developing later in life. PE is commonly caused by psychological factors like anxiety but can also have biological causes. Treatment involves psychotherapy, behavioral techniques, oral medications, and topical anesthetics to delay ejaculation.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    You are on page 1of 4

    Premature ejaculation

    Dr. Joe King Chien Lee


    Urologist
    St Joseph’s Hospital, London, ON, Canada

    What is premature ejaculation?


    Premature ejaculation (PE) happens when a man regularly reaches an orgasm (or ejaculates) much
    sooner during sexual intercourse than what he or his partner would have desired.

    There are 2 types of PE:

    1. Lifelong PE (primary), which existed when you first became sexually active.
    2. Acquired PE (secondary), which develops over time after you have had a normal sexual
    life, without ejaculation issues.
    The formal definition for lifelong PE is: “Ejaculation which always or nearly always occurs prior to or
    within about one minute of vaginal penetration, and the inability to delay ejaculation on all or nearly
    all vaginal penetrations, and negative personal consequences such as distress, bother, frustration
    and/or the avoidance of sexual intimacy.”

    There is no fixed definition for acquired PE, but it is believed to share the same characteristics as
    lifelong PE except that it comes on later in life, after a period of sexual normalcy.

    What are the symptoms?


    People who suffer from the following conditions are at greater-than-normal risk of developing kidney
    failure and/or progressive loss of their kidney function (or end-stage renal disease):

    • The symptoms become clear when the sexual relationship between a couple becomes
    affected due to PE. The man usually experiences distress as a result of this.
    • PE does not go away with different sexual environments or scenarios, such as
    masturbation.

    How do you get PE?


    It’s a mix of psychology and biology. No one really knows how it is caused.

    Psychology
    The psychological part includes fear or anxiety – maybe because you had to reach orgasm quickly
    when you were young for fear of being discovered. This has now caused you to reach orgasm quickly
    and early.

    The Consumer’s Handbook of Urological Health 275


    Some men find that the PE occurs only with a certain partner, but not with others. This may be a clue
    to a relationship problem.

    Biology
    The biological part includes hormonal disorders, such as thyroid disease or infections in the male
    genitourinary tract (urethra or prostate) – but these causes are rare.

    PE is common in men who also have erectile dysfunction (ED). Because these men have difficulties
    maintaining their erections, they are usually anxious during intercourse and rush to ejaculate before
    their erections vanish.

    Less commonly, PE may be a result of nerve injuries from either trauma or previous surgery.

    How is PE diagnosed?
    When it comes to diagnosing PE, your history is very important, because most of the time there are no
    physical symptoms or abnormalities.

    You may have to get a blood test to check your male hormone and thyroid hormones if this may be
    an issue.

    Questions to think about and talk about with your doctor


    • When did the PE start?
    • How often does it happen?
    • Does it happen all the time?
    • Does it occur only with a specific sexual partner or under a specific situation?
    • Do you ejaculate before penetration or shortly after?
    • If ejaculation happens only after penetration, how long after?
    • How has your relationship been affected by the PE?
    • Are you having relationship problems because of it?
    • Are you taking any medications or recreational drugs?

    What is the treatment for PE?


    Generally, treatment is divided into 2 types:

    1. Non-medical therapy: psychotherapy, sexual therapy and behavioural therapy


    2. Medical therapy: oral or topical medication

    Psychotherapy
    If stress or anxiety is an obvious cause, then you may benefit from a therapy session with a
    psychotherapist. This can help alleviate any hidden fears, emotions and the you may be able to better
    overcome your relationship difficulties.

    276
    The Consumer’s Handbook of Urological Health
    Sex therapy
    Sexual satisfaction doesn’t only come with intercourse. You will learn other ways to get pleasure and
    sexual intimacy (i.e., through foreplay).

    After sex, men’s genitals are less responsive – some patients have seen improvements in their PE if
    they masturbate a few hours before their actual intercourse. Without this, they may take a long time
    to ejaculate when they attempt intercourse a second time, shortly after the initial ejaculation.

    Behavioural therapy
    Learning about your Step 1: With the help of your partner, START
    sexual organs can help stroking the penis as what you would in
    regular foreplay or masturbation.
    you control them better.
    The stop-start-squeeze Step 2: When you are about to ejaculate,
    technique is a form of STOP stroking the penis.
    behavioural therapy you Step 3: Signal to your partner who will then
    can learn and try with SQUEEZE the end of penis between the head
    and shaft between the thumb and first two
    your partner. By fingers until the urge to ejaculate goes away.
    identifying the sensation
    Step 4: Release the squeeze, wait for 30
    just before ejaculation
    seconds then restart the first step by stroking
    and learning how to abate the penis again.
    it so that ejaculation does
    not occur, you can
    experience a longer time
    to ejaculation when it
    becomes a habit.

    Oral medications
    • Certain antidepressants can delay orgasms (one of the side effects of some
    antidepressants). The category most commonly used is the selective serotonin reuptake
    inhibitors (SSRIs). Commonly prescribed agents of this class are: paroxetine (Paxil),
    sertraline (Zoloft), fluoxetine (Prozac) and dapoxetine (Priligy). Depending on your
    profile, you may take these daily or a few hours before intercourse. Your doctor will let you
    know which is best for you.
    • Another category that can be used is the tricyclic antidepressants (TCAs) such as
    clomipramine (Anafranil).
    • Antidepressants may lead to other common side effects such as drowsiness, loss or
    decrease in libido and nausea. This form of therapy is recommended only for patients
    who can tolerate the medications.

    The Consumer’s Handbook of Urological Health 277


    Topical medications
    • These include local anesthetics that work by decreasing the sensation of the penis, and
    delaying the time to ejaculation. The common medications used in these creams,
    ointments or spray are lidocaine and prilocaine. You should apply these to the head and
    other sensitive areas of the penis 15-30 minutes before intercourse.
    • It is important that you wipe these treatments off your penis before intercourse, so that
    the medications will not be transferred to their partners and cause unwanted numbness.
    • Some patients can’t tolerate this form of treatment because the numbness they
    experience in their penis affects their sexual pleasure.

    How does PE affect my general health?


    PE does not come with major health risks and is not linked with any dangerous underlying conditions
    – especially if there are not biological factors found during your physical exam or in your blood tests.

    PE can lead to problems in your relationships if the other partner is sexually unfulfilled. This can lead
    to stress in you and your partner.

    Fertility is usually not affected if penetration is still possible. If you consistently ejaculate before
    penetrating the vagina, this could lead to a fertility issue. In worst case scenarios, the couple may
    require assisted fertility.

    What do I do if I think I have PE?


    If you think you may have PE, take note of the symptoms of PE and discuss them with your doctor.

    If PE is rare, it could be related to your specific environment, emotion or partner. Try to avoid these
    triggers.

    What are common myths about PE?


    PE only happens in men who are sexually inexperienced because their penises are too sensitive.
    While it may seem true that men who just turned sexually active may have a shorter time to
    ejaculation, this “starter’s PE” should resolve once they are regularly sexually active.

    If I have PE, I can get better by getting a circumcision.


    There is no evidence to suggest that circumcision can increase your time to ejaculation. PE happens
    equally in circumcised and in uncircumcised men.

    The time my penis spends in her vagina is the most important thing about PE.
    The time between penetration to ejaculation is only a guide in the diagnosis of PE. Overall sexual
    satisfaction is more important. As long as you and your partner are sexually satisfied and have a good
    relationship, it doesn’t matter how long it takes to ejaculate.

    278
    The Consumer’s Handbook of Urological Health

    You might also like