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Premature Ejaculation

Premature Ejaculation

What is Premature Ejaculation (P.E.)?

There is a considerable amount of misunderstanding about premature ejaculation. It isn’t just a problem of young or sexually inexperienced men, but can affect older men, especially those who have co-existing problems with erections. It is often the subject of humor and ridicule, making it even more difficult for those affected to seek help. It is probably best understood as a man’s inability to delay orgasm and ejaculation so that both partners are able to enjoy a satisfying sexual experience.

T.V. and films are not helpful in their portrayal of sex, presenting scenes of couples engrossed in uninterrupted, passionate sex for prolonged periods of time. In fact, most people are surprised to learn that the average duration of intercourse, from penetration to orgasm is about 5 minutes. The amount of time spent in sexual engagement prior to ejaculation can vary over time in a long-term relationship.

Sometimes an orgasm may occur within seconds, or sometimes it may last much longer. Provided the intimacy is satisfactory for both partners, the amount of time spent should not be the main focus of the experience. Whether the encounter lasts for 60 seconds or 10 minutes, any amount of time can be considered “great sex”, and longer is not always better....Sixty seconds of intense excitement and intimacy is better than ten minutes of routine and boredom! If premature ejaculation leaves one or both partners regularly unsatisfied, then professional help should be sought.

Are there Different Types of Premature Ejaculations?

Premature ejaculation can be divided into two main subtypes: “Lifelong” and “Acquired.” Lifelong Premature Ejaculation describes a man who has suffered with P.E. since his first sexual encounter. Acquired P.E. describes a man who has developed symptoms after a period of previously satisfactory experiences of ejaculation.

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What is a Common Length of Time from Penetration to Ejaculation?

In multi-national studies, the most frequently experienced time from penetration to ejaculation was around 5.4 minutes…this value may differ between nationalities, but current research suggests the difference is probably slight.

What is the Medical Definition of Premature Ejaculation?

Premature ejaculation is a term used to describe the experience a man feels…

1. if the period of time from penetration to ejaculation is too short
2. that he is unable to control when he ejaculates
3. distress from this experience

The International Sexual Medicine Society describes Lifelong Premature Ejaculation as a male sexual dysfunction characterized by (i) ejaculation which always or nearly always occurs prior to or within about 1 minute of penetration,(ii) the inability to delay ejaculation on all or nearly all penetrations, and (iii) negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy.

It describes Acquired Premature Ejaculation as a clinically significant reduction in latency time, often to about 3 minutes or less, and negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy. The most severe form of P.E. is termed Ante Portas Ejaculation. Ante portas is Latin for “Before the gates”, and describes ejaculation that occurs before penetration.

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What causes Premature Ejaculation?

Despite much speculation, the causes of premature ejaculation are still unknown. There is evidence to suggest genetic factors may play a role in some men but, to date, no biological factor has been shown to be the causative agent in the majority of men.

Who is Affected by Premature Ejaculation?

Unfortunately, reliable information on the proportion of men affected by P.E. is lacking. This may be due to the emotional distress and embarrassment of reporting the problem, and may also be affected by one’s relationship and/or socio-cultural influences. P.E. is often described as the most common male sexual problem and is thought to affect between 3 to 30% of men. If men who ejaculate about one minute after penetration are excluded, the proportion affected by P.E. is probably less than 3%. Men who ejaculate between one and five minutes after penetration may experience the negative psychological concequences that are characteristic of premature ejaculation. Men should have the right to have their concerns sympathetically and respectfully assessed by a health care professional and, when appropriate, choose to receive treatment.

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What Impact does Premature Ejaculation have on Men and Their Partners?

High levels of personal distress are consistently reported by both men with P.E. and their partners.  They are also more likely to report relationship problems and an overall reduction in quality-of-life as a consequence of premature ejaculation. The negative impact on single men may be greater than on men in relationships, as it can form a barrier to them seeking out and becoming involved in a new relationship.

How is Premature Ejaculation Treated?

Premature ejaculation may be treated with sex therapy, drug therapy, or a combination of both. Whatever treatment is chosen, it is important that proper attention is given to the emotional and relationship aspects, rather than focusing solely on extending time to ejaculation. As P.E. treatments affect both partners, both should be involved in making choices about treatment.

Sex Therapy: Sex Therapy should be provided by an appropriately experienced psychotherapist, counselor, or physician. A range of techniques have been used to treat P.E., but the most common approach is a form of cognitive-behavioral therapy, which our medical professionals will review with you during your visit.

laser-mach-2Drug Therapy: Drug Therapy should only be prescribed by a physician after you have had a medical evaluation and assessment. There are several types of drugs that may be used as single agents or in combination and should always be accompanied by education about P.E. and promoting sexual well-being, as well as instructions for the proper and safe use of the drug.

Not all drug therapies are approved by national regulatory authorities. Drugs obtained through the internet without a physician’s medical assessment, or through other unregulated sources, could be very dangerous. Your physician will discuss this with you before prescribing any drug that has not been approved for treatment of premature ejaculation. There are currently several clinical trials in progress to test the safety and efficacy of new drugs to treat this condition.

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Finally….

Sex is a healthy, natural activity and is central in most loving relationships. It is important to both men and women, whatever their age, race, creed or color. Cultural and religious backgrounds may affect the way people perceive sex but it will always be an important part of the human experience. Sexual health is just as important as other aspects of health and if you have a problem, you should not be afraid or embarrassed about seeking professional help.

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