Premature Ejaculation: A Comprehensive Guide

Many men worldwide are concerned about Premature Ejaculation (PE).

In the US, approximately every 1 in 3 men experience this issue.

PE can make them feel irritated and self-conscious and make them have unsatisfying sexual experiences.

It is a condition that makes a man unable to control ejaculation during sex.

Premature Ejaculation is a sensitive issue, which makes it more important to be discussed so that people have more awareness and don’t hesitate to seek help.

This article addresses the condition, sharing details like symptoms, causes, treatment, and more.

Understanding ejaculation and Premature Ejaculation

A man with Premature Ejaculation ejaculates earlier than preferred during sexual intercourse.

Although there is no particular time when he must ejaculate, if it happens within sixty seconds of penetration, it is referred to as premature or early. 

Ejaculation consists of two stages: emission and expulsion.

In the first stage, the reproductive organs contract to propel seminal fluid containing sperm into the urethra.

The pelvic floor muscle contractions kickstart the second phase, and it is also accompanied by the contractions in the muscles at the penis’ base.

The semen is then rhythmically ejected through the penis due to these contractions.

But how long does Premature Ejaculation last?

The duration of ejaculation may be different for every individual; it can be considered early or ‘premature’ if it happens at a time that does not provide sexual satisfaction.

The pleasure in sexual experiences forms the core part of intercourse.

Types of Premature Ejaculation

Premature Ejaculation problems can either be present from the beginning or develop later in life for some individuals.

Based on this, PE can be of two types: primary or secondary.

Primary PE refers to the lifelong condition in which an individual has always had it or experienced it since their  sexual activity.

Secondary PE is the acquired condition, meaning a person had a better ejaculation period and is experiencing PE in the present.

Premature Ejaculation symptoms

If Premature Ejaculation happens rarely or occasionally, it is nothing to be concerned about.

However, if someone experiences this frequently, it is better to consult a doctor. 

Typical PE symptoms include:

• Ejaculating within a minute of penetration
• Not being able to delay the ejaculation

Ejaculating within a minute or two can make both partners in a sexual act unsatisfied.

The quality of ejaculation control, or the lack of it, adds to the difficulty of continuing the act.

The unsatisfactory sexual encounters can cause emotional distress to people affected with PE.

They may feel anxious, frustrated, or embarrassed during intimate moments.

When their partners feel dissatisfied and frustrated, it can strain their relationship.

Due to being unable to control ejaculation, some men may start avoiding sex altogether.

Therefore, Premature Ejaculation can decrease sexual confidence considerably.

Causes of Premature Ejaculation

Various factors, such as medical and relationship issues, can cause Premature Ejaculation.

A range of psychological and biological reasons can cause PE.

The common causes of Premature Ejaculation have been discussed below.

Psychological factors

Mental and emotional factors have a huge influence on erections, libido, and sexual desires.

All of these factors affect sexual performance, too.

The key psychological reasons behind PE include:

• Performance anxiety
• Stress
• Body image issues
• Depression
• Earlier sexual encounters
• Relationship issues
• Sexual abuse
  

Biological or physical factors

Certain biological factors can cause quick release during sexual activity.

This includes unnatural neurotransmitter levels such as Serotonin.

The sleep cycle affects ejaculation because of Serotonin’s role in ejaculation regulation.

Poor sleep quality leads to Serotonin levels falling, leading to Premature Ejaculation.

Other major physical  and chemical factors causing PE include:

• Aging
• Abnormal reflex activity of the ejaculatory system
• Erectile Dysfunction
• Genetic factors
• Hormonal imbalances
• Urethral or prostate inflammation or illness
  

Medical factors

Sometimes, medical reasons can be behind Premature Ejaculation.

Potential medical factors include

• Alcoholism
• Diabetes
• High Blood Pressure
• Hyperthyroidism
• Multiple Sclerosis
• Recreational drug use

Premature Ejaculation treatment

There is no one-size-fits-all or definite treatment for Premature Ejaculation.

Nevertheless, it is important to see a doctor when experiencing PE consistently.

Urologists, sex therapists, and other sexual health professionals can suggest the best strategies to improve Premature Ejaculation.

Sometimes, modifying sexual behavior can help treat the condition.

Some treatment options that may help in getting rid of Premature Ejaculation have been mentioned below.

Topical products

Topical medications such as desensitizing creams or sprays are considered the first-line treatment for Premature Ejaculation.

They are more popular than oral medications, too.

Topical anesthetics typically contain Prilocaine or Lidocaine, which are numbing agents.

Some topical medications to treat PE include

Numbing creams

These creams numb the nerve endings and reduce sensation, which can help sustain the time taken to reach ejaculation.

These medications are applied to the penis 20-30 minutes before sexual activity and washed off 5-10 minutes beforehand.

Thickened or delay condoms

Delay condoms can be effective in helping men last longer during sex by dulling the sensation through their thicker sheath.

They also use a special lubricant on the inside of the condom that contains local anesthetics such as Benzocaine or Lidocaine.

This can effectively prolong the time of sexual intercourse and improve the symptoms of Premature Ejaculation.

Delay sprays for men

Delay sprays for men also contain a local anesthetic as the active ingredient, such as Lidocaine.

When used, these products reduce sensitivity and prolong sexual activity.

These sprays are applied to the most sensitive areas of the penis 10-15 minutes before sexual activity.

They are fast-acting and absorb quickly into the skin.

PE wipes

Disposable wipes, known as Premature Ejaculation wipes, usually include a small amount of Benzocaine, a moderate topical anesthetic.

These wipes should be used prior to sex.

The solution on these wipes gradually lessens sensitivity on the penis’ head and shaft after a few minutes, which could assist in extending the period until climax.

Prescription pills

For a persistent or severe Premature Ejaculation case, a doctor may prescribe medications.

However, the FDA has not approved oral medications for Premature Ejaculation treatment.

Thus, doctors prescribe off-label uses of these medicines when necessary.

These prescription medications may include the following pills:

Antidepressants

Though antidepressants were designed to treat Depression and Anxiety, antidepressants like Dapoxetine and Sertraline are effective and safe in treating PE.

Dapoxetine is one of the SSRIs (Selective Serotonin Reuptake Inhibitors) which can delay ejaculation effectively.

Sertraline (Zoloft) can also increase the time before one ejaculates. 

A doctor may prescribe 25-50 mg of Sertraline daily for up to three or four weeks to treat PE.

ED medications

Some doctors may suggest ED medications for Premature Ejaculation.

Phosphodiesterase type 5 (PDE5) inhibitors, which are usually used for Erectile Dysfunction, can help with PE, too.

Some of these are:

• Sildenafil
• Tadalafil
• Avanafil
• Vardenafil

However, one must have a detailed discussion on the risks and side effects before taking any medications for PE.

Surgery

Surgery for Premature Ejaculation may include dorsal neurectomy or penile nerve blockage.

The goal is to lessen penile sensitivity, which might cause a delay in ejaculation.

Other surgical remedies for Premature Ejaculation worth considering include operations like 

• Glans augmentation
• Pulsed Radio Frequency Neuromodulation
• Varicocelectomy

Surgery is only considered if no other course of treatment is effective. 

Going over the advantages and disadvantages in detail with a urologist is crucial.

Therapy

In addition to prescription medications, a doctor may suggest couples therapy or counseling. 

A combination of both might be a better solution for PE.

When psychological factors are contributing to the problem, sex therapy may be useful.

A sex therapist can provide a detailed sexual and psychosocial assessment to identify any psychological issues or relationship conflicts that may be influencing the condition.

The therapist may recommend techniques, communication strategies, and exercises to help the individual or couple gain more control over ejaculation and improve sexual satisfaction.

These may include strategies to reduce performance anxiety, enhance self-esteem, and improve communication and intimacy within the relationship.

Techniques

Individuals can help train their bodies away from PE at home by using natural methods like:

• Squeeze method: In this method, the penis is stimulated until the individual is close to ejaculation, and then the penis is firmly squeezed, causing the erection to go away partly. The goal is to become familiar with the sensations leading to climax
  
• Stop-start method: This method involves stimulating the penis until just before ejaculation and then stopping the stimulation until the urge to climax subsides. As control is regained, the penis is stimulated again. This is repeated three times to ejaculate on the fourth time. The method is repeated three times a week until more control is gained

Preventing Premature Ejaculation

A healthy lifestyle may help to avoid PE.

Home remedies such as exercise and diet can improve the overall sexual health of an individual.

Exercises

To improve control over PE, various exercises can be helpful. 

Some proven exercises include kegel exercises like back squeeze, the side squeeze method, and chair squeezes.

Kegel exercises can help strengthen the pelvic floor muscles, which are essential for improving ejaculatory control and preventing PE.

Yoga and meditation can be helpful home remedies for PE as they can help reduce anxiety, increase relaxation, and improve mindfulness during sexual encounters.

Regularly practicing these exercises may help delay ejaculation and improve sexual performance.

Diet change

Making diet changes can be an effective way to manage Premature Ejaculation (PE). 

Maintain a well-balanced diet that includes fruits, vegetables, whole grains, lean proteins, and healthy fats.

As low libido can be present along with PE in some cases, eating foods that help improve sex drive and sensation is recommended.

These include cucumber, pineapple, peach, eggplant, watermelon, pomegranate, and garlic.

Some dietary adjustments that can help include:

• Reducing junk food intake
• Increasing vitamin-rich foods
• Limiting alcohol, tobacco, and energy drinks
• Incorporating a balanced diet

In addition to dietary changes, it’s essential to maintain a healthy lifestyle by incorporating regular physical activity, managing stress, and getting adequate sleep.

Conclusion

Premature Ejaculation (PE) affects one in three men in the US, causing distress and impacting relationships. 

Understanding the psychological and biological factors contributing to PE is crucial, with medical conditions, psychological stressors, and biological imbalances playing significant roles.

Treatment options range from prescription medications and topical products to surgical interventions and therapy. 

Additionally, incorporating certain techniques, exercises, and lifestyle changes can contribute to better ejaculatory control.

By addressing PE comprehensively, individuals can regain sexual confidence and enhance overall intimacy, underscoring the importance of seeking professional help for a satisfying sexual life.

Frequently Asked Questions