Premature ejaculation occurs when a man ejaculates sooner during sexual intercourse than they or their partner would like. As long as it happens infrequently, it's not cause for concern. However, if you regularly ejaculate sooner than you and your partner wish — such as before intercourse begins or shortly afterward it can be considered premature ejaculation.
Premature ejaculation is a common sexual complaint. Estimates vary, but as many as 1 out of 3 men may be affected by this problem at some time.
Both psychological and biological factors can play a role in premature ejaculation. Although many men feel embarrassed to talk about it, premature ejaculation is a common and treatable condition.
Medications, psychological counseling and sexual techniques that delay ejaculation can improve sex for you and your partner. For many men, a combination of treatments works best.
The primary sign of premature ejaculation is ejaculation that occurs before both partners wish, causing concern or stress. However, the problem may occur in all sexual situations, even including during masturbation.
Doctors generally classify premature ejaculation as either lifelong (primary) or acquired (secondary).
According to the International Society for Sexual Medicine, lifelong premature ejaculation is characterized by:
Secondary premature ejaculation is generally understood to share the same symptoms as lifelong premature ejaculation, but with one key difference:
When to see a doctor
For some men, however, a conversation with your doctor may actually reassure you that your occasional premature ejaculation is normal — or possibly not even premature. The average time from the beginning of intercourse to ejaculation is generally about five minutes.
The exact cause of premature ejaculation isn't known. While it was once thought to be only psychological, doctors now know premature ejaculation is more complicated and involves a complex interaction of both psychological and biological factors.
Other factors that can play a role in causing premature ejaculation include:
Rarely, premature ejaculation is caused by:
Various factors can increase your risk of premature ejaculation, including:
While premature ejaculation doesn't increase your risk of serious health problems, it can cause problems in your personal life, including:
Preparing for your appointment
You're likely to first talk with your family doctor or general practitioner about premature ejaculation, or you may be quickly referred to a urologist. Don't hesitate to bring up the topic with your doctor during a general checkup or a visit for other health concerns. Your doctor knows that a healthy sex life is very important to your well-being, and he or she may ask you about your satisfaction with your sex life before you even have a chance to bring it up.
It's normal to feel embarrassed when talking about sexual problems, but you can trust that your doctor has had similar conversations with many other men. Premature ejaculation is a very common — and treatable — condition.
Being ready to talk about premature ejaculation will help you get the treatment you need to get your sex life back on track. The information below should help you prepare to make the most of your appointment.
Information to write down in advance
Basic questions to ask your doctor
What to expect from your doctor
What you can do in the meantime
Tests and diagnosis
In addition to a detailed interview about your sex life, your doctor will want to know about your health history and may perform a general physical exam. He or she may refer you to a urologist who specializes in sexual dysfunction or to a mental health professional to help make the diagnosis.
If you have both premature ejaculation and trouble getting or maintaining an erection, your doctor may order blood tests to check your male hormone (testosterone) levels or other tests.
Treatments and drugs
Treatment options for premature ejaculation include sexual therapy, medications and psychotherapy. For many men, a combination of these treatments works best.
The squeeze technique
By repeating this as many times as necessary, you can reach the point of entering your partner without ejaculating. After a few practice sessions, the feeling of knowing how to delay ejaculation may become a habit that no longer requires the squeeze technique.
Antidepressants are not approved in the treatment of premature ejaculation. They work by taking advantage of a side effect common to these medications. Talk with your doctor about whether the risk and benefits are worth it in your case.
Topical anesthetic creams
Some men using topical anesthetic creams report reduced sexual pleasure because of lessened sensitivity. Although the cream is wiped off before intercourse, in some studies female partners reported that it also reduced their genital sensitivity and sexual pleasure. In rare cases lidocaine or prilocaine can cause an allergic reaction.
Cognitive behavioral therapy
Some people have tried yoga as one possible alternative treatment for premature ejaculation. More research is needed to evaluate how well it, or other alternative treatments, might work.
Coping and support
Many men who experience premature ejaculation feel frustrated and even ashamed. It may help you to know that this problem is common and often very treatable. Talk to your doctor if it's causing relationship problems for you or your partner.
While you explore treatment options, consider lifting the pressure off the sexual side of your relationship. Some doctors recommend avoiding intercourse entirely for a short time and sharing other forms of physical pleasure and affection instead. Connecting in this way can help you re-establish a satisfying physical bond with your partner.
Taking the emphasis off intercourse can remove the worry about ejaculating too soon — and it can help lay the foundation for a more fulfilling sexual relationship.
In some cases, premature ejaculation may be caused by poor communication between partners or a lack of understanding of the differences between male and female sexual functioning. Women typically require more-prolonged stimulation than men do to reach orgasm, and this difference can cause sexual resentment between partners and add pressure to sexual encounters. For many men, feeling pressure during sexual intercourse increases the risk of premature ejaculation.
Open communication between sexual partners, as well as a willingness to try a variety of approaches to help both partners feel satisfied, can help reduce conflict and performance anxiety. If you're not satisfied with your sexual relationship, talk with your partner about your concerns. Try to approach the topic in a loving way and to avoid blaming your partner for your dissatisfaction.
If you're not able to resolve sexual problems on your own, talk with your doctor. He or she may recommend seeing a therapist.
Last Updated: 2011-02-24
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