Premature ejaculation (PE) is the most common ailment among numerous ejaculatory problems that may affect men of all ages. Each can have a detrimental impact on psychological health; invoking feelings of anxiety, depression, and guilt. According to a study in The Journal of Sexual Medicine (2006), up to 30% of men have suffered from ejaculatory disorders at some point in their life.
In many cases, it is a relatively benign symptom, related to new sexual experiences, inexperience or unique and isolated incidents. However, when a man frequently ejaculates “too soon”—often ascribed to a 50% rule—it becomes a sexual disorder. Again, this “too soon” is a culturally and subjectively defined time range, spanning anywhere from 30 seconds to 4 minutes. Numerous causes and factors influence PE—from psychological to physical—each with its own potential treatment and remedy.
The causes of premature ejaculation span physical influences, such as prostate, thyroid and drug and alcohol abuse, to the psychological, involving stress, relationship problems, anxiety, and depression. More serious and deep reaching causes of premature ejaculation may include sexual conditioning, biological sensitivity and traumatic sexual experiences which have been implanted since childhood. Isolating this cause is fundamental to overcoming the disorder. It is advised that one seeks professional medical or psychological help if their sexual disorder has negatively impacted the individual’s mental well-being. Otherwise, there is a range of home treatments, over-the-counter medicines, supplements and techniques that may prolong ejaculation and make one “last longer” in bed.
Some of the most commonly successful treatments include quite simple adjustments to your sexual behaviour; taking breaks, masturbating before sex, using thicker condoms, topical anaesthetic condoms, stop-and-start methods, yoga and breathing techniques may all prolong intercourse. Of these methods, the “pause-squeeze” technique has been popularly espoused by both long-term sufferers and doctors alike. Here, the patient and partner are encouraged to begin sexual activity as normal. When ready to ejaculate, the partner should squeeze the tip of the penis for several seconds, until the urge to ejaculate has subsided. This can be repeated throughout sexual activity, working as a conditioning and therapeutic method that may exponentially extend the ejaculation time.
Medically, selective serotonin re-uptake inhibitors (SSRIs), commonly referred to as antidepressants, are treatments commonly prescribed by professionals for their capacity to delay ejaculation; paroxetine, sertraline, and fluoxetine all have proven track records in positively improving symptoms. Before taking any SSRI, one should be made aware of potential side effects, which range from fatigue and tiredness, nausea and feeling sick, diarrhoea and excessive sweating, among others.
A new SSRI has been designed specifically to treat premature ejaculation. Dapoxetine is licensed in the UK as Priligy, an “on demand” tablet prescribed by the NHS which can immediately tackle PE. It should not be taken more than once a day, with your recovery tracked by an NHS professional so as to alleviate any potentially harmful side effects. Other than these prescription drugs, many over-the-counter herbal supplements have anecdotal success rates; look out for L-Arginine, St. John’s Wort, Saw Palmetto and other branded multivitamins aimed at improving male reproductive potency.
Whatever technique or product is chosen, it is important that partners are understanding, encouraging and patient, so as to remove any anxiety that may exacerbate the problem.