What is premature ejaculation? everything you need to know

Premature ejaculation is a situation that happens to a large section of men. Here, the semen leaves the body before the time when engaged in intercourse. Around 30-40% men in India report experiencing premature ejaculation. Some common causes of premature ejaculation are hormonal imbalance, physical issues, and emotional and psychological factors.

It's nothing serious. However, if it happens all the time then it's time to seek medical help.

If a person has frequent premature ejaculations or if premature ejaculation is causing anxiety or depression and is affecting their relationship, they should seek an appointment to see a urologist.

• The person ejaculates within 1-3 minutes right after penetration.
• If the person fails to delay ejaculation all the time or during intercourse.
• If the recurring premature ejaculation makes the individual struggle emotionally leading to avoiding intercourse.

Well, premature ejaculation is treatable. Methods such as -

• Consumption of medication.
• Counselling.
• A specific technique that delays ejaculation.

Are typically implemented to help.   

Premature Ejaculation Causes

Men experiencing physical, emotional, and psychological issues, suffer from premature ejaculation. 

Here are some physical and hormonal causes to help understand the condition better-

• A sensitive penis.
• Low release of serotonin and dopamine levels.
• Low release of oxytocin.
• An underlying erectile dysfunction.

Here are some emotional and psychological causes to help understand the condition better-

• Stress.
• Depression.
• Relationship problems.
• Performance anxiety.

Premature Ejaculation Symptoms

The common symptom is when the person is unable to delay the ejaculation after 1-3 minutes of penetration. This might be the case in every sexual situation, including masturbation. 

Premature ejaculation is classified as

• Acquired -

It’s a condition that develops after multiple intercourse sessions. Here the man didn’t experience premature ejaculation at the beginning of his sexual life. Rather, it develops over time. 

• Lifelong - Lifelong premature ejaculation begins when a person first becomes sexually active.

Premature ejaculation Diagnosis

Many men believe that they are suffering from premature ejaculation. However, the symptoms typically don't match the diagnosis criteria. Here are the questions typically asked by sexologist/urologist to determine if the patient is struggling with premature ejaculation-

• How long has the patient been struggling with the issue?
• What are the circumstances?
• What is the frequency of premature ejaculation?
• Is it common with all the partners?
• Does premature ejaculation occur at every sexual attempt?
• Does the patient struggle with maintaining an erection?
• Does the patient struggle with premature ejaculation when masturbating?

While the questions are personal, it’s important to answer honestly so doctors can best diagnose the source of the problem.

The patient will also be asked about other medicines and supplements. Alcohol and drug use should also be mentioned to the sexologists. 

Also Read  : Vitamin E Foods And Benefits

Premature Ejaculation Treatment

There are many different treatment options for premature ejaculation depending on the cause.

The most common treatments are-

• Behavioural therapy.
• Medication.
• Counselling.

Most causes of premature ejaculation are usually treated first with behavioral therapy and/or counseling to help with emotional concerns, performance anxiety or stressors that may be contributing. 

Behavioral Treatment-

Behavioral therapy involves trying different practical methods to delay your orgasm. The goal is to teach you how to control your body and your feelings. Methods include:

• Start and Stop- 

Here the patient and the partner are involved in a 30-second penis stimulation process. This continues until the patient gains control of the response. The Start and Stop process should be continued 3-4 times, before allowing the patient to ejaculate. 

• Squeeze Therapy-

Here the patient/ the partner squeezes the head of the penis to lose erection. Again the process should be 30 seconds. The process needs to be repeated 3-4 times before allowing ejaculation.

• Distracted Thinking-

The patient will be pushed to be distracted by non-sexual objects from around while being sexually stimulated.

• Counselling

Counselling can only help patients with premature ejaculation when-

• The person is struggling with relationship issues.
• The person is suffering from anxiety, depression, stress, and guilt.
• The person is suffering from performance anxiety.

If the cause of premature ejaculation is psychological, emotional or due to relationship issues — like performance anxiety, depression, stress, guilt or a troubled relationship — seek the help of a psychologist, psychiatrist or sex therapist. A urologist can help direct the patient to these health professionals.

Medicines To Help With Premature Ejaculation

Medicines to help patients with premature ejaculation are-

• Antidepressant.
• Anaesthetic.
• Erectile dysfunction medicines.

Don't ever reach out to over-the-counter medicine to treat your premature ejaculation. Consult a doctor and learn about the condition for better treatment.

Kegel Exercises for Premature Ejaculation

Kegel or pelvic exercises are notable in treating premature ejaculation. It is in fact considered the immediate treatment. 

Weak pelvic floor muscles might make it harder to delay ejaculation. Pelvic floor exercises (Kegel exercises) can help strengthen these muscles.

How to do Kegel exercises

Before you start your Kegel exercises, make sure to urinate so your bladder is empty. Remember, do not do Kegel exercises while you have a Foley catheter in place.

When you’re ready, follow these steps:

Start by holding your pelvic floor muscles in for 5 seconds. To do this, think of pulling in and lifting up your genitals.

Do not hold your breath while you do this. Counting out loud can stop you from holding your breath.

After holding for 5 seconds, slowly and completely relax your muscles for 5 seconds.

Repeat this process 10 times, at least 3 times every day.

Your pelvic floor muscles may get tired during this exercise. If this happens, stop and do the exercise later.

Do not use your stomach, leg, or buttock muscles when doing this exercise. Exercising these muscles will not help you get back urinary control or improve your sexual health.

As you continue to practice these exercises, increase the time you hold and rest your pelvic floor muscles. Start with 5 seconds, and slowly build up the time each week. Do this until you’re holding in and resting for 10 seconds.

When to see a doctor?

It's advisable to visit a Sexologist when the patient is struggling with premature ejaculation very often. Many find it very embarrassing to talk. However, early diagnosis and proper treatment can help cure the situation.  

References:

1. Marissa Crowdis; Stephen W. Leslie; Saad Nazir.Premature Ejaculation; In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; [updated 2023 May 30]; [cited 2024 Aug 30]; Available from: https://www.ncbi.nlm.nih.gov/books/NBK546701/
2. Boston University School of Medicine - Sexual Medicine [Internet] ; Ejaculation Problems: Too Fast, Too Slow or Not at All?; [cited 2024 Aug 30]; Available from: https://www.bumc.bu.edu/sexualmedicine/informationsessions/ejaculation-problems-too-fast-too-slow-or-not-at-all/
3. Medscape [Internet]:Premature Ejaculation; [updated 2023 May 19][cited 2024 Aug 30]; Available from: https://emedicine.medscape.com/article/435884-overview?form=fpf/
4. MSD Manual [Internet] ; Premature Ejaculation;[updated 2023 July] [cited 2024 Aug 30];Available from : https://www.msdmanuals.com/home/quick-facts-men-s-health-issues/sexual-dysfunction-in-men/premature-ejaculation.

Disclaimer: The content provided in this article is intended solely for educational purposes and should not be considered a replacement for professional medical treatment. Given the distinct needs of each individual, it is advisable for the reader to seek guidance from their healthcare provider to assess the relevance of the information to their specific circumstances.