Premature ejaculation

 

Many men will experience premature ejaculation (PE) at some time in their lives. When a man has PE often, this can sometimes affect his confidence and relationships. Most of the time, the root cause of PE is psychological but there are also physical factors at play. 

Many men feel shy discussing PE with their Doctor, so it’s difficult to estimate the number of men affected, but this is thought to be around 30 percent.

Experiencing PE from time to time is normal and nothing to worry about, but if it’s happening around half of the times you have sex, it may help to seek treatment.

What is premature ejaculation?

PE is when a man often reaches climax too soon than he and his partner would like him to during sex, affecting further intimacy. But it's important to note that there isn't a set time that intercourse is supposed to last. 

A study assessed 500 couples from five countries and found that, on average, sexual intercourse lasts around five and half minutes. Ultimately, it's the couple who decides what feels satisfying for them. 

What are the symptoms?

• A man reaches climax and ejaculates sooner than the couple expects

• Symptoms occur most of the time you have intercourse

A man may experience PE after several years without any symptoms. Some men develop PE over time. Some have PE from the first time they become sexually active, although this isn't very common. 

What are the causes?

The cause of premature ejaculation can be psychological or physical. This is why you should consider seeing your GP if you develop symptoms. Your Doctor will be able to exclude or diagnose the cause and advise you on treatment options that may be suitable for you.

Which psychological problems cause PE & how do they arise?

The most common psychological problems that can cause PE are anxiety and depression. Both conditions can often be managed well with talking therapy, prescription-only medicines, or a combination of both. Stress is another very common cause for PE. This can range from stress at work, to relationship problems to everyday stress.

Other reasons why a man can develop PE include:

  • Anxiety about performing well during intercourse. This is common during a new relationship or in a relationship where things aren't going well
  • Notions on sex and upbringing. If these beliefs are prohibitive and instil guilty and shameful thoughts, you may feel that you need to finish quickly. You may also have conditioned yourself to masturbate quickly to avoid getting caught as a teenager, leading to a sense of urgency around ejaculation
  • Past traumatic sexual experiences
  • Some men find their penis is extra sensitive, resulting in PE

Which medical conditions can cause PE?

Physical causes of PE can include:

  • Having an overactive or underactive thyroid
  • Having prostate problems
  • Alcohol and recreational drugs

If you're concerned about any of the above, consider making an appointment with your Doctor. Your Doctor will be able to take a full history, carry out a thorough examination, and arrange tests if required to exclude any underlying medical condition for your PE. Once you get the appropriate treatment, you'll usually see an improvement in PE symptoms.

When should I see my Doctor?

Make an appointment with your Doctor if:

  • You get PE most of the time you have intercourse
  • Your PE is causing distress or relationship problems
  • You're worried that something may be wrong

How can I treat my PE?

This is really depends on the cause. If the cause is physical, then treating the underlying condition should help resolve PE. If the cause of your PE is psychological, your doctor will be able to advise you on management techniques and may choose to refer you for counselling.

Here are some of the techniques they may recommend for self-management, which you can try at home:

  • Use thicker condoms to help with oversensitivity
  • Have sex or masturbate frequently. It's sometimes helpful masturbating a couple of hours before intercourse. PE is more likely if you leave longer periods of time between sexual activity
  • When you feel you're close to ejaculating, take a deep breath to delay climax. This is a natural reflex that can temporarily halt progression to ejaculation

You can also try therapy for couples or other techniques that require participation of both partners. These include the 'squeeze' technique and the 'stop-go' technique. Both procedures delay climax and help the man gain more control over when he ejaculates. Your Doctror pharmacist may also suggest medicines or anaesthetic sprays to help delay ejaculation.

Do I have PE or erectile dysfunction (ED)?

Erectile dysfunction (ED) is when it's difficult to achieve or maintain an erection. Like PE, it's also common during times of stress, particularly when a couple's relationship is tense. Some men may experience both PE and ED. In some instances, one may add to stress and anxiety, and trigger the other.

Next steps

  • Ask your Doctor for help if you think you have PE
  • Try some self-management techniques
  • Consider couples therapy if PE is creating strain in your relationship, or if you believe tension between you and your partner is causing PE