Tuesday, January 16, 2018

Premature ejaculation


Mark Fraser

Premature ejaculation occurs when a man ejaculates sooner during sexual intercourse than he or his partner would like. It can occur with a new partner, only in certain sexual situations, or if it has been a long time since the last ejaculation. For some men it could be because of a medical problem. According to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV), premature ejaculation is “persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it.

This is the most frequently encountered sexual complaint of men and couples and estimates are that it occurs in roughly 30 per cent of all men. This may come as a surprise for many men, but it is a common and treatable condition. It is most common in adolescents, young adults, and men who don’t have a lot of sexual knowledge about normal male and female sexual response and/or a lack of sexual experience. Occasional premature ejaculation is actually considered normal. One report states the normal average time from beginning to the end of intercourse is roughly five minutes.

The physical problem associated with premature ejaculation relates mainly to “over-sensitivity” of the penis with the psychological aspect usually leading to “performance anxiety”. In some cases, men may actually avoid sex because they fear not satisfying their partner. This can cause further difficulties in the relationship or make it difficult to find a partner.

If you have problems with erectile dysfunction, this could cause premature ejaculation. Research also shows a significant association between premature ejaculation and cardiovascular disease. Premature ejaculation has also been found to be common in diabetic patients.

Treatment options for premature ejaculation include counselling, oral medications, topical anaesthetics and behavioural therapy. The pause squeeze technique is one form of behavioural therapy that has proven to be effective in treating premature ejaculation and requires you and your partner to discuss the technique prior to attempting. For more information on the pause-squeeze technique, send a blank e-mail to ps@brachy4u.ca

In 1943, the use of local anaesthetics was first introduced. This was found to be very attractive because you could use them on an “as needed” basis and reports state they worked quite well. Lignocaine spray, marketed as Stud 100 or Premjact, has been available on the market for years, and available for purchase over the counter. Promescent is another type of topical spray medication on the market that is applied ten minutes before sexual activity. Local anaesthetics help manage the sensations of sex through desensitisation.

Kegel exercises, (previous article) are also helpful in strengthening the muscles of the pelvic floor. Strengthening what they call your pubococcygeus (pronounced “pew-boh-cox-e-g-us”) muscle can help control ejaculation. For more info on Kegel exercises, send a blank e-mail to kegel@brachy4u.ca

There are also some medications called “selective serotonin reuptake inhibitors” (SSRIs), a class of antidepressants, that has shown effectiveness in premature ejaculation. Please note that like other medications, you should be aware of the potential side effects related to taking these medications. Speak with your doctor regarding what is right for your situation.

Sometimes a man’s issues with premature ejaculation are clearly psychological. This can have a major impact on his emotional well-being. It is very common for some men to feel insecure, disappointed, frustrated, embarrassed, or even ashamed because of premature ejaculation. This can affect their relationship and is why sex therapy and counselling is a crucial part of treatment for premature ejaculation.