Unfashionably early: Talking about premature ejaculation

Nobody likes being the first person at a party. The same can be said of ejaculation, especially when your partner hasn’t even had the time to RSVP. It’s a common problem and there are many ways to work on your personal best in the bedroom. Take some time to read this article and ‘bone up’ on the basics. Your study will pay off – when it’s time to get off.

What’s the frequency, Kenneth?

Premature ejaculation can be hard to define, but it generally refers to a man’s inability to control ejaculation shortly after penetration occurs. So if you’ve just rocked up to the party and peaked too soon – let’s say, under two minutes – then you may feel it’s time to work on your staying power.

You may never have had a problem with control before – this is known as secondary or ‘aquired’ premature ejaculation. Or perhaps you have experienced premature ejaculation as a lifelong difficulty, which is primary premature ejaculation.

In either case, it’s actually the most common form of sexual dysfunction for men. Don’t worry, you’re not alone.

Premature ejaculation can also happen before penetration. We know that this can be frustrating and yes, embarrassing at times, but there are definitely things you can do about it. So don’t hide your head in the sand because how we feel about our sex lives plays an important part in our whole lives.

Why me?

Lifelong premature ejaculation is now thought to be an inheritable neurological condition, so it may run in the family, whereas acquired premature ejaculation may be related to conditions like urethritis, prostatitis, hyperthyroidism, erectile dysfunction and obesity.

Also, emotional and psychological factors play a huge part in your man parts. Sometimes stress, self-esteem and relationship problems will contribute to early bursts below the belt. If your partner experiences sexual dysfunction, this may also contribute to your own, although, causes can be very complex.

We do know, however, that experiencing this creates more stress which in turn worsens the problem, especially within a relationship, which is why it’s so important to talk to a professional about it.

When the ref gives you the red card

Premature ejaculation might mean you’re out of the game at the time, but it certainly doesn’t mean that you can’t get back in with some off-season training. While so-called lifelong premature ejaculation cannot be cured, it can be managed with psychoeducational and/or pharmacological treatment in the majority of cases – meaning you’ll most likely be much better off if you go in for some treatment.

Acquired premature ejaculation can be treated by treating the underlying causes. For example, if a man has erectile dysfunction and ejaculates prematurely to compensate for his inability to maintain an erection, treating erectile dysfunction may also treat the premature ejaculation.

Getting help

Going to the doctor is the first place to start. You just need to tell your doc about what you’re experiencing when you’re getting busy. Your doc may have a quick look around downstairs just to check for any STIs in case that’s a factor. But apart from that, it’s not difficult at all.

Lifelong premature ejaculation

The ‘no-meds’ approach

Behavioural therapy involves ‘training’ with your partner, using a kind of stop-start technique, depending on your level of arousal. It has been used for 50 years but there is no strong evidence that it is a ‘cure’.

Condoms can also be used to reduce the sensation in your penis. Topical anaesthetics work in the same way, but be careful because in some cases, they can cause erectile dysfunction as a result of reduced sensation.

Physiotherapy, particularly pelvic floor exercises, has been used in clinical practice, but there is a lack of scientific evidence regarding its effectiveness in delaying ejaculation.

Sometimes the best medicine is talking it out. Many men with premature ejaculation also have associated psychological problems. This can be used in combination with other therapies and is considered a great way to work through issues of self esteem and sexual anxiety.

The harder stuff

There are medications that can successfully treat early climax, such as tricyclic antidepressants. These have been proven effective in delaying ejaculation, although the side effects may in turn inhibit sexual function, so it’s important to know the risks as well as the benefits. This medication can be administered either daily or just before sexual activity.

There’s also selective serotonin reuptake inhibitors (SSRIs). However, the slow onset of their effect means that daily doses are necessary, rather than on-demand doses just before sexual activity. In addition, SSRIs can reduce libido and inhibit orgasm.

Phosphodiesterase (PDE-5) inhibitors are the most common treatment for erectile dysfunction, and have also been used in the treatment of premature ejaculation.

Talk to your doctor about which may be the best option for you.

Acquired premature ejaculation

For men suffering prostatitis and urethritis, your doctor will easily hook you up with antibiotics. For those with erectile dysfunction, your doctor will probably prescribe a PDE-5 inhibitor that best suits your particular circumstances.

In some cases stress or difficulties in a relationship may cause, rather than be caused by, premature ejaculation. In such cases, couples should receive counselling and/or sex therapy.

If you experience premature ejaculation, but only from time to time, meds are not recommended. The best thing to do is talk to your doctor or therapist about what and when this is happening, and you may find a specific underlying cause.

Some men think their ejaculation time to be too short when in reality it is in the normal range. This is actually a problem in itself, and your doctor will let you know what is considered ‘too short’ if you are unsure. It’s also best to talk to a counsellor about this.

If you are frustrated with premature ejaculation, don’t stew in silence. Speak up to keep it up!