Premature Ejaculation (PE) occurs when a man comes (ejaculates) more quickly than he and/or his partner would like. It can mean ejaculating soon after his penis enters his partner or even sometimes before.
PE is the most common sexual problem in men but its cause is not well understood. The average length of time a man takes to ejaculate during sex is 5 minutes, but this takes into account those with significantly longer and shorter ejaculation times than this.
It affects roughly 30% of the population worldwide. PE can be very distressing for those who have it and their partner. It can result is less enjoyment of orgasm and difficulties in becoming aroused in some cases. Sometimes it can cause difficulties in a relationship.
Despite being so common many men delay in seeking help due to embarrassment or not being sure where to get help.
There are many factors that can cause premature ejaculation:
PE can be organised into 2 distinct groups. Those who have experienced PE since the beginning of the sexual life (Lifelong or Primary PE) or those who have suddenly developed symptoms after normal sexual functioning (Secondary or Acquired PE).
Treatment of PE can vary depending on the type and presentation. It can require behavioural techniques to be learnt, such as the stop-start technique. These techniques can be used to avoid use of medication, which in some cases may need to be used lifelong. There are medications which may also help.
Stop/Start Technique
This technique should also be practiced during masturbation initially to get the hang of it. You need to be able to identify the point just before orgasm becomes inevitable. At this point you would stop the stimulation/sex and wait for 30 seconds- 2mins for your level of excitation to reduce a little before resuming stimulation/sex. This requires practice before trying it with your partner.
Emla Cream
Emla cream is a topical anaesthetic cream, which contains Lidocaine and Prilocaine, that reduces the sensitivity of the penis when applied to the glans (head of the penis). It should be applied 20 minutes before sexual activity. It is advised to be used with condoms, so it doesn’t affect your partner and washed off after sex. You can also buy condoms with local anaesthetic eg “Performa”.
Priligy (Dapoxetine)
Priligy is a short-acting SSRI (Selective Serotonin Reuptake Inhibitor), which is the only licensed medication to treat PE. It is taken 30 minutes before sexual activity and may be very effective in prolonging the time until ejaculation occurs.
Other S.S.R.I medication
S.S.R.I. medication is a type of antidepressant, which may have the helpful side effect of delaying ejaculation. They can be taken daily for the most effective treatment or an hour before sexual activity, if a daily dose results in unwanted side effects. There are several drugs in this group but the most common ones prescribed are Paroxetine, Sertraline and Fluoxetine. You may need to take this type of medication for at least 3 weeks before noticing any improvement. This medication only works if you continue to take it. Some people may experience unwanted side effects from these medications that prevents them from taking them longterm. Sometimes it requires a bit of trial and error to find the type of S.S.R.I. that suits.
Phosphodiesterase Inhibitors (PDE5I)
PDE5I medications include Viagra (Sildenafil), Cialis (Tadalafil) and Levitra (Vardenafil). They are a class of medications that are most often used to treat erectile dysfunction. Some people may experience erectile dysfunction as part of their sexual problem. These drugs can also be prescribed off-licence to help with P.E. management. They can also be used in combination with S.S.R.I. medication.
At your appointment you will be asked questions about your symptoms, how it is affecting you and your relationship. Sometimes blood tests are done to exclude medical causes e.g. thyroid disease.
You may also be asked if you can be examined to exclude any physical causes. You may require several appointments to help with this problem.
If you are unsure if I can help with a problem you are experiencing please email me at: enquiries@spg.scot to discuss further.