Premature ejaculation (PE) is a sexual dysfunction which occurs when a man ejaculates sooner than expected during sexual intercourse. It occurs in men who cannot naturally control their ejaculation and cannot last longer than 2 minutes during sex.
Many men still find it uncomfortable speaking to a doctor about PE and other types of sexual dysfunction. However, it shouldn’t be something to feel embarrassed about, as 1 in 3 men experience PE at some point in their life. Studies reveal that although PE reduced sexual satisfaction, many women reported that it did not impact their overall relationship.
Causes of PE
Whilst the exact cause of PE is unknown, it is thought to involve various physical and psychological factors.
- High blood pressure
- Thyroid issues
- Use of recreational drugs
- Excessive alcohol intake
- Relationship issues
- Anxiety – typically about sexual performance
Types of PE
There are two main types of PE:
Primary PE – This is where PE has always been an issue since the first sexual experience. Primary PE may occur when early sexual experiences influence behaviour later on in life, or if your culture and upbringing is strict about sex.
Secondary PE – Also known as acquired premature ejaculation, this is when PE has developed after previously never encountering ejaculatory problems. This could be because of physical causes or the stress and anxiety relating to a new relationship forming.
- Ejaculation happens with little control or with little stimulation.
- Reduced sexual pleasure because of the lack of control over the ejaculation.
- Feelings of embarrassment, frustration and guilt.
How to treat PE
Priligy has been specifically designed to help treat PE. It belongs to a group of medicines called ‘selective serotonin reuptake inhibitors’. The active ingredient, dapoxetine increases the activity of the neurotransmitter serotonin in the nervous system to delay ejaculation. Serotonin passes messages between the nerve cells resulting in ejaculation so by increasing the amount of serotonin that reaches the brain will hence delay ejaculation and may help to improve the control over the ejaculation as well.
Not all men are suitable to use Priligy, in particular men suffering from liver, kidney or heart problems and it should not be used in conjunction with antidepressants.
Stop-start technique: This is when a man has the urge to ejaculate through sex or sexual stimulation, then allows the feeling to subside, then starts again. This is repeated several times until you are able to build control during sex without stopping.
Squeeze method: The penis is stimulated until the urge of ejaculation, then stops and squeeze the head of the penis until the sensation lessens. Over time you should recognise the impulse and be able to control it without squeezing.
Topical anaesthetics and condoms
Topical anaesthetics such as prilocaine and lidocaine are effective as they desensitise the penis. Usually, it is applied 30 minutes before planning to have sex and washed off before you have sex once the feeling in the penis has decreased. If it is left on, it may reduce the sensation for your partner as well.
Condoms are also effective, especially thicker ones to reduce the sensitivity during sex.
As discussed, PE can be caused by psychological factors including depression, stress and anxiety. PE can lower your self-confidence making you feel frustrated about your sexual performance and often feel reluctant about starting new relationships. Your partner may suffer in silence as they fear they may upset or offend you. In this case, it is important to talk to a specialist and seek help. Couples therapy may be beneficial if the root cause of your PE is relationship problems.