What is Premature Ejaculation?
Premature ejaculation is defined when a man finds it difficult to control his ejaculation and ejaculates too quickly during sexual intercourse. This can cause feelings of anxiety and distress. It is one of the most common male sexual disorders affecting men aged between 18-64.
Some men may sometimes experience premature ejaculation, however international guidelines define premature ejaculation as an intravaginal ejaculation latency time (IELT) of under two minutes, a history of over 6 months of premature ejaculation and feelings of anxiety and distress as a result.
There is still a stigma surrounding PE, similar to other types of erectile dysfunctions and many men still find it uncomfortable speaking to a doctor, but it should not be something you should feel embarrassed about. Around 1 in 3 men experience PE at some point in their life and studies reveal that although PE causes reduced sexual satisfaction, many women reported that it did not impact their overall relationship.
Although there is limited evidence to identify the cause of premature ejaculation, there is some evidence to suggest that men with this condition have an altered sensitivity of the serotonin receptors involved in ejaculation.
Possible causes include:
- Thyroid problems (overactive or underactive thyroid gland)
- Use of recreational drugs
- Prostate problems
- Relationship problems
- Anxiety about sexual performance
This is when a man has suffered from PE from the first sexual encounter and may be attributed to physical or psychological factors. These include:
- Conditioning – when early sexual experiences will influence your sexual behaviour later in life.
- Strict upbringing and belief about sex.
- Traumatic sexual experience from childhood.
- Biological causes – abnormal hormone levels or inherited traits.
This is when PE gradually or suddenly occurs when the man has previously gone years without suffering from ejaculation issues. This could be due to health problems such diabetes, high or psychological factors like stress, anxiety or stress.
Is it permanent?
The good news is that PE is a treatable condition and is not permanent. It might be longer lasting with men who have primary PE and have suffered with the problem since they first became sexually active. With the correct training and medical treatments, men suffering with primary ejaculation will still have a good chance of improving their condition.
It might be harder to manage if you suffer from diabetes or multiple sclerosis but it is important to speak to your doctor or pharmacist about what the best course of action is for you.
PE may be common in men starting a new relationship or experimenting with a new type of sexual activity but over stimulation and over excitement is common and is PE may occur, but that does not mean it is likely to be a permanent issue.
How is Premature Ejaculation Treated?
Historically, a group of medications used to treat depression that selectively target the serotonin reuptake inhibitors, such as paroxetine, demonstrated the ability to delay ejaculation as a side effect and have since been used as an “off label” solution to safely and effectively treat premature ejaculation. However, the dose for treating premature ejaculation is lower than that used for treating patients with depression. These SSRIs are generally well tolerated with common side effects including dry mouth, fatigue, nausea, headaches and dizziness but are slow acting as it can take up to 2 weeks to see results on delaying ejaculation.
Priligy is the first drug specifically licensed to treat premature ejaculation. It contains the active ingredient Dapoxetine which is also a selective serotonin reuptake inhibitor and works by influencing the amount of serotonin that reaches the brain. Increasing the levels of serotonin will in turn delay ejaculation. It is shorter acting and can be used as an on-demand treatment when taken 1 to 3 hours before sexual intercourse. It is also rapidly eliminated from the body, with a half-life of less than one and half hours. In clinical studies, IELT time improved 2 to 3-fold after taking Dapoxetine 30mg or 60mg compared to the placebo study. Priligy works in approximately 8 out of 10 men where men noticed a better control of ejaculation and were overall more satisfied with their sexual performance.
However, not all men are suitable to take Priligy. It is only advised for men who ejaculate in less than two minutes and have been experiencing this for a minimum of 6 months. Men suffering from heart disease, kidney or liver problems are not recommended to take Priligy. It can also interact with other medication and cause serious side effects but your doctor will be aware of which medicines this applies to.