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Sexual Health

Premature Ejaculation (PE): Symptoms, Causes, Treatments & More

Slow and steady wins the race, even in bed. Unfortunately, men with premature ejaculation (PE) go too fast against their own will. Read on to learn more about PE.

Remember the proverb, “slow and steady wins the race”? Whether or not you actually heed this advice in your daily life, I’m sure you’ll agree that this proverb holds potent truth in bed. Indeed, coming too fast in bed often ruins the mood and can be extremely distressing for both you and your partner.

With 1 in every 3 men aged between 18 and 59 years old experiencing premature ejaculation (PE) at some point, PE is more common than you think.  

What is premature ejaculation (PE)?

Premature ejaculation occurs when:

  1. A man orgasms and ejaculates sooner than he or his partner would like.
  2. A man orgasms with very little stimulation.

How soon is too soon?

There is no clearly defined time period of what constitutes PE. The time frame can vary across individuals, depending on what he or his partner constitutes as “too soon”. International guidelines often cite that a man has PE if he ejaculates within 1 minute of entering your partner. Once again, this isn’t a hard-line definition, and it really depends on you and your partners’ preferences and feelings. 

What if it happens only occasionally?

It’s okay to have some disappointing nights, you can’t always have it all. However, if the problem occurs almost every time for more than 6 months and causes you significant distress, then you may have PE. 

Types of premature ejaculation

Also, did you know that not every PE is the same? Here, we break down the 2 different types of PE for you.

  • Lifelong PE (primary PE): These men have been experiencing PE ever since their first sexual encounter. 
  • Acquired PE (secondary PE): These men have previously had normal ejaculations, but later developed PE.

Lifelong PE is often caused by psychological factors, whereas acquired PE can be caused by a mixture of both psychological and biological factors. Moving on, let’s explore the different reasons for PE. 

Causes of premature ejaculation

PE may be due to psychological factors or physical factors, or a mixture of both. It’s good to know the common causes of PE so that you can identify which ones have led to your PE. 

Psychological factors

Anxiety is one of the leading factors of PE. This usually comes in the form of performance anxiety, where a man is concerned about his sexual performance. However, anxiety and stress about other aspects of life, such as work or relationship problems, can also play a part in PE. Other psychological factors that cause PE include depression, guilt, low self-confidence and unrealistic expectations about sex. 

Think back about your teenage years. If you recall masturbating hurriedly for fear of getting caught by your parents or others, that might have caused a lasting effect and led to your PE today. Besides that, traumatic sexual experiences at a young age or strict upbringing that frowns upon sex as shameful can lead to PE. 

Biological factors

Ever heard of serotonin, the happy hormone? Not only does serotonin boost your mood, but it is also the controller of your sexual desires and erection. The higher the serotonin levels in your brain, the longer it takes for you to ejaculate, allowing more satisfactory and happier sex. However, when serotonin levels are low, the time to ejaculation is shortened, causing PE. Not so happy anymore.

Besides serotonin imbalance, other medical conditions can also lead to PE. These include erectile dysfunction (ED), diabetes, an overactive thyroid and some prostate-related conditions. Genetics or simply an overly sensitive penis may even be at blame. 

Medical treatment for premature ejaculation

Oral medication

A common way to treat PE is using selective serotonin reuptake inhibitors (SSRIs). This is a class of drugs that increases the level of serotonin, hence prolonging the time it takes to ejaculate. They may also help increase your sense of control over ejaculation. If deemed medically appropriate, Arx can prescribe you an SSRI medication known as Priligy®, which contains dapoxetine. 

In men who have both PE and erectile dysfunction (ED), ED pills can help. These include sildenafil (Viagra®), also known as the blue pill, as well as avanafil (Spedra®) and tadalafil (Cialis®). These pills improve blood flow to the penis, which is necessary for an erection. 

Not sure if you have ED? Check out our previous blog article to learn more about ED.

Sprays and creams

Some men may find that local anaesthetic sprays and creams help reduce penile sensation, increasing the time to ejaculation. These sprays or creams should be applied onto the head of the penis up to 30 minutes before sex. You should wash the spray or cream off your penis 5 to 10 minutes before sex or put on a condom to prevent absorption of the spray or cream by your partner. Otherwise, it may cause vaginal numbness in your partner during vaginal sex. The condom also helps reduce your penile sensation, ultimately prolonging your time to ejaculation. 

Other tips and tricks to combat premature ejaculation

There are several natural ways to combat premature ejaculation. These include behavioural therapy, psychological therapy, lifestyle changes and even switching up your sex positions and techniques. We’ll save those for the next blog post, so do keep a close lookout for it!

Our final tip to all men with PE is to talk to your partner and seek treatment. Keep in mind that PE does not only affect you, but it can also lead to frustration and feelings of hurt from your partner. This may, of course, be a difficult topic to approach. However, your partner can be a great pillar of emotional support, and an open discussion with your partner will help to pave the way for mutual understanding. 

Lastly, remember that PE can be easily treated. That’s fortunate, but it means nothing if you shun away from seeking treatment. We know that visiting the clinic for treatment can be embarrassing and daunting, and that’s where we step in to help you. At Arx, simply fill up a questionnaire to answer the awkward questions and connect with one of our doctors for a video consultation, all from the comfort and privacy of your own home. 

References

  • What are the DSM-5 diagnostic criteria for premature ejaculation (PE)? Latest Medical News, Clinical Trials, Guidelines – Today on Medscape. (2021, June 4). https://www.medscape.com/answers/435884-30677/what-are-the-dsm-5-diagnostic-criteria-for-premature-ejaculation-pe. 
  • Nazario, B. (2020, July 7). Premature Ejaculation: Symptoms, Causes, Treatment, & Prevention. WebMD. https://www.webmd.com/men/what-is-premature-ejaculation. 
  • NHS. (2019, July 24). Ejaculation problems. NHS Choices. https://www.nhs.uk/conditions/ejaculation-problems/. 
  • Premature Ejaculation. Premature Ejaculation: Causes & Treatment – Urology Care Foundation. (2020, July 16). https://www.urologyhealth.org/urology-a-z/p/premature-ejaculation. 
  • Lowy, M. (2018). Premature Ejaculation Fact Sheet. Healthy Male (Andrology Australia). 
  • Urology Care Foundation. (2020). Premature Ejaculation Patient Guide

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