Premature ejaculation, also referred to as early or rapid ejaculation, is defined by the International Society for Sexual Medicine (ISSM) as a male sexual dysfunction characterized by ejaculation which always or nearly always occurs prior to or within about one minute of penetration, and the inability to delay ejaculation on all or nearly all penetrations.
It often causes significant anxiety and frustration for the couple and can lead to avoidance of sexual intimacy.
Premature ejaculation (PE) is one of the most common forms of sexual dysfunction, affecting as many as 1 in 4 adult men, according to a survey conducted by Canadian Male Sexual Health Council.
Many experts believe that PE is probably under-diagnosed as many men find it difficult to openly discuss it with their care providers.
Premature ejaculation is categorized into either Lifelong PE or Acquired PE.
Patients with lifelong PE could never achieve a normal ejaculatory experience, often ejaculating in less than 1 minute.
In the case of acquired PE, there is usually a contributory factor such as performance anxiety that causes rapid ejaculation in otherwise healthy individuals. Patients with acquired PE may experience an ejaculatory time of less than 3 minutes.
While premature ejaculation is more common in younger men, it can happen at any age.
Having an orgasm too soon is not always cause for concern. However, clinical diagnosis is made when a man exhibits the following symptoms:
Both psychological and biological factors can play a role in premature ejaculation. Although many men feel embarrassed talking about it, premature ejaculation is a common and treatable condition.
Premature ejaculation can cause problems in a man’s personal life, including:
Premature ejaculation treatment explained by Dr. Pollock
The exact cause of premature ejaculation is still uncertain however, many believe that Lifelong PE is believed to be a result of penile hypersensitivity, while acquired PE is often caused by a complex neurochemical and psychological disturbance.
In addition, there are some speculations that PE may also be affected by genetic, ethnic, and cultural factors for which further scientific evidence is required.
Premature ejaculation involves a complex interaction of psychological and biological factors.
Psychological factors that might play a role include:
A number of biological factors might contribute to premature ejaculation, including:
An individualized treatment plan will be determined for each patient after a thorough medical examination and consultation and with consideration of the patient’s goals, values and preferences. Options include:
In addition to the above there are a variety of other pharmacological and non-pharmacological treatment options for premature ejaculation.
Traditionally, a topical anesthetic combination applied to penis can be used to treat PE by reducing penile sensitivity; however, the side effects such as genital numbness and irritation for the patient and his partner can be quite bothersome if the topical medication is not applied and administered properly.
Oral medications such as Selective Serotonin Reuptake Inhibitors (SSRIs) which are used to treat depression and anxiety have been shown effective in prolonging the ejaculatory time. Some experts also suggest a trial of Phosphodiesterase-5 inhibitors to help with PE especially in men who also suffer from erectile dysfunction. Other medications have also been suggested but may in some people be associated with a more significant side effect profile.
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