Premature ejaculation is the term used when you achieve orgasm very soon after putting your penis inside (penetrating) your partner or even before penetration. It can be caused by stress, inflammation of the prostate, nervous system disorders or it can be a side-effect of medicines. It can be helped by certain techniques used during sex, psychological treatments, creams or sprays that numb the penis and, very occasionally, surgery.
How common is premature ejaculation?
Many men do not seek help from their doctor for this problem so it is not known how common it is. Surveys that have been done suggest it affects about two out of ten men.
What causes premature ejaculation?
It is more likely to happen if you are young and in the early stages of a relationship, in which case it often gets better with time.
There is some evidence that psychological factors such as anxiety about sex or your feelings during your first sexual experience can contribute towards premature ejaculation.
Medicines of the dopaminergic group (eg, cabergoline), used for the treatment of illnesses such as Parkinson's disease, can cause premature ejaculation.
Premature ejaculation can be caused by drugs of addiction such as cocaine and amfetamine.
Persistent infection or inflammation of the prostate gland (chronic prostatitis) is known to be associated with premature ejaculation.
Nervous system diseases such as multiple sclerosis (a condition resulting from unwinding of the covering of nerves) and peripheral neuropathy (damage to the nerves supplying the peripheral nerves of the body) can also be a cause.
What is the treatment for premature ejaculation?
Premature ejaculation is sometimes temporary and gets better on its own.
You may find that increasing the frequency of sex (either intercourse or masturbation) solves the problem.
Wearing a condom reduces sensation and this may be helpful.
Premature ejaculation is less likely if you have sex with your partner on top.
If you have a co-operative partner, you may want to try the 'squeeze technique'. Get your partner to masturbate you and signal to them when you are about to have an orgasm. At this point, if your partner gently but firmly squeezes the head of your penis, the feeling will go away. Your partner needs to squeeze for about 10-20 seconds and then start masturbating you again, repeating the process several times and stay last longer in bed. The 'stop-go' technique is similar but your partner just stops masturbating you and does not squeeze.
Various medicines have been found to be helpful. These include:
Selective serotonin reuptake inhibitor (SSRI) antidepressants or ED Pills ProSolution Plus, ProSolution Pills VigRX Plus. You may need to take these daily for at least 12 weeks to get the full effect and you may find they start to wear off after 6 to 12 months.
If you cannot tolerate the side-effects of SSRIs (which can include sickness, dizziness and drowsiness) you could try taking clomipramine just when you need it.
Dapoxetine is an SSRI which has specially been developed for the treatment of premature ejaculation.
Sildenafil, a medicine used for erection problems, can also be useful for premature ejaculation. It is sometimes taken in combination with an SSRI.
If you don't want to take tablets, local anaesthetic creams and sprays are available which help to reduce the sensitivity of the penis. Take the advice of your GP or pharmacist because there are many preparations advertised in magazines and on the internet, some of which are more effective than others.
Psychological treatments are sometimes used but no one is sure just how effective they are.
Surgery has occasionally been helpful in men who have a short frenulum (the bridge of skin joining the head of the penis to the shaft).