Premature ejaculation – Causes and Treatments

Premature ejaculation is a condition when a man achieves orgasm and ejaculates very quickly during sexual intercourse and with minimal stimulation to the penis. The International Society for Sexual Medicine (ISSM) defines premature ejaculation as ejaculation which always or nearly always occurs prior to or within about one minute of sexual intercourse from the first sexual experience or a clinically significant reduction in latency time often to about three minutes or less. Premature ejaculation is a sexual dysfunction prevalent in men of varying ages. Men suffering from premature ejaculation report having less control over ejaculating.

Premature ejaculation is one of the most prevalent sexual dysfunction that men suffer most from. But since every man has a different time required to ejaculate, it difficult to quantitatively measure the exact prevalence rate of premature ejaculation. Generally, men tend to underestimate their performance and often report that they wish they could last longer. As a result it is often unreliable when they report suffering from premature ejaculation and it becomes difficult for researchers to ascertain the prevalence rate of premature ejaculation. Different researchers define premature ejaculation using different criteria and different time required to ejaculate and as result come up with different statistics of the prevalence rate of premature ejaculation. According to study conducted by University of Chicago it was found that between the ages twelve to fifty nine, approximately thirty percent of the men reported having suffered from premature ejaculation at least once during the previous twelve months compared to ten percent of men reporting erectile dysfunction.

According to some estimates erectile dysfunction is more prevalent in men compared to premature ejaculation. Although erectile dysfunction is more prevalent sexual dysfunction in men after the age of sixty, premature ejaculation still remains a significant condition. According to the surveys, it affects twenty eight percent men of the ages sixty five to seventy four, and twenty two percent men of the ages seventy five to eighty five. Different studies estimate premature ejaculation prevalence rate from three percent to forty one percent in men above the age of eighteen. But a large number of studies have estimated a prevalence rate of twenty to thirty percent. This makes premature ejaculation a very common sex problem.

There is a misconception that younger men are more likely to suffer from premature ejaculation and that the condition reduces with age. Studies have shown that the prevalence rate of premature ejaculation remains constant across age groups.

Premature ejaculation can be lifelong or acquired. Men with lifelong premature ejaculation suffer since their first sexual experience. Whereas acquired premature ejaculation is where the patient has only developed the condition recently and did not suffer from such a problem earlier. Psychological conditions or anxiety about sex that relates to disturbing past experiences encountered during adolescence characterize lifelong premature ejaculation. Whereas in case of men with acquired premature ejaculation characteristics include erectile dysfunction, performance anxiety and psychotropic drug use.

For men suffering from lifelong premature ejaculation, following causes must be addressed through therapy:
• Early psychological difficulties
• Early sexual experiences
• Family relationships during childhood and adolescence
• Peer relationships
• General attitude towards sex
• Level of involvement of the sexual partner in treatment

For men suffering from acquired premature ejaculation, following causes must be addressed through therapy:
• Previous relationships
• Current relationship
• Level of involvement of the sexual partner in treatment
• Impotence problems
• Sexual response of the partner

Premature ejaculation is generally self diagnosable and does not require any laboratory tests or imaging tests. However, if a person suffers from depression in conjunction with premature ejaculation, the doctor may suggest laboratory tests specific to depression or to another relevant psychological problems.

The following conditions are considered in the diagnosis of premature ejaculation:
• Severely delayed orgasm in the female partner
• Adverse effect from a psychotropic drug
• Erectile dysfunction

There are several methods available for the treatment of premature ejaculation. However, any primary medical condition like angina or other cardiovascular diseases should be treated first as should any accompanying erectile dysfunction. It is advisable to have the female partner participate in the treatment and counseling.

The following medications are available for the treatment of premature ejaculation:
• Desensitizing agents or local anesthetic sprays or gels (Lidocaine or Prilocaine)
• SSRI medicines (Dapoxetine, Fluoxetine, etc.)
• PDE5 inhibitor medicines (Sildenafil, Tadalafil, Vardenafil)

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