Description

Premature ejaculation occurs in men when the semen comes out of the body (cum) before what I wanted during sex. Premature ejaculation is a common sexual complaint. As 1 of every 3 people who say they have it at some point.

The ejaculation is not a cause for concern if it doesn't happen often. But you can be diagnosed with premature ejaculation if you:

  • Always or nearly always ejaculate within 1 to 3 minutes of penetration
  • You are not able to delay ejaculation during sex all or nearly all the time
  • I feel distressed and frustrated, and tend to avoid sexual intimacy as a result

Premature ejaculation is a treatable condition. Medications, counseling and techniques that delay ejaculation can help improve sex for you and your partner.

Symptoms

The main symptom of premature ejaculation is not being able to delay ejaculation for more than three minutes after penetration. But it might occur in all sexual situations, even during masturbation.

The ejaculation can be classified as:

  • Of all life. Lifelong premature ejaculation occurs all or nearly all the time, starting with the first sexual encounter.
  • Acquired. Acquired premature ejaculation develops after previous sexual experiences without problems with ejaculation.

Many people feel that they have symptoms of premature ejaculation, but the symptoms do not meet criteria for a diagnosis. It is typical of the experience premature ejaculation at times.

When to see a doctor

Talk with your health care provider if you ejaculate sooner than you want during most sexual encounters. It is common to feel embarrassed to discuss sexual health concerns. But don't let that stop you from talking with your provider. Premature ejaculation is a common and treatable.

A conversation with a care provider could help to reduce concerns. For example, it can be comforting to hear that is typical of the experience premature ejaculation from time to time. It may also help to know that the average time from the beginning of intercourse to ejaculation is about five minutes.

Causes

The exact cause of premature ejaculation is not known. Once thought to be only psychological. But the health care providers to know that the ejaculation involves a complex interaction of psychological and biological factors.

Psychological causes

The psychological factors that may play a role include:

  • Early sexual experiences
  • Sexual Abuse
  • Poor body image
  • Depression
  • Worry about premature ejaculation
  • Feelings of guilt that can cause you to rush through sex

Other factors that may play a role include:

  • Erectile dysfunction. Being anxious about getting and keeping an erection could form a pattern of rushing to ejaculate. The pattern can be difficult to change.
  • Anxiety. It is common for premature ejaculation and anxiety occur together. Anxiety may be about sexual performance or related to other issues.
  • The problems of the relationship. Relationship problems can contribute to premature ejaculation. This can be true if you've had sexual relationships with other partners in which premature ejaculation does not happen often.

Biological causes

A number of biological factors may contribute to premature ejaculation. They may include:

  • Irregular levels of the hormone
  • Irregular levels of brain chemicals
  • The inflammation and infection of the prostate or urethra.
  • The inherited traits.

Risk factors

Several factors can increase the risk of premature ejaculation. They may include:

  • Erectile dysfunction. You may be at increased risk of premature ejaculation if you have problems getting or keeping an erection. The fear of losing an erection can cause you to rush through sex. This can occur if you are aware of it or not.
  • Stress. Emotional or mental strain in any area of life can play a role in premature ejaculation. The stress can limit the ability to relax and focus during sexual intercourse.

Complications

The premature ejaculation can cause problems in your personal life. These could include:

  • Stress and relationship problems. A common complication of premature ejaculation is relationship stress.
  • Fertility problems. Premature ejaculation can sometimes make it difficult for a couple to become pregnant. This can happen if ejaculation does not occur in the vagina.

Diagnosis

Your health care provider will ask about your sex life and your health history. Your provider may also do a physical exam. If you have premature ejaculation and trouble getting or maintaining an erection, your doctor may order blood tests. The tests can check your hormone levels.

In some cases, your doctor may suggest that you go to a urologist or a mental health provider who specializes in sexual problems.

Treatment

Common treatment options for premature ejaculation include behavioral techniques, medications and counseling. It may take time to find the treatment or combination of treatments that work for you. Behavioral treatment plus drug therapy might be the most effective.

Behavioral techniques

In some cases, therapy for premature ejaculation consists in simple steps. They can include masturbation of an hour or two before sexual intercourse. This may allow you to delay ejaculation when you have sex with your partner.

Your health care provider may recommend avoiding intercourse for a period of time. Focusing on other types of sex games can remove the pressure that you may feel during sex.

Pelvic floor exercises

Weak pelvic floor muscles may make it more difficult to delay ejaculation. Pelvic floor exercises (Kegel exercises) can help strengthen these muscles.

To perform these exercises:

  • Find the right muscles. To find the pelvic floor muscles, stop urination in midstream. Or tighten the muscles that keep you from passing gas. Both actions use of the muscles of the pelvic floor. Once you've identified your pelvic floor muscles, you can exercise, at any position. However, you may find that it is easier to do lying down at first.
  • Perfect your technique. Tighten the pelvic floor muscles, hold for three seconds and then relax for three seconds. Try it a few times in a row. When the muscles get stronger, try doing Kegel exercises while sitting, standing or walking.
  • Stay focused. For best results, focus on tightening only your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely during the exercises.
  • Repeat three times a day. The goal of doing at least three sets of 10 repetitions a day.

The pause-squeeze technique

Your health care provider may indicate that you and your partner use of the pause-squeeze technique. This method works in the following way:

  • Begin sexual activity, including stimulation of the penis, until you feel ready to ejaculate.
  • Below, you or your partner squeeze the end of your penis where the head joins the shaft. Keep pressing for several seconds until the urge to ejaculate passes.
  • Repeat the process of tightening as needed.

By repeating as many times as necessary, you can reach the point of entering your partner without ejaculating. After some practice, delay ejaculation may become a habit that no longer requires the pause-squeeze technique.

If the pause-squeeze technique causes pain or discomfort, you can try the start and stop technique. This involves stopping the sexual stimulation just before the ejaculation. Then wait until the level of excitation has subsided, and start again.

Condoms

Condoms can make the penis less sensitive, which can help delay ejaculation. Specially designed for the "climax control" condoms are available without a prescription. These condoms contain numbing agents such as benzocaine or lidocaine to delay ejaculation. Could also be thicker latex. Examples include Trojan Extended Pleasure and Durex Prolong.

Drugs

Topical anesthetic agents

Creams, gels and sprays that contain a numbing agent, such as benzocaine, lidocaine or prilocaine — are sometimes used to treat premature ejaculation. Is applied to the penis 10 to 15 minutes before you have sex to reduce sensation and help delay ejaculation. Are available without a prescription. However, a cream that contains both the lidocaine and prilocaine (EMLA) is available with a prescription.

Although topical anesthetic agents are effective and well tolerated, they have potential side effects. Can cause a decrease of sensation and sexual pleasure of both partners.

Oral medications

Many medications can delay the orgasm. These drugs not approved by the Food and Drug Administration to treat premature ejaculation, but some of them are used for this purpose. They include antidepressants, analgesics and drugs for the treatment of erectile dysfunction.

These medicines may be prescribed for either on-demand or daily use. Also, they can be prescribed alone or with other treatments.

  • Antidepressants.A side effect of certain antidepressants is delayed orgasm. For this reason, the selective inhibitors of serotonin reuptake inhibitors (Ssris) are used to treat premature ejaculation.The ssris include paroxetine (Paxil, Pexeva, Brisdelle), escitalopram (Lexapro), citalopram (Celexa), sertraline (Zoloft), or fluoxetine (Prozac). TheSSRIdapoxetine is often used as the first treatment for premature ejaculation in some countries. Does not currently available in the united States. Of the drugs approved for use in the united States, paroxetine seems to be the most effective. These medications are usually 5 to 10 days to begin working. But it could take 2 to 3 weeks of treatment to see the full effect. IfSSRIs do not improve the time of ejaculation, your health care provider may prescribe the tricyclic antidepressant clomipramine (Anafranil). Side effects of antidepressants can include nausea, sweating, drowsiness and decreased libido.
  • Pain relievers.Tramadol (Ultram, Conzip, Qdolo) is a medication used to treat pain. It also has side effects that delay ejaculation. Tramadol may be prescribed whenSSRIs has not been effective. Tramadol may not be used in combination with anSSRI. The side effects can include nausea, headache, drowsiness and dizziness. Tramadol may become habit-forming when taken long-term.
  • Phosphodiesterase-5 inhibitors. Some of the medicines used to deal with erectile dysfunction can also help premature ejaculation. These medications include sildenafil (Viagra), tadalafil (Cialis, Adcirca), avanafil (Stendra), and vardenafil. Side effects may include headache, facial flushing, and indigestion. These medications may be more effective when used in combination with an SSRI .

Antidepressants. A side effect of certain antidepressants is delayed orgasm. For this reason, the selective inhibitors of serotonin reuptake inhibitors (Ssris) are used to treat premature ejaculation. SSRI's include paroxetine (Paxil, Pexeva, Brisdelle), escitalopram (Lexapro), citalopram (Celexa), sertraline (Zoloft), or fluoxetine (Prozac).

The SSRIS, dapoxetine is often used as the first treatment for premature ejaculation in some countries. Does not currently available in the united States.

Of the drugs approved for use in the united States, paroxetine seems to be the most effective. These medications are usually 5 to 10 days to begin working. But it could take 2 to 3 weeks of treatment to see the full effect.

If SSRI's do not improve the time of ejaculation, your health care provider may prescribe the tricyclic antidepressant clomipramine (Anafranil). Side effects of antidepressants can include nausea, sweating, drowsiness and decreased libido.

Pain relievers. Tramadol (Ultram, Conzip, Qdolo) is a medication used to treat pain. It also has side effects that delay ejaculation. Tramadol may be prescribed when SSRIS s have not been effective. Tramadol may not be used in combination with an SSRI .

The side effects can include nausea, headache, drowsiness and dizziness. Tramadol may become habit-forming when taken long-term.

Potential future treatment

The research suggests that some of the drugs that could be useful in the treatment of premature ejaculation. But more studies are needed. These medications include:

  • Modafinil (Provigil). This is a treatment for the sleep disorder narcolepsy.
  • Silodosin (Rapaflo). This drug treats prostate gland enlargement.
  • OnabotulinumtoxinA (Botox). Researchers are studying whether the injection of Botox into the muscles that help the cause of ejaculation can treat premature ejaculation.

Advice

This approach involves talking with a mental health provider about your relationships and experiences. The sessions can help to reduce performance anxiety and find better ways to cope with stress. The counseling is more likely to help when used in combination with drug therapy.

With premature ejaculation, you might feel that you lose some of the closeness shared with a sexual partner. You may feel angry, ashamed and upset, and turn away from your partner.

Your partner also might be upset with the change in sexual intimacy. Premature ejaculation can cause partners to feel less connected or hurt. Talking about the problem is an important step. Relationship counseling or sex therapy might also be useful.

Alternative medicine

Several treatments of alternative medicine have been studied, including yoga, meditation and acupuncture. However, more research is needed to determine its effectiveness.

Preparing for your appointment

It is typical to feel embarrassed to talk about sexual problems. But you can trust that your health care provider has had similar conversations with many others. Premature ejaculation is a very common condition. And it is one that can be treated.

Be ready to talk about premature ejaculation will help you get the treatment you need to put your sex life back on track. The information below will help you to prepare to make the most of your appointment.

Collection of information by advance

  • Pre-appointment restrictions. When you make your appointment, ask if there are any restrictions you need to follow in the time prior to your visit.
  • Symptoms. How often do you ejaculate before you or your partner would wish? How long after you start having sex will not tend to ejaculate?
  • Sexual History. Think about your relationships and sexual encounters since he became sexually active. Has had problems with premature ejaculation before? With whom, and under what circumstances?
  • History of medicine. List any other medical condition that you have been diagnosed, including mental health conditions. Also note the names and strengths of all the medications you are taking or have recently taken, including prescription medicines and those bought without a prescription.
  • Questions to ask your health care provider. Write questions in advance to make the most of your time with your provider.

Basic questions to ask your doctor

The following list suggests questions to ask your health care provider about the premature ejaculation. Do not hesitate to ask more questions during your appointment.

  • What can be the cause of my premature ejaculation?
  • What tests do you recommend?
  • What treatment approach do you recommend?
  • How soon after you start the treatment, you can expect an improvement?
  • What improvements can I expect?
  • Am I at risk of this recurring problem?
  • Is there a generic alternative to the medicine you're prescribing?
  • Are there brochures or other printed material that I can take my house? What sites do you recommend to visit?

What to expect from your doctor

Your health care provider might ask very personal questions, and you may also want to talk with your partner. To help your provider determine the cause of your problem and the best course of treatment, be prepared to answer questions, such as:

  • How often do you have premature ejaculation?
  • When was the first experience of premature ejaculation?
  • Do you have premature ejaculation, only with the partner or partners?
  • To make the experience of premature ejaculation when you masturbate?
  • Do you have premature ejaculation every time you have sex?
  • How often do you have sex?
  • How much are you bothered by premature ejaculation?
  • How much is your partner upset because of the premature ejaculation?
  • How satisfied are you with your current relationship?
  • Are you having trouble getting and maintaining an erection (erectile dysfunction)?
  • Not to take prescription medications? If so, what medicines you have recently started or stopped taking?
  • Do you use recreational drugs?

What you can do in the meantime

You decide to talk with their health care provider is an important step. In the meantime, consider the possibility of exploring other ways in which you and your partner can connect. Despite the fact that the ejaculation can cause stress and anxiety in a relationship, it is a treatable condition.

Symptoms and treatment of Premature ejaculation