Premature Ejaculation (PE) is a prevalent sexual concern where a man ejaculates too swiftly during sexual intercourse. It is typically defined as ejaculating within one minute of commencing sexual activity, as per global guidelines. However, it’s crucial to recognize that what constitutes a satisfying duration varies from person to person and can be influenced by both individual and partner preferences.
PE manifests in two primary forms:
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Primary Premature Ejaculation: This occurs when an individual consistently experiences premature ejaculation throughout their sexual history. Often, it has underlying psychological causes, such as early traumatic sexual experiences.
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Secondary Premature Ejaculation (or “Acquired Premature Ejaculation”): This type emerges later in life and can result from a combination of psychological and physical factors. Physical factors may include excessive alcohol consumption or inflammation of the prostate gland (prostatitis).
The approach to treating premature ejaculation hinges on its root cause:
1. Physical Causes: When PE is linked to physical conditions, addressing the underlying issue can be effective. Seeking advice from a GP is crucial to explore potential treatment options.
2. Psychological Causes: Managing PE associated with psychological factors can be more complex but is often successful. Many individuals find relief through therapy and counseling, addressing underlying psychological issues that contribute to PE.
Before seeking medical intervention, there are self-help techniques to consider:
- Masturbating 1 to 2 hours before intercourse: This can potentially extend the time to ejaculation during intercourse.
- Using a thick condom: This reduces sensitivity and can help delay ejaculation.
- Practicing deep breathing techniques: These methods can temporarily postpone ejaculation.
- Exploring different sexual positions: Having your partner on top can help control the pace.
- Taking breaks during intercourse: Distracting yourself with unrelated thoughts can aid in delaying ejaculation.
In the context of long-term relationships, couples therapy can be beneficial. It allows partners to address relationship dynamics that may contribute to premature ejaculation.
Medications, such as selective serotonin reuptake inhibitors (SSRIs), may be prescribed if self-help methods prove ineffective. SSRIs, typically used to treat depression, have a notable side effect of delaying ejaculation. Dapoxetine, a specific SSRI designed for PE treatment, can be taken as needed, usually 1 to 3 hours before sex. If dapoxetine proves ineffective, a GP may recommend trying other off-label SSRIs like paroxetine, sertraline, or fluoxetine, with full effects typically observed after 1 to 2 weeks of regular use.
Additionally, anaesthetic creams and sprays containing substances like lidocaine or prilocaine can desensitize the penis and delay ejaculation. Combining such creams with a condom can enhance their effectiveness, and your GP can guide you in choosing an appropriate cream.
It’s vital to remember that premature ejaculation is a common issue, and seeking help from a healthcare provider can lead to effective treatments that enhance sexual satisfaction and overall well-being.