Premature ejaculation(PE) is the most common form of sexual dysfunction in men throughout the world with prevalance of 20-45% in men of all ages.
What is premature ejaculation?
PE is the lack of ejaculatory control either before or shortly after sexual penetration, resulting in unsatisfactory sexual experience for one or both partners. Others such as Masters and Johnson have defined PE as ejaculation before his partner achieves orgasm in more than fifty percent of his sexual encounters while researchers have attempted to define PE as ejaculation within two minutes or less of penetration.
What causes premature ejaculation?
The exact cause of premature ejaculation is not clear. In the past, PE was assumed to have a psychological basis but new neurophysiological research strongly suggests abnormal metabolism in areas of the brain where sexual responses are integrated. Early sexual experiences such as situations in which ejaculation is hurried in order to avoid being discovered or guilty feelings may establish a psychological scar that can be difficult to change later in life. Other factors like erectile dysfunction and anxiety may also contribute to PE.
When to seek medical advice?
Most men experience PE at least once in their lives. Often adolescents and young men experience early ejaculation during their first sexual encounters, but eventually learn ejaculatory control. However, if it is a recurrent problem that affects sexual satisfaction of either partner, help should be seeked.
How is premature ejaculation treated?
Men's Health Services
S H HO UROLOGY AND LAPAROSCOPY CENTRE
Recent publications on premature ejaculation
Updated 12 April 09
Treatment options for premature ejaculation include sexual counselling and medications. For many, a combination treatment works best.
Sexual counselling may involve simple steps such as:
1. masturbating an hour or two before intercourse
2. avoiding intercourse
for a period of time and focusing on foreplay so that pressure is removed from sexual encounters
3. start and stop technique
Medical therapy falls into 2 main groups:
1. application of a local anaesthetic agent to the tip of penis and use of
condom to de-sensitise the penis
2. use of anti-depressants such as SSRIs group which is known to cause delay in ejaculation. These
drugs can be taken on a daily basis or a few hours prior to sexual encounterA new short acting SSRI called Dapoxetine, which is being
developed specifically for PE has demostrated a significant increase in intravaginal ejaculatory latency time from less than 1 minute
to over 3 minutes. Dapoxetine is awaiting FDA approval as therapy for PE.