What is premature ejaculation?
Premature ejaculation is when a man ejaculates too quickly. Sometimes this happens before there is direct stimulation of the penis and the mere imagination of sex can trigger premature ejaculation, however, more often it happens while the penis is being inserted or shortly afterwards. Premature ejaculation is one of the most common problems that plague men, and most men suffer from it at one time or another. When premature ejaculation occurs in most sexual encounters, it becomes a serious problem. Studies have shown that the incidence of this disorder is quite high and spreads across all segments of society, with over 40% of men suffering from it.
How fast is too fast?
Premature ejaculation is defined as ejaculation that usually occurs within 2 minutes of vaginal penetration. Some people may last longer than 2 minutes, while others may go faster than that. The important thing is that if ejaculation occurs earlier than the couple expects and as a result causes sexual tension for both partners, this can be called ejaculating too early or ejaculating too quickly.
At what age does premature ejaculation occur?
Premature ejaculation can occur at any age and in any situation, but is more common in younger people. The occurrence of premature ejaculation is related to the strain of the sexual experience (new spouse or different environment) and not so much to age.
What causes premature ejaculation?
Some conditions can affect the process of ejaculation, such as prostate disease, atherosclerosis, diabetes and nervous system dysfunction, but most cases are caused by insufficient control over ejaculation. The pioneers of sex research believe that the development of premature ejaculation is related to premature sexual intercourse. They explain that due to early stress and panic, dissatisfaction with early sexual experiences causes them to develop a rapid ejaculation habit later (a negative situation). Inappropriate locations and environments, such as the back seat of a car, fear of detection, and one-night stands may contribute to the development of rapid ejaculation.
Psychological problems that can lead to premature ejaculation include
Spouse’s illness
Occupational stress/financial pressure/changing jobs
Family problems/loss of a loved one/children
Crime/sexual orientation
Lack of sexual experience/opportunity
Poor housing conditions/overcrowding
Excessive anxiety/fear of failure/personal expectations
Lack of sexual skills/interpersonal skills
A common cause of premature ejaculation is interpersonal problems. Some causes of interpersonal stress are: unrealistic and excessive demands from sexual partners, dissatisfaction, lack of communication and trust, problems with work pressure, spouse with sexual dysfunction and excessive emphasis on pleasing each other. Discontent during sex may make the situation worse, leading to a vicious cycle of sexual failure and anxiety.
Current treatment for premature ejaculation
The main goal of premature ejaculation treatment is to improve control of ejaculation. Improved ejaculatory control is associated with satisfaction with a couple’s sex life, and short ejaculation times can also cause personal stress and barriers to communication between couples. Many men can delay ejaculation through self-help methods. But others may need professional help. The first step is to discuss the problem with your partner and know their needs and desires.
A simple and effective self-help therapy is “move-stop therapy. This method can be exercised by the man personally or with his partner if she wishes.
Step 1: Gradually stimulate the penis and stop stimulating the penis as soon as ejaculation is imminent.
Step 2: Stop stimulating for 30-60 seconds.
Step 3: Re-stimulate the penis, stopping or decreasing the amount of stimulation until the ejaculation sensation disappears.
Step 4: Repeat the above four to five times until you know when you are about to ejaculate, and then complete the ejaculation.
This method of masturbation can be improved by a partner and is called penile squeeze therapy. Your partner masturbates you until orgasm and then squeezes the glans and the connection with the penis body with his or her fingers. The sensation of ejaculation will disappear and the erect penis will become soft until the stimulation starts again. Of course, this can be difficult to perform and requires the thoughtfulness and commitment of the partner in order to be successful.
The methods that can be used to treat premature ejaculation are behavioral therapy, speech therapy, topical therapy, condom therapy and medication. Perhaps the most commonly used treatment is behavioral therapy, which is based on the premise that the sexual stimulation reflex and ejaculation reflex can be controlled through exercise, thereby improving the patient’s ability to control ejaculation.
Topical creams and sprays with anesthetic effects are also used to treat premature ejaculation and are effective in some men, but may result in impaired sexual sensation and reduced sexual satisfaction. In addition, many new treatments for premature ejaculation are currently in the research phase, such as oral or topical medications, which may offer new options for treating premature ejaculation.
Dapoxetine (PRILIGY) is the first prescription medication to treat premature ejaculation. It is a short-acting selective pentazocine inhibitor for administration when needed. It is taken 1-3 hours before sexual intercourse, not every day. Dapoxetine is a prescription drug, so patients can only buy it with a doctor’s prescription. It is capable of interacting with a number of other medications, including antidepressants and certain pain medications such as aspirin and NSAIDs.
Side effects include: uncommonly, dizziness and postural hypotension, which may cause mild headache. Patients with psychiatric and bleeding disorders, hepatic or renal insufficiency, or epilepsy should consult a clinician before taking them. Only a physician can determine what type of patient is suitable for treatment with dapoxetine and thus ensure the safety and efficacy of the clinical use of the drug. (Note from Guo Jun: Dapoxetine is already manufactured and marketed by Janssen Pharmaceuticals Ltd. and will be available in China next year)
About the European Sexual Health Alliance (ESHA)
The European Sexual Health Alliance (ESHA) is a large European patient relief organization. ESHA’s goal is to help couples facing sexual dysfunction to talk openly and honestly about their sexual problems in order to find ways to improve their sexual function and quality of life as a couple.