What is Premature Ejaculation?
Premature ejaculation (PE) occurs when a man or his partner ejaculates earlier than desired during sexual intercourse, within a defined period, usually less than 2 or 3 minutes.
Occasional PE is also known as rapid ejaculation, premature climax, or premature ejaculation. PE may not be a cause for concern. However, it can be frustrating if it hinders sexual enjoyment and negatively affects the relationship. If it occurs frequently and causes problems, your doctor can help.
Premature ejaculation and erectile dysfunction (ED)
PE is sometimes a problem for men who suffer from erectile dysfunction (ED). This occurs when men are unable to achieve or maintain an erection strong enough for sexual intercourse. Since the erection disappears after ejaculation, it can be difficult to determine whether the problem is PE or ED. It's best to treat ED first, as premature ejaculation may cease to be a problem once treated.
How does Premature Ejaculation work?
Ejaculation is the sudden and pleasurable release of semen through the penis. It is controlled by the brain (central nervous system). When sexual stimulation occurs, signals are sent through the spinal cord to the brain. When a certain level of arousal is reached, the brain signals the reproductive organs to expel. This causes the expulsion of semen through the penis (ejaculation).
Ejaculation consists of two phases: emission and expulsion.
Phase 1: Emission
Emission occurs when sperm travel from the testicles to the prostate. There, they mix with seminal fluid to form semen. The vas deferens are the tubes that help transport sperm from the testicles to the prostate and the base of the penis. (When only one of these tubes is involved, it is called the vas deferens.)
Stage 2: Expulsion
Expulsion occurs when the muscles at the base of the penis contract. This expels semen from the penis. Often, ejaculation and orgasm (climax) occur simultaneously. Some men reach orgasm without ejaculating. In most cases, erections disappear after this phase.
Symptoms of Premature Ejaculation
The main symptom of premature ejaculation is the inability to delay ejaculation for more than three minutes after penetration. However, it can occur in any sexual situation, including masturbation.
Premature ejaculation can be classified as:
Permanent. Permanent premature ejaculation always or almost always occurs after the first sexual intercourse.
Acquired. Acquired premature ejaculation develops after previous sexual experiences without ejaculatory problems.
Many people believe they have symptoms of premature ejaculation, but these symptoms don't meet the criteria for a diagnosis. Sometimes, premature ejaculation is normal.
Causes of Premature Ejaculation
The cause of premature ejaculation is unknown, but brain chemistry may be at least partly responsible. People with low levels of serotonin in the brain tend to take less time to ejaculate.
Psychological causes that may play a role include:
- Stress
- Depression
- Anxiety
- Guilt
- Relationship problems
- Lack of self-confidence or poor body image
- Concern about sexual performance
- Negative feelings about the idea of sex (sexual repression)
- Early sexual experiences
- Sexual abuse
Premature ejaculation Treatment options
Treatment may begin with psychological therapy. A psychologist or psychiatrist can help you overcome problems such as depression, anxiety, or stress that can contribute to premature ejaculation. Other ways to treat premature ejaculation include:
Premature ejaculation pills
Your doctor may also discuss medications with you. While there are no medications specifically approved for the treatment of premature ejaculation (PE), medications used to treat other problems may be helpful in some cases. This is called off-label use and is not approved by the FDA, so be sure to discuss it with your doctor. These include:
Antidepressants. A side effect of some selective serotonin reuptake inhibitors (SSRIs) is delayed orgasm. However, these medications also have side effects, such as nausea and drowsiness. They can also affect sexual desire. Therefore, you may be confusing one problem with another. You and your doctor will decide what is best for you.
Tramadol. This is a pain reliever that can delay ejaculation. It may be prescribed if antidepressants don't help. This medication is addictive, so it may not be an option for you.
Erectile dysfunction medications. These medications can also help you maintain erection. They include sildenafil citrate (Viagra), tadalafil (Cialis), or vardenafil HCI (Levitra).
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