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Premature Ejaculation: Causes And Treatment

February 22, 2022 | Dr.Amna Zubair

The American Urological Association defines premature ejaculation as ejaculation that occurs earlier during the initial phase of sexual intercourse and becomes a cause of distress for one or both partners. A man may ejaculate before penetration or within a minute of sexual activity. There is no definite time limit to define what counts as premature, but most doctors would say that ejaculation in less than a minute of sexual activity is premature. 

Premature ejaculation can cause stress for a man and his partner. Most men feel embarrassed to discuss this issue. It can also exhibit psychological effects on a person if they don’t perform up to expectations or feel like they cannot satisfy their partner. It can be reassuring to know that premature ejaculation is a common problem, and most men have experienced it at some point in their lives. If you seem to have a persistent issue or it has affected your mental health, the good news is that this issue is treatable, and your sexual performance can be improved with medical and therapeutic help. 

What Causes Premature Ejaculation?

The exact cause of premature ejaculation has not been identified yet. However, it is assumed to be of a complex origin contributed by psychological, physiological, chemical, and hormonal mechanisms. Multiple factors can be linked to premature ejaculation. Some common factors include:

  • Early experience: Premature ejaculation can be of common occurrence during your initial sexual encounters. Lack of sexual experience or awareness can result in ejaculation earlier than usual. This can be temporary and gets better over time.
  • Performance anxiety: Many men experience this issue before or during sexual intercourse. The anxiety to fulfill their partner’s expectations can lead to premature ejaculation.
  • Existing psychological issues: If you have depression, anxiety, feelings of guilt, or a history of sexual abuse, it can also render you incapable of delaying ejaculation. 
  • Relationship factors: Being overly excited with a new sexual partner can also be the cause. On the contrary, a lack of sexual satisfaction from your partner regularly can cause premature ejaculation when you have sex after a long time. 
  • Erectile Dysfunction (ED): If a man has pre-existent erectile dysfunction, he may develop a habit of ejaculating prematurely while trying to achieve orgasm or to satisfy their partner. It can become difficult to distinguish ED from premature ejaculation. 
  • Hormonal irregularities: Fluctuations in oxytocin levels, luteinizing hormone, prolactin, serotonin, and dopamine that play a role in sexual excitement and activity may also cause premature ejaculation. 
  • High sensitivity: Increased penile sensitivity can also play a role in this condition. It can also be attributed to genetic factors. 
  • Medical conditions: Infections of the prostate or urethra may also cause premature ejaculation in certain cases.

When Do You Need to See a Doctor?

If you experience a persistent problem of premature ejaculation, it is better to consult a doctor and discuss this issue with them. Premature ejaculation is a frequent complaint, so there is nothing to be ashamed of. Feel free to open up to your doctor regarding this problem so they can guide you about necessary treatment measures. 

Also, if you begin to experience emotional or psychological distress because of this problem, there is no harm in seeking medical help. Some people may need to consult a psychologist or therapist if they have any pre-existing issues like anxiety, depression, etc., resulting in premature ejaculation. 

How Can Premature Ejaculation Be Treated?

Behavioral therapy and counseling are the first-line measures to treat premature ejaculation. Your doctor will guide you about a few techniques that can be used to delay ejaculation. 

One of these techniques is called the start and stop method. During this technique, you or your partner stimulates your penis to the point of ejaculation and stops before you reach climax. The urge to ejaculate is withheld until it passes away. This is practiced multiple times to regain control over ejaculation time. 

Another technique is the squeeze method. You or your partner stimulate your penis close to the point of ejaculation and then squeeze the head before you reach a climax until the erection goes away. The focus is to learn how to control your urge to ejaculate prematurely.

Your doctor may also guide you about distraction methods, pelvic muscles exercises, or the use of condoms that help in delaying ejaculation. If you have psychological issues, discuss them with a therapist to give you the necessary counseling on managing them. 

Medications are only prescribed if the above techniques don’t work. These may include antidepressants, analgesics, topical anesthetics, or drugs to treat ED. Use these medications only in specific dosages as prescribed by your doctor. 

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