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How to Stop Premature Ejaculation

In this week's article we take a look at the very common condition of premature ejaculation. If you are reading this article, it is important to know that it is nothing to be embarrassed about and it is certainly treatable. In the UK, between 30%-40% of men will experience premature ejaculation (PE) at some point in their life. In this article we will discuss what PE is, what can cause it, the different types of PE as well as how we can stop premature ejaculation from happening.

What is Premature Ejaculation?

Premature ejaculation is a type of sexual dysfunction that occurs when a man has an orgasm and releases semen sooner than he or his partner would like. It often happens before or shortly after penetration during intercourse. Premature ejaculation can be a frustrating experience for both you and your sexual partner and makes your sex lives less enjoyable. However, the good news is that it can normally be treated.

Types of Ejaculation Problems

There are three main categories for ejaculation problems; premature ejaculation, delayed ejaculation, and retrograde ejaculation.

Premature ejaculation (PE) is the most common ejaculation problem. It's where the male ejaculates too quickly during sexual intercourse. Despite there being no exact time on how long sex should last, it is reported from a study that the average time it takes for a man to ejaculate from sex is 5 and a half minutes. Occasionally, episodes of premature ejaculation are common and are not a cause for concern for men. That being said, if you are finding that around half of your attempts at sex result in premature ejaculation, it might be time to get help.

Delayed ejaculation is classed as either experiencing a significant  delay before ejaculation or not being unable to ejaculate at all,even though the man wants to and his erection is normal. You may have delayed ejaculation if you cant ejaculate around half of the times you have sex. Delayed ejaculation can be caused by psychological and physical factors. Possible psychological causes of delayed ejaculation are similar to those of premature ejaculation – for example, early sexual trauma, strict upbringing, relationship problems, stress or depression.

Retrograde ejaculation is a rarer type of ejaculation problem - It happens when semen travels backwards into the bladder instead of through the urethra which is the tube that urine passes through. It is caused by damage to the nerves or muscles that surround the neck of the bladder and damage to the surrounding muscles or nerves can stop the bladder neck closing, causing the semen to move into the bladder rather than up through the urethra.

Causes of Premature Ejaculation

Various psychological and physical factors can cause a man to suddenly experience premature ejaculation.

Common physical causes include:

  • An underlying erectile dysfunction diagnosis.
  • A hormonal problem with hormone levels that play a role in sexual function include luteinizing hormone (LH), prolactin and thyroid stimulating hormone (TSH) for example and overactive or underactive thyroid.
  • Low serotonin or dopamine levels, chemicals in the brain that are involved in sexual desire and excitement.
  • A penis that is extra sensitive to stimulation.


Emotional or psychological causes include:

  •  Performance anxiety  - could be due to the nervousness of being with a new partner; the anxiousness of having sex again after a long period of abstinence, lack of confidence, guilt, being overly excited or stimulated
  • Stress
  • Relationship problems
  • Depression


Symptoms of Premature Ejaculation

In relation to premature ejaculation, the only symptom is the ability to ejaculate very quickly. If however you have other issues related to the penis for example if it is sore or swollen, it may be beneficial to speak to your GP.

How to Stop Premature Ejaculation

The million dollar question. Thankfully premature ejaculation is something that is very treatable and many things can be tried before seeking medical treatment. For example, if you want to desensitize the penis then It can sometimes help to masturbate an hour or two before having sex and use a thick condom to help decrease the sensation. It may also be wise to take breaks during having sex and think of something boring to keep you distracted. You can also use numbing sprays and creams such as Stud 100 desensitizing spray or Emla Cream 5%, respectively.

For those that are in longer relationships, couples therapy may be advisable. During the session the therapist will allow you to discuss your relationship and resolve any issues. As well as teaching you the stop start technique. The stop start technique is where your partner masturbates you and just before you feel like you are about to ejaculate you stop for 30 seconds, this trains you into gradually becoming more resistant to premature ejacuation.

Premature Ejaculation Medication

Selective serotonin reuptake inhibitors (SSRIs) are designed to treat depression, but they also delay ejaculation. SSRIs used for this purpose include paroxetine, sertraline, and fluoxetine. Some men may experience an improvement as soon as treatment begins. However, you'll usually need to take the medicine for a couple weeks before you notice the full effects.

Side effects of SSRIs include fatigue, feeling sick and being sick, diarrhoea, and excessive sweating. These are fairly common and mild side effects that subside within two to three weeks of initiating them.

However, there is an SSRI specific for premature ejaculation called Priligy (Dapoxetine). It acts much faster than the SSRIs mentioned above and can be used when required as opposed to daily. You’ll usually be advised to take it between one to three hours before sex, but not more than once a day. Priligy comes in both 30mg and 60mg tablets.

Sildenafil Tablets (Generic Viagra), although primarily prescribed for erectile dysfunction (ED), has also been shown to help reduce premature ejaculation.

The use of topical anaesthetics such as lidocaine or prilocaine can help but may be transferred and absorbed to the vagina, causing decreased sensation. Thick condoms can also be used and are effective, particularly when combined with local anaesthesia.

 

Author: Matt Jennings

MRPharmS

Clinically Reviewed By:

Ibrahim Nakib BSc(Hons) MRPharmS

 

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