What is premature ejaculation and how is it treated?

Premature ejaculation is a problem we encounter frequently. Most men feel embarrassed about the condition and avoid treatment. The reality is, that the right treatment method can bring very successful results.

What is premature ejaculation?

This sexual problem is one of the most common sexual dysfunctions encountered in men under the age of 40. Many specialists describe premature ejaculation as a condition in which a man ejaculates earlier than he or his partner would like him to. Therefore an approach, that such and such time is a normal ejaculation time and anything else is an abnormal situation which requires treatment, is entirely unfounded. If premature ejaculation occurs from infrequently it is regarded as a natural occurrence, whereas if it occurs for example in more than 50% of a man’s sexual encounters, it means that it has become chronic and has reached a stage where treatment is indicated.

To explain in more detail, if for example the male partner ejaculates 8 minutes after his penis enters the vagina, and the female partner normally reaches orgasm in 5 minutes, and if both partners are happy with these durations, then we cannot talk about premature ejaculation. Let’s say, another man can hold back ejaculation for 20 minutes and in spite of foreplay his female partner needs 35 minutes of vaginal intercourse to reach an orgasm. In this situation the male partner may be inclined to believe that he has a problem of early ejaculation. In this second example, if the movement of the penis inside the vagina is the only method of sexual arousal for the couple, then once the male partner ejaculates after 20 minutes and his penis loses its stiffness, he will no longer be able to arouse the female partner through the penis, whereas the female partner will still need a further 20 minutes of intercourse. Such en encounter can be interpreted as unsuccessful.

How will your doctor assess your complaint of premature ejaculation?

It is essential that a patient who presents with a complaint of premature ejaculation, undergoes psychosexual, relational and medical assessment. Since in premature ejaculation cases there may also be a sexual dysfunction on the part of the woman, it is helpful if the female partner is included in the assessment, if possible. It should particularly be investigated what the reason for the couples enquiry is and what they expect from the treatment. The doctor who will undertake the treatment should first of all establish if the expectations of the couple are realistic, and if this is not the case he should offer to help in finding solutions with regards to these unrealistic expectations.

Once premature ejaculation turns into a problem, it is not just a matter of early ejaculation after the penis enters the vagina, but the behaviour and attitude of both partners become part of the problem. The socio-cultural background of the man and the woman and public attitude with regards to premature ejaculation also come into the picture.

What do you need to do before coming for treatment?

Bring any previous medical urological test results with you to the consultation. It is normal that you may be embarrassed to talk about sexual problems, but remember that your doctor has discussed similar issues with many patients before you. Premature ejaculation is a common health problem which can be treated.

What are methods of treatment?

• Sexual therapy

Discussing sexuality and understanding what the problems are, helps with the treatment. At this stage the focus will be on wrong thoughts and expectations. In some cases sexual therapy can be intensified by simple methods. Masturbation one or two hours before intercourse can delay ejaculation during the intercourse. Your doctor may advise that at first you avoid sexual intercourse by penetration for a certain amount of time and during this time focus on other sexual games. This may reduce the pressure associated with your prior sexual habits.

• Squeeze – Release technique

Your doctor may suggest this technique to you. The squeeze – release technique consists of the following stages:

First stage: Start foreplay as usual. Proceed until the point on which you feel that you are close to ejaculation.

Second stage: Ask your partner to hold between her fingers the part of your penis where the cone shaped head meets the body of the penis, and to squeeze for a few minutes. She should continue with this until your urge to ejaculated passes.

Third stage: After the squeeze stage wait approximately 30 seconds and return to foreplay. During the squeeze stage there may be a slight reduction in the stiffness of your penis but it will regain full stiffness after arousal.

Fourth stage: Once the urge to ejaculate returns, ask your partner to repeat the squeeze procedure.

When you repeatedly go through these stages you can start vaginal intercourse without ejaculation at the moment of entrance into the vagina. After some practice you will have learned how to delay ejaculation without any need for the squeeze-release technique.

• Drugs

Some antidepressants and certain creams that desensitize the penis when applied onto it, can also be used to treat premature ejaculation.