- Premature ejaculation (31%) is more prevalent than erectile dysfunction(20%).
- Men with premature ejaculation have:
- 90% Poor control over ejaculation
- 75% has personal distress
- 78% has dissatisfaction
- 50% has interpersonal difficulty
- Only 38% of partner with premature ejaculation felt satisfied with their intimate relationship.
Premature ejaculation (PE) is a condition where a man ejaculate earlier than his partner would like to. Various definition has been used worldwide. For example:
- American Psychiatry Association define PE as persistent or recurrent ejaculation with minimal sexual stimulation prior to or shortly after penetration and before person wishes it.
- WHO defined PE as the inability to delay ejaculation sufficiently to enjoy lovemaking, which is demonstrated by either an occurrence of ejaculation before or shortly after the beginning of intercourse or ejaculation that occurs in the absence of a sufficient errection to make ejaculation possible.
- International Society for Sexual Medicine deines PE as a male sexual dysfunction characterised by ejaculation which always or nearly occurs prior to or within about one minute of vaginal penetration and inability to delay ejaculation on all or nearly vagina penetrations and negative personal consequences such as distress, bother, frustration and/or the avoidance of sexual intimacy.
Based on these definitions, there are 3 important points: time to ejaculate, inability to control or delay ejaculation and negative consequences like bother or distress from PE.
Aetiology Of PE
It is estimated around 20-30% of men has PE and it is widely considered as the most common male sexual dysfunction. However, the causes behind PE is still obscure. Some conditions have been associated with PE, for example:
- Psychological problem: anxiety, poor body image, relationship problem, depression
- Biological problem: reduction of certain hormone level, proctitis, metabolic syndrome
- Neurological problem.
Most of the time, psychological issue is the most relatable cause for PE. With proper treatment, patient may able to overcome PE and thus experience normal sexual pleasure.
How do I know if I have PE?
As mentioned previously, there 3 important factors that need to be considered in order to understand the problem.
- Time to ejaculate: always or frequently ejaculate within one minute of penetration.
- Inability to prolong ejaculation during intercourse
- You and your partner felt distressed about this issue.
While seeing your doctor, he or she may want to ask further history regarding your sexual intimacy and it is always recommended if you can be open and share your problem with the doctor. Apart from that, the doctor may need to examine you and look for specific signs that may point towards the causes of PE.
There are also questionnaire that can be used by the doctor. For example, Premature Ejaculation Diagnostic Tool (PEDT) which is self-administered questionnaire to help doctor to screen and asses PE and its treatment.
- Non pharmacological intervention
- Start and stop technique
- Squeeze method
- Kegel exercise
These methods success rate is about 50-60%. However success rate will improve greatly if you could combine above method with pharmacological intervention.
- Pharmacological intervention
- Local anaesthetic agent: with minimum side effects, you may improve ejaculation time by applying this topical cream.
- Selective serotonin reuptake inhibitor (SSRI): this medication can be taken either on daily basis or on demand basis. Many people prefer to take only on demand basis due to its possible side effects which include dizziness, abdominal discomfort, nausea and headache.
- PDE5i: this medication is primarily use to treat erectile dysfunction. So how can it improve your ejaculation time? With stronger and long lasting erection, some people will have more confidence and motivation during their sexual activity hence improving ejaculation time as well.
- Shock wave treatment: primarily use to treat erectile dysfunction, this treatment option also give extra options to patient who do not prefer any medications that may have certain unwanted side effects but a treatment which may improve ED/PE without worrying of undesirable side effects.
Come and speak with us if you have premature ejaculation. We would be delighted to share our experience with you hence giving you extra motivation in your quest to conquer your problem.