Premature ejaculation manifests when a man attains climax sooner than intended during intimate encounters, impacting both his satisfaction and that of his partner. This prevalent concern affects 30% to 40% of men and stems from a confluence of physical, chemical, and emotional/psychological factors. Delve into the following article for a comprehensive exploration of the underlying causes of premature ejaculation.
Expert insights in this article have been provided by Dr. Sarah Ellen Huffam, a medical consultant from Royal Darwin Hospital in Tiwi NT, Australia.
12 Causes of Premature Ejaculation
Historically, premature ejaculation was predominantly ascribed to psychological origins. However, contemporary perspectives posit that certain men, particularly those grappling with lifelong premature ejaculation, may be contending with neurobiological factors – a chemical imbalance in the brain centers governing this physiological function. This imbalance can precipitate consequential psychological challenges, notably performance anxiety.
Psychological contributors to premature ejaculation encompass:
- Depression or anxiety, particularly associated with performance concerns.
- Apprehension and stress stemming from the fear of rejection by a partner.
- Pervasive expectations of failure.
- Negative sexual experiences during formative years.
- Influences of religious beliefs.
- Stressors within interpersonal relationships.
- Medical etiologies, including urethral inflammation, prostatic inflammation, foreskin inflammation, and systemic conditions such as diabetes, hypertension, hyperlipidemia, as well as hepatic and renal ailments, obesity, etc., may also
- underlie premature ejaculation.
- Furthermore, immoderate or improper masturbation, uncomfortable or confining sexual environments, and the misuse of stimulants like alcohol, beer, alcoholic beverages, and habitual tobacco consumption can exacerbate the
- In certain cases, premature ejaculation may manifest concomitantly with erectile dysfunction, where individuals encounter challenges in achieving or sustaining an erection suitable for sexual intercourse.
Premature Ejaculation Treatment
Initiating the journey towards premature ejaculation treatment through consultation with a physician or a certified sex therapist is a prudent decision. The chosen treatment approach hinges on the root causes of the condition and whether it is a persistent or acquired issue. Treatment options encompass:
1. Psychological and Behavioral Therapy
Behavioral therapy involves the exploration of various techniques aimed at delaying climax. The objective is to impart control over both physiological and emotional responses. Techniques include:
- Start-Stop Technique: Collaboratively with your partner, stimulate your penis close to climax and then interrupt stimulation for approximately 30 seconds until mastery over your response is regained. Reiterate the “start and stop” process three or four times before allowing climax. Persistence in this technique enhances control.
- Squeeze Technique: This method involves stimulating the penis near climax and gently squeezing the glans for about 30 seconds to induce loss of erection. Replicate this technique several times before permitting climax. Consistent practice contributes to gaining mastery over delaying climax.
- Distracting Thoughts: Redirecting focus towards unrelated, mundane thoughts during sexual stimulation is part of this technique. Structuring a mental list serves as an effective distraction. For example, mentally list the businesses passed on the way to the gym, the players in a favorite sports team, or the products on the shelves of a preferred store.
2. Psychological Counseling
When the crux of premature ejaculation lies in psychological, emotional, or relational complexities such as performance anxiety, depression, stress, guilt, or relationship discord, seeking guidance from psychologists, psychotherapists, couples’ therapists, or sex therapists is advised. Your urologist can facilitate referrals to these healthcare professionals. Under the expert guidance of a seasoned sex therapist, underlying sexual concerns can be explored and alleviated.
3. Reducing Penis Sensation
Topical anesthetics, comprising sprays and creams, are employed to mitigate penile sensitivity and are applied 30 minutes before intercourse. Utilizing these treatments in conjunction with condoms prevents absorption by the partner. The use of two condoms can further diminish sensitivity.
If premature ejaculation is intertwined with erectile dysfunction, medications addressing erectile dysfunction, such as PDE5 inhibitors (Viagra, Cialis, Levitra), may aid in regaining control over ejaculation.
Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) like citalopram, escitalopram, fluoxetine, paroxetine, and sertraline, or tricyclic antidepressants like clomipramine, exhibit efficacy in delaying premature ejaculation. This application is considered off-label (not FDA-approved for this purpose). A thorough discussion regarding potential side effects should be conducted with your urologist to ensure appropriateness.
SSRIs and tricyclic antidepressants, recognized for their delay in ejaculation when used for treating depression, can be beneficial for premature ejaculation when employed alongside counseling. SSRIs may present side effects such as reduced libido, nausea, sweating, gastrointestinal disturbances, and fatigue. Dapoxetine, a specific SSRI, stands as the lone FDA-approved medication for treating premature ejaculation and is taken on-demand before sexual activity.
Topical anesthetics, in the form of creams and sprays applied to the head and shaft of the penis, represent an additional medication option for delaying ejaculation. Application should occur 10 to 30 minutes prior to intercourse or until diminished sensitivity is perceived. It is imperative to cleanse the penis before sexual activity to prevent numbing the partner’s vagina or compromising the ability to sustain an erection.
Premature ejaculation, often amenable to treatment through straightforward measures, underscores the importance of consulting a urologist or relevant healthcare professionals when experiencing such concerns.