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Premature Ejaculation

  • Male reproductive organs

Definition

Premature ejaculation is a condition in which semen is released from the penis before the partner has had adequate time or stimulation to become fully aroused. Ejaculation may even occurs before intercourse begins.

What is going on in the body?

The causes of this condition are not well understood. It is common for a man to have this problem once in a while. If the problem occur repeatedly, it can cause stress in a relationship. Ejaculation may occur before either partner has had time to fully enjoy the sexual activity.

Risks

What are the causes and risks of the condition?

The cause of premature ejaculation is rarely physical. The condition may result from the following psychologic factors:
  • anxiety
  • sexual inexperience
  • guilty feelings about sex
  • negative feelings toward the sexual partner
The physical causative factors are as follows:
  • increased sensitivity of the penis
  • abnormal ejaculatory threshold in brain pathways
  • multiple sclerosis
  • inflammation of the urethra or the prostate, such as acute prostatitis.

Prevention

What can be done to prevent the condition?

It is hard to prevent this problem since its cause is not always known.

Diagnosed

How is the condition diagnosed?

Diagnosis of this problem is based on symptoms. A man's physical exam and laboratory tests usually appear normal.

Long Term Effects

What are the long-term effects of the condition?

Long term effects of may include:
  • stress on both partners
  • erectile dysfunction as a result of anxiety over the problem
  • strain on the relationship

Other Risks

What are the risks to others?

This is not a contagious disease. It may have a negative impact on the man's sexual partner, whose sexual needs are not being met.

Treatments

What are the treatments for the condition?

There are three general types of treatment. These include counseling, behavioral modification, and medical therapy. Psychological issues are often part of the cause. Therefore, counseling by a sex therapist is often advised. Therapy may involve both partners becoming more aware of their own and each other's bodies. Partner may be encouraged to caresses the other's body without intercourse. Instead, they are to focus on the pleasures of touch.
Another method involves a squeeze technique. In this exercise, the couple engages sexual activity including penile stimulation without intercourse until the man is almost ready to ejaculate. The partner then squeezes the head of the penis. Squeezing should be sustained for several seconds. After the pressure is released, the couple should wait about a half a minute. After that, they may continue foreplay. This process is repeated until it both partners are ready to climax. The goal of this technique is for the man to become accustomed to the feeling of delayed ejaculation. After several sessions, regular intercourse may be tried without the squeeze technique.
Antidepressant medications have had good results in slowing ejaculation. Treatment with medications is an excellent choice when behavioral therapy or counseling is rejected or fails. It is also a choice when partners are unwilling to cooperate in treatment.

Side Effects

What are the side effects of the treatments?

Side effects of antidepressants include:
  • sleep disorders
  • drowsiness
  • jittery feelings or anxiety

After Treatment

What happens after treatment for the condition?

During and after treatment it is important for a man to:
  • maintain a positive self-image
  • remember that this is a common condition
  • keep in mind that the condition does not reflect on masculinity
  • remember that the condition is reversible

Monitor

How is the condition monitored?

If the condition improves, there is no need for further monitoring. If symptoms recur, the same techniques are used.

Sources

Professional Guide to Diseases, Springhouse, 1995.

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