Premature Ejaculation – Evaluation and Management

What is Premature Ejaculation?

In most people, once the penis enters the vagina during sexual intercourse, there is a delay of 5 to 6 minutes before ejaculation. Premature dysfunction is a male sexual disorder in which you ejaculate before fully satisfying yourself or your partner over 50% of the time.

Causes of Premature Ejaculation

Most conditions of premature dysfunction develop over time (secondary premature ejaculation), but some cases may be life-long (primary premature ejaculation). Life-long conditions may be the result of

  • Habits formed in your youth, negative sexual experiences, strict beliefs or upbringing which prevent you from relaxing during the act
  • Genetic influences
  • Highly sensitive penis

Premature dysfunction acquired over time usually have the following causes:

  • Physical causes include high blood pressure, diabetes, neurological disorders, prostate disease, thyroid problems and substance abuse
  • Psychological causes include performance anxiety, relationship problems, depression or stress

Diagnosis of Premature Ejaculation

Having an occasional episode of premature dysfunction is normal, but if it occurs frequently enough to affect your quality of life, do not hesitate to get it evaluated. Your doctor will review your history and perform a physical examination with tests to identify any medical problems that may be causing premature dysfunction. You will also be interviewed to identify any substance abuse or psychological causes.

Treatment of Premature Ejaculation

Your doctor may prescribe medication to treat premature dysfunction. Couples therapy may be recommended to resolve marital issues, improve intimacy, remove psychological blocks, and teach you sexual techniques that delay ejaculation. Topical anaesthetics or thick condoms may be recommended to decrease sensation; thereby delaying ejaculation. You are counselled against substance abuse and if necessary, therapy is recommended.