Premature ejaculation, definition, causes, what to do?
Premature ejaculation is a condition in which a man ejaculates sooner during intercourse than he or his partner would like. Premature ejaculation can happen before or shortly after penetration. Premature ejaculation can be frustrating and embarrassing. You may feel you don’t have enough time to enjoy sex. For some men, embarrassment about premature ejaculation can cause problems with intimacy and damage their relationships.
There are a number of possible causes of premature ejaculation, including psychological causes such as anxiety, guilt or depression. Other possible causes include physical problems such as inflammation of the prostate gland or a nervous system disorder.
If you’re concerned about premature ejaculation, talk to your doctor. He or she may refer you to a urologist or a mental health provider specializing in sexual problems.
If you have premature ejaculation, you may find relief with medication, counseling or sexual techniques.
Medication. Two types of medications have been found to be effective in treating premature ejaculation — topical anesthetics and certain antidepressants.
Topical anesthetics. These products are applied to the head of the penis to reduce sensation. They can help you last longer in bed, but they can also reduce the pleasure you feel during sex.
Certain antidepressants. Tricyclic antidepressants, such as clomipramine (Anafranil), and selective serotonin reuptake inhibitors, such as fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft), may delay ejaculation. These drugs may be used on an as-needed basis or daily. Possible side effects include decreased libido, nausea and vomiting.
Counseling. If you have premature ejaculation, you and your partner may benefit from counseling. Counseling can help you and your partner to communicate better and to understand each other’s needs.
Sexual techniques. You may be able to reduce the problem by using a different sexual technique, such as the stop-start method. With this method, you or your partner stimulates your penis until you feel almost ready to ejaculate. Then stimulation is stopped for about 30 seconds. The process is repeated three to five times before you allow yourself to ejaculate.
When to see a doctor
Talk to your doctor if you’re concerned about premature ejaculation, especially if it’s a new problem.