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Premature Ejaculation

Information on premature ejaculation and how to delay ejaculation

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Dr Hilary Jones discusses premature ejaculation and the treatments available at HealthExpress

Premature ejaculation is said to affect up to 30% of men in the UK and is one of the most frequently occurring male sexual conditions. This condition can occur during vaginal, anal and oral sex. Although a personal diagnosis can be seen as subjective, a general theory by doctors is that premature ejaculation (PE) is usually diagnosed if you are a man who frequently ejaculates under 2 minutes after penetration. By understanding why PE occurs, it may help in preventing or treating the condition providing more control of the ejaculatory reflexes.

If you believe you are suffering from PE, then there's no need to be worried, most cases are psychological and not long term and dealing with the psychological aspect whilst using proven treatment can help to alleviate worries about future performances. You can order a medically proven premature ejaculation treatment below, or read further for more information about the condition.

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What is premature ejaculation?

It isn't unusual for a man to suffer from PE at some point in their life, and this could be due to sexual inexperience, a long gap between sexual intercourse, or if experiencing nerves when having sexual intercourse with a new partner. What is defined as too early can also vary from individual-to-individual, however medical professionals often diagnose premature ejaculation (PE) when a man ejaculates (orgasms) less than 2 minutes of being aroused. This must happen most of the time and can be caused by one or all of the following:

  • Vaginal sex
  • Anal sex
  • Oral sex
  • Masturbation
  • Physical contact

Each individual will have different expectations to whether their ejaculation is premature making the condition difficult to define, however this is the main diagnosis doctors currently follow. It doesn't matter what method of stimulation causes your condition – all can be treated.

Premature ejaculation is not to be confused with:

  • Delayed ejaculation; an inability to ejaculate or significant delay, typically over 30 minutes
  • Retrograde ejaculation; production of no semen or a small amount sue to sperm travelling backwards

The differences between premature ejaculation and erectile dysfunction

Premature ejaculation can sometimes be mistaken for being similar to erectile dysfunction. However, premature ejaculation is in fact different in its definition. According to WebMD [1]"premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration. It happens with minimal sexual stimulation and before the person wishes. It may result in unsatisfactory sex for both partners".

Premature ejaculation and erectile dysfunction, otherwise known as impotence, are often associated with one another, as both affect your erection. The difference is that PE is ejaculating (cumming) too quickly whilst impotence is the inability to either achieve or maintain an erection.

How is premature ejaculation diagnosed?

The average time before ejaculation during sexual activity differs for each man. Whilst some men are capable of lasting for longer than 30 minutes before climaxing, others may ejaculate after only a few minutes or even seconds. Various studies have suggested that the average time of intercourse before ejaculation is between 6-12 minutes. As it depends so much on personal experiences and expectations, it is difficult to determine the cut-off point for men who suffer from premature ejaculation and those who don't.

As a general rule, experts in the medical profession consider that premature ejaculation occurs when men reach climax in less than 2 minutes. Asking your doctor for a routine check-up or completing an online consultation can determine whether you may be suffering from this condition.

Types of premature ejaculation

Premature ejaculation can be categorised into two forms known as lifelong' or acquired premature ejaculation:

  • Lifelong premature ejaculation refers to the condition being present from the first time of having intercourse and continuing throughout the lifetime of the man.
  • Acquired premature ejaculation on the other hand is usually identified by a gradual or sudden onset of the problem, with ejaculatory periods becoming shorter each time, or a psychological/physical cause bringing about premature ejaculation.[2]

Causes of premature ejaculation

Premature ejaculation can occur due to various reasons, and these can be categorised into psychological, physical or lifestyle factors, or in some cases a combination of all three. Major psychological causes are stress, a lack of confidence, guilt and anxiety. Men who are sexually inexperienced are more prone to psychologically caused premature ejaculation, however, this is likely to improve as they become more sexually confident.

Physical causes such as neurological related problems, vascular conditions, spinal cord injuries and multiple sclerosis can also play a large part in causing an early climax. More often than not, these problems are a symptom of an unavoidable circumstance, such as a medical condition. The intake of alcohol, drugs and nicotine are all preventable causes of premature ejaculation. These poor lifestyle habits may, if continued, lead to permanent problems later in life.

For a clearer idea of the premature ejaculation cases, you can see below:

Physical factors

More often than not, the physical factors associated with PE symptoms are an unavoidable circumstance, such as a medical condition:

  • Vascular conditions
  • Spinal cord injuries
  • Multiple sclerosis
  • Diabetes
  • Prostate disease
  • High blood pressure
  • Neurological related issues

Psychological factors

Those who are more sexually inexperienced are prone to psychologically caused premature ejaculation as well as those with previous negative experiences of sex and quite possibly even sexual health education; however, this is likely to improve as you become more sexually confident:

  • Stress
  • A lack of confidence
  • Guilt
  • Anxiety
  • Unresolved emotional issues

For more information about psychological issues surrounding PE, you can find out more at the NHS.[3]

Lifestyle factors

All lifestyle factors are preventable causes of premature ejaculation (PE) that can always be altered:

  • Alcohol
  • Drugs
  • Nicotine

If you're experiencing premature ejaculation and you feel your medication could be the cause, it is advised to see your GP for further help.

Symptoms of premature ejaculation

It's currently very difficult to clearly indicate what the specific symptoms of premature ejaculation are. This is because all men have a different perception of how long sex should last; therefore this perception differs from person-to-person. Although no accurate length for sexual intercourse has been determined, early studies into this condition have discovered the following symptoms:

  • Ejaculation occurring within under two minutes (120 seconds)
  • The above symptom occurring regularly, as most men will experience early ejaculation at some point in their life.

A regular occurrence of early ejaculation is a sign that you may potentially be suffering from premature ejaculation. It is still important to discuss your symptoms with a doctor, so that they can determine whether medication is required.

Benefits of treating premature ejaculation

There are a number of benefits that can be experienced from successfully treating premature ejaculation:

  • Improving self confidence
  • Improving your partner's confidence
  • Enhancing sexual performance
  • Better long-term sex life
  • Stress and anxiety from being unable to sustain an erection is avoided

Premature ejaculation can negatively affect one's sexual performance, which can cause strain on a relationship. By treating premature ejaculation, these issues can be mended, and a healthier relationship can be restored.

How to treat premature ejaculation

Before you settle on a treatment you need to consider what might be causing your problem. The best way to do that, is to ask yourself the following questions:

  • Is the problem due to psychological factors or a combination of psychological and physical factors?
  • Is the problem lifelong or have you been experiencing it recently?
  • Do you regularly suffer from premature ejaculation or is it situational?

If you're still having difficulty finding your cause, then it may be best to consult a medical specialist to understand and diagnose the situation. If you are merely looking for a medical solution then you can take the online consultation here and receive clinically proven treatment for the condition.

Therapy

Couples therapy can benefit those who are in a long-term relationship. You and your partner are encouraged to explore any issues that may be affecting your relationship, and receive professional advice about how to resolve them. You can also learn techniques that can help counteract premature ejaculation such as the 'squeeze technique' and the 'stop-go technique'. You can also pay privately for sex therapy, which can cost around £40 a session.

Selective serotonin re-uptake inhibitors (SSRIs)

Selective serotonin re-uptake inhibitors (SSRIs) have also been used as unlicensed alternative treatments for premature ejaculation. Although their primary function is to treat depression, their effects have been known to increase the time before ejaculation so that men can achieve longer-lasting sex. Some short-acting SSRIs have been manufactured specifically to treat premature ejaculation, although they are not currently licensed for use in the UK or available on the NHS.

Prescription medication

Prescription medication is the most effective treatment for premature ejaculation. In particular, Priligy is the only medication available to treat this condition, and is also currently the most reliable and effective method for treating premature ejaculation. This is because there isn't enough evidence or studies reflecting the effectiveness of the other methods mentioned above. While Priligy pills aren't considered a cure, it does overcome premature ejaculation in the short term, and has been proven to do so in various clinical studies. In order to get the best results possible, it is recommended that you use prescription medication alongside another one of these methods. The below prevention tips can also help you to avoid premature ejaculation in the long run, preventing a reoccurrence.

How to prevent premature ejaculation

Before you settle on a treatment you need to consider what might be causing your problem. The best way to do that is to ask yourself the following questions:

  • Is the problem due to psychological, physical or lifestyle factors or a combination?
  • Is the problem lifelong or acquired - have you been experiencing it recently?
  • Do you regularly suffer from premature ejaculation or is it situational?

If you're still having difficulty pinpointing your cause, take an online consultation with us and one of our doctors can diagnose your condition in the strictest of confidence.

There are a variety of techniques that have been said to help slow down or prevent premature ejaculation, although not all have been scientifically tested or proven. These techniques include:

  • Deep breathing – helps to control arousal and tension, leading to early ejaculation
  • Using thick condoms – helps to decrease sensation
  • Having sex with your partner on top – allowing them to pull away when you are close to ejaculating
  • Taking breaks during sex – increases the length of sexual intercourse

How to last longer in bed

There are a number ways to address premature ejaculation problems. Simple things you can do include:

  • Wearing a thicker condom (condom)
  • Using delay creams (cream tube)
  • Benzocaine condoms (condom)

Both delay creams and benzocaine condoms use a mild anaesthetic. There are a number of behavioural techniques that may also help to delay the time taken to ejaculate during sexual activity. These include the 'stop and squeeze' and the 'stop/start' method detailed below.

What PE treatment should I choose?

Medication

The only clinically proven medication for premature ejaculation is Priligy dapoxetine. Taken orally, trails have shown an increase of 200%-300%. Belonging to the same group as selective serotonin re-uptake inhibitors (see below), the medication works by stopping the ejaculatory expulsion reflex, prolonging sexual intercourse.

A bit more about selective serotonin re-uptake inhibitors (SSRIs)

Although their primary function is to treat depression, their effects have been known to increase the time before ejaculation so that men can achieve longer-lasting sex. Some short-acting SSRIs have been manufactured specifically to treat premature ejaculation.

Couples therapy

Couples therapy can encourage those in a short-term or long-term relationship to explore any issues that may be affecting your relationship, and receive professional advice about how to resolve them. This is a slow process, but potentially beneficial and more effective for those with PE stemming from psychological factors. You can also pay privately for sex therapy, which can cost around £40 a session.

Squeeze technique and start-stop technique

You can also learn techniques that can help counteract premature ejaculation such as the 'squeeze technique' and the 'stop-go technique'.

  • The squeeze technique involves squeezing the shaft of the penis between the thumb and the forefinger just before ejaculation. Practice makes perfect with this method, with your partner and without, but it has been proven to work.
  • The start-stop technique involves stopping mid-way towards an orgasm, cooling down then starting again to prolong intercourse.

Do I need surgery?

As with all conditions, operations are seldom advised to treat premature ejaculation, especially as a large proportion of cases are psychologically induced. Instead, you may wish to try various forms of therapy, such as couples therapy or psychosexual therapy, or medication.

What are the options we have to offer?

At HealthExpress we only offer proven, prescription treatments approved by the MHRA to treat different conditions. In the case of premature ejaculation, we provide Priligy which works to increase the duration of intercourse before ejaculation.

With a quick and completely discreet service tailored for your lifestyle, just complete our free, no obligation consultation to order your treatment, without the hassle of a face-to-face appointment with a GP. You can then place an order online, and your prescription will then be sent directly to our UK-based pharmacy. There is no charge for delivery and your treatment could be with you the next day, or same day for London postcodes.

Sources