Sexual concerns, including premature ejaculation, are relatively common. Here we learn about how to manage premature ejaculation.
Premature ejaculation happens when a person with a penis climaxes before they or their partner would’ve wanted to during sex. People dealing with premature ejaculation tend to orgasm within 1 minute of being stimulated sexually and are usually unable to delay ejaculation.
It can be frustrating and even embarrassing, but it’s a common issue for men. Between 30% to 40% have it at some time in their life. So, keep in mind — it’s not something to worry about if it happens only occasionally.
What Causes Premature Ejaculation?
PE can be psychological and/or biological and can occur because of over-sensitive genital skin, hyperactive reflexes, extreme arousal, or infrequent sexual activity. Other factors are genetics, guilt, fear, performance anxiety, inflammation, and/or infection of the prostate or urethra and also can be related to the use of alcohol or other substances.
PE occurs in up to 30% of men, involving all ages, ethnicities, and socioeconomic groups. PE can cause embarrassment, frustration, and loss of self-confidence and can be devastating to a relationship. It is very typical among men during their earliest sexual experiences.
PE can be lifelong or acquired and sometimes occurs on a situational basis. Lifelong PE is thought to have a strong biological component. Acquired PE can be biological, based on inflammation/infection of the reproductive tract, or psychological, based upon situational stressors. PE can sometimes be related to Erectile Dysfunction (ED), with the rapid ejaculation brought on by the desire to climax before losing the election.
Emphasis on ejaculation as the focal point of sexual intercourse tends to increase the performance anxiety that can initiate the problem. Once PE has occurred and established itself, fear of and mental preoccupation with the issue can actually induce the unwanted rapid ejaculation, creating a vicious cycle.
Emotional factors can play a role:
- Relationship problems
- Lack of confidence or poor body image
- Concern over your sexual performance
- Negative feelings about the idea of sex (sexual repression)
Some physical conditions may also cause PE, including:
- Unusual hormone levels
- Irregular levels of neurotransmitters (an imbalance of the chemicals in your brain that pass messages or impulses to the rest of your body)
- Inflammation or an infection in your prostate or urethra (the tube that runs from your bladder and sends pee out of the body)
- Genetic traits you inherit from your parents
Sometimes PE can be a problem for men with erectile dysfunction (ED). That’s when the penis doesn’t remain firm enough for sex. Men who are worried they could lose their erection may develop a pattern of rushing to ejaculate. It can be a hard habit to break.
Treating erectile dysfunction may make premature ejaculation go away. There are many medication options.
Types of Premature Ejaculation
There are different forms of premature ejaculation.
When a penis owner experiences premature ejaculation from their first sexual encounter onward, consistently ejaculating within one minute after vaginal penetration, this is said to be a lifelong condition. In the case of lifelong PE, sexual intercourse has always been marked by unwanted, early ejaculation within seconds.
This condition is usually linked to difficulty in timing erections, detumescence (loss of an erection), and arousal.
People with lifelong PE may also experience early erections, early ejaculation, and early detumescence. Lifelong premature ejaculation may be traced to neurobiological and genetic factors, including familial history of the condition.
Acquired Premature Ejaculation
A person with acquired PE has had some experiences with normal ejaculation. Acquired premature ejaculation may develop at some point in an individual’s life due to a medical, psychological, or relational origin.
This condition may also be caused by an infection of the prostate, thyroid disorders, erectile dysfunction, or prostatitis.
Generalized Premature Ejaculation
Premature ejaculation is considered generalized when it occurs with every partner and in any setting. Early ejaculation can happen regardless of the kind of stimulation received.
Situational Premature Ejaculation
People with situational PE may experience it in identified situational contexts. It may only occur with certain types of stimulation, with a particular partner, or in specific situations or scenarios.
How to Manage With Premature Ejaculation
There are different options available to manage premature ejaculation. Depending on the cause of the condition, treatment may be through behavior therapy, counseling, or medication.
The first consideration for care is usually behavior therapy. This may, however, be combined with other methods for effective relief.
This treatment is aimed at teaching the body to control orgasms and their timing. Different methods may be adopted:
The “Stop-Start” Strategy for Delaying Ejaculation
Using this technique, a penis owner may stimulate the penis alone or with the help of a partner. This usually continues until the point where the urge to ejaculate is felt, at which point stimulation stops until the sensation passes. This technique is repeated several more times before allowing the ejaculation to occur. The start and stop method is also known as “edging.” To build control over ejaculation time, this exercise should be practiced often.
The “Pause-Squeeze” Technique for Delaying Ejaculation
Similar to start and stop, this method is meant to teach ejaculation delay tactics. The stop-squeeze or pause-squeeze technique may be practiced alone or with a partner. The goal is to stimulate the penis until the urge to ejaculate is felt. At that point, stimulation is stopped and the top of the penis is squeezed at the point where the head (glans) joins the shaft. Hold the squeeze for several seconds until the urge to ejaculate passes. This process is repeated several times to build resistance to premature ejaculation.
Masturbating Before Sex
You can try to masturbate before engaging in sex to delay ejaculation when you do have intercourse. In younger people, masturbation is employed before intercourse to prevent early ejaculation. This method may be less popular with older individuals because of the longer recovery time that may be required after masturbating.
Another technique suggests allowing the mind to wander to other things when sexually stimulated. By focusing on other thoughts, concentration is focused on something other than an imminent orgasm. Examples of distracted thoughts could be attempting to recall a colleague’s outfits from the past week or considering alternate names for different ice cream flavors.
When premature ejaculation is caused by emotional distress, mental health counseling or sex therapy may be helpful. If relationship difficulties or serious mental health issues like depression or anxiety are affecting sexual performance, therapy can help with healing and recovery.
Medication for Premature Ejaculation
Many pharmaceutical options are available to help treat premature ejaculation. A common side effect of certain antidepressants is delayed ejaculation, so selective serotonin reuptake inhibitors (SSRIs) such as Paxil (paroxetine) may be helpful.
When used sporadically, Ultram (tramadol)—a medication commonly used to treat pain with a side effect that delays ejaculation—has been shown to improve the sex lives of patients. It is important to consult with your doctor if you are considering any of these options to help treat premature ejaculation.
Before deciding on a pharmaceutical option to manage PE, it is important to consult with your physician or urologist.
The oral medications for erectile dysfunction—phosphodiesterase-5 (PDE5) inhibitors—work by enhancing the effects of nitric oxide, a naturally-occurring substance that relaxes blood vessels to allow blood to flow into the penis. With this effect in place, it’s possible to get an erection in response to sexual stimulation and sustain it.
Viagra (sildenafil): Maybe effective within 30 to 60 minutes can last up to 12 hours
Cialis (tadalafil): May be effective within 60 to 120 minutes and may last up to 36 hours
Levitra or Staxyn (vardenafil): May be effective within 30 to 60 minutes and can last up to 10 hours
Stendra (avanafil): Maybe effective within 15 to 30 minutes and can last up to 12 hours
Another pharmacological option is numbing medication. Anesthetic/desensitizing creams or sprays may be applied to the head and penile shaft to slow ejaculation. These creams should be applied around 20 minutes before expected intercourse. These creams may require condom use to avoid a mess. Condoms also manage the effects of the cream upon penetration.
Numbing sprays require about five minutes before taking effect. This spray may be wiped off before penetration and does not require condoms to manage its effects.
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