Definition Premature ejaculation is a condition in which semen is released from the penis with little sexual excitement. Ejaculation usually occurs before or shortly after 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 occurs repeatedly, it can cause stress in a relationship. Ejaculation may occur before either partner has had time to fully enjoy the sexual activity.
What are the signs and symptoms of the condition? Signs and symptoms of premature ejaculation include:
ejaculation before the penis is inserted into the vagina
ejaculation 1 to 2 minutes after intercourse begins
self-doubt, anxiety and guilt
What are the causes and risks of the condition? The cause of premature ejaculation is rarely physical. The condition may result from:
anxiety
sexual inexperience
guilty feelings about sex
negative feelings toward the sexual partner
Rarely, this condition may be linked to neurological problems such as multiple sclerosis. It can also be due to inflammation of the urethra or the prostate, such as acute prostatitis.
What can be done to prevent the condition? It is hard to prevent this problem since its cause is not always known.
How is the condition diagnosed? Diagnosis of this problem is based on symptoms. A man's physical examination and laboratory tests usually appear normal.
What are the long-term effects of the condition? Long term effects of may include:
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.
What are the treatments for the condition? There are three general types of treatment. These include counselling, behavioural modification, and medical therapy. Psychological issues are often part of the cause. Therefore, counselling 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 behavioural therapy or counselling is rejected or fails. It is also a choice when partners are unwilling to cooperate in treatment.
What are the side effects of the treatments? Side effects of antidepressants include:
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
How is the condition monitored? If the condition improves, there is no need for further monitoring. If symptoms recur, the same techniques are used.
Author: Stuart Wolf, MD Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
