Dr. Rahul Yadav is currently Senior Consultant in Department of
Urology and Renal Transplant, Apollomedics Super Speciality Hospital, Lucknow
discusses about Premature Ejaculation, Signs,
Diagnoses, Treatments, Behavioral methods, questions etc.
What
is premature ejaculation?
Premature ejaculation happens when a man has
an orgasm sooner than he or his partner would like. Premature ejaculation can
happen before or shortly after penetration.
There is no set time for how long a man
should "last" during sex. But when a man has an orgasm before he
wants to, he loses his erection and can't continue with intercourse. Premature
ejaculation can be frustrating and embarrassing. You may feel you don't have
enough time to enjoy sex. You may have difficulty satisfying your partner. For
some men, embarrassment about premature ejaculation can cause problems with
intimacy and damage their relationships.
Premature ejaculation is a common problem
among men. About 30% to 40% of men have this problem at some time in their
lives.
What
causes premature ejaculation?
A number of emotional and physical factors
can lead to premature ejaculation. It may happen when a man becomes too excited
or stimulated, or if his penis is very sensitive. It may also happen if a man
is nervous or uncomfortable with a new partner. Other common causes include the
following:
Men who have a low amount of a special
chemical called serotonin in their brain may have problems with premature
ejaculation.
·
Anxiety about performance
·
Guilty feelings
·
Depression
·
Stress
·
Relationship problems
Is
premature ejaculation a sign of a serious health problem?
Not in most cases. Rarely, premature
ejaculation results from a serious health problem, such as nervous system
damage from surgery or trauma.
How
Is Premature Ejaculation Diagnosed?
To make a diagnosis, the health care provider
asks questions about sexual history: experience, emotions, fears, and sexual
disorders. For the diagnosis, premature ejaculation must cause distress or
problems with a relationship. It can’t be related to drugs, such as narcotics.
How
is premature ejaculation treated?
If it happens frequently, and it makes you or
your partner unhappy, you may want to talk to your family doctor. There are
several possible methods for delaying orgasm.
Behavioral
methods
Behavioral methods are helpful for more than
95% of men who have premature ejaculation. In this type of treatment, you
practice controlling your ejaculation, either alone or with a partner.
In addition to using a behavioral method, you
may want to try thought distractions. For example, while you're being sexually
stimulated, think about the names of players on your favorite sports team.
·
In the start-and-stop method, you
or your partner will stimulate your penis until you feel like you are about to
have an orgasm. Then the stimulation stops for about 30 seconds. Once you
regain control of your response, stimulation begins again. This process is
repeated 3 or 4 times before you allow yourself to have an orgasm.
·
The squeeze method, works in a similar way.
When you feel like you are about to ejaculate, you or your partner will gently
squeeze the head of your penis for about 30 seconds so that you begin to lose
your erection. You repeat this process several times before you allow yourself
to reach orgasm.
Psychological
Assistance
Anxiety, depression and other emotional
issues can lead to premature ejaculation. For these issues, seeking the help of
a psychologist, psychiatrist or sex therapist may be helpful. Couples therapy
may also help if relationship problems are the cause of premature ejaculation.
Several medical treatments may help men who
have premature ejaculation. Some antidepressants seem to help delay
ejaculation, including antidepressants called selective serotonin re-uptake
inhibitors (SSRIs). These antidepressants are available with your doctor's prescription.
Also, antidepressants may cause side effects such as nausea, dry mouth and
drowsiness. Antidepressants may also decrease your desire to have sex. Your
family doctor can help you decide if an antidepressant is right for you.
Anesthetic creams can also be used to prevent
premature ejaculation. These creams are applied to the head of the penis to
make it less sensitive. Usually, the cream is applied about 30 minutes before
sex and then washed off once it has decreased the feeling in your penis. The cream
must be washed off before sex. If it is left on, it can cause a loss of
erection and vaginal numbness.
For some men, simply wearing a condom can
help delay ejaculation because it may make the penis slightly less sensitive.
Questions?
·
What can I do to stop myself from ejaculating
so quickly?
·
Is there a medicine that I can take that will
help?
·
I'm embarrassed by this—is there someone I
can talk to about it?
·
Premature ejaculation is causing problems in
my relationship; should we go to counseling?
·
Should I wear a condom when I have sex?
·
Is there an underlying problem that could be
causing my premature ejaculation?
DO’s
and DON’Ts in Managing Premature Ejaculation:
·
DO have the best atmosphere for sex. Fear of
interruption and secret sex increase chances of premature ejaculation.
·
DO talk with your partner, so you both can
express feelings and expectations about sex. Together you may work out methods
to prolong erections.
·
DO try to relax. Anxiety (especially
performance anxiety) makes the condition worse.
·
DO call your health care provider if you
cannot have an erection. Call if you’re depressed about premature ejaculation.
·
DO call your health care provider if you have
a bloody or bad-smelling discharge or pain during sex.
·
DON’T use risky birth control methods such as
withdrawal before ejaculation.
·
DON’T feel embarrassed to discuss this
condition with your health care provider.
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