Premature Ejaculation

What Is Premature Ejaculation?

Premature ejaculation is a type of sexual dysfunction in which a man experiences an orgasm and ejaculates semen sooner than he or his partner would prefer. It typically occurs before or shortly after penetration during intercourse.

Is Premature Ejaculation Common Among Men?

Premature ejaculation is a common condition, and it affects between 30 to 40% of men. The American Urological Association states that premature ejaculation is the most prevalent type of sexual dysfunction among men.

What Are the Symptoms of Premature Ejaculation?

The only symptom of premature ejaculation is the condition itself, where the man ejaculates prematurely or before he wants to. This might occur before or soon after penetration, leaving the couple feeling dissatisfied.

What Are the Causes of Premature Ejaculation?

Physical and chemical problems

• Erectile dysfunction
• Hormonal problems (hormones such as oxytocin, luteinising hormone, prolactin, and thyroid stimulating hormone might impact sexual performance)
• Prostate or thyroid problems
• Low levels of serotonin or dopamine (chemicals in the brain)
• Penis that is extremely sensitive to stimulation

Emotional or psychological causes

• Sexual performance anxiety (for example, concern about being with a new partner, feeling anxious about having sex again after a long period of abstinence, and lack of confidence)
• Stress
• Relationship problems
• Depression
• Past traumatic sexual experience

Other factors

• Illegal drug use (for example cocaine and amphetamine)
• Medications (an example is cabergoline which is used for Parkinson's disease)

Does Smoking Cause Premature Ejaculation?

Yes, studies have demonstrated that smoking can cause premature ejaculation.Smoking can also lower your libido and affect your fertility.

How Is Premature Ejaculation Diagnosed?

Premature ejaculation is diagnosed via:

• Medical and sexual history: Your doctor will ask you questions about your personal and sexual life such as:
• How long has this issue been bothering you?
• What conditions led to this happening?
• How frequently does it occur?
• Does every attempt at sexual activity result in premature ejaculation?
• Do you have any medical conditions?
• Are you taking any medications?
• Lab tests: Blood or urine tests to rule out any physical problems.

How Is Premature Ejaculation Treated?

Premature ejaculation can be treated by:

• Premature ejaculation medicine
• Antidepressants: For example, citalopram, escitalopram, and fluoxetine to help delay premature ejaculation.
• Anaesthetic (numbing) creams and sprays: Applying these to the head and shaft of the penis helps to reduce stimulation and thus delay ejaculation.
• Erectile dysfunction medications: Medicines such as sildenafil, tadalafil, and vardenafil have also been used to treat premature ejaculation.

• Behavioural therapy
• This approach entails attempting various strategies to delay your orgasm.
• Start and stop: This technique involves you or your partner stimulating your penis towards the verge of orgasm, then stopping the stimulation for around 30 seconds until you regain control of your response. Repeat this a few times before allowing yourself to orgasm.
• Squeeze therapy: You or your partner stimulates your penis close to the point of orgasm before gently squeezing the head of your penis for around 30 seconds, causing you to lose your erection. Repeat this approach several times before allowing yourself to orgasm.
• Distracted thinking: This approach aims to make you focus on nonsexual things while you are being sexually stimulated.

• Counselling
• A session with a psychologist, psychiatrist, couples’ therapist, or sex therapist may help you address the psychological, emotional, or relationship issues that are causing your premature ejaculation.

Are There Ways to Prevent Premature Ejaculation?

Premature ejaculation can be prevented through various ways including:

• Quitting smoking
• Taking your prescribed medications
• Seeking counselling if needed
• Increasing the frequency of sex (either intercourse or masturbation)
• Wearing a condom
• Having sex with your partner on top

When Should I See a Doctor for Premature Ejaculation?

You should make an appointment to see your doctor if you experience premature ejaculations frequently or if they are negatively impacting your relationship and causing you to feel anxious or depressed.

Premature ejaculation is often treatable with a few simple actions. Although it may be unpleasant to discuss sexual problems openly, it is important that you see your urologist or other doctors if you are experiencing premature ejaculation.

Make an Appointment at Pantai Hospitals

A dedicated and expert team of urologists at Pantai Hospital is available for consultation to provide the best care and assistance. Get in touch with us to book an appointment today if you have any concerns or questions regarding your reproductive health.

For health screening appointments, please contact the Health Screening Centre at your nearest Pantai Hospital.

Pantai Hospital has been accredited by the Malaysian Society for Quality in Health (MSQH) for its commitment to patient safety and service quality.

This article has been medically reviewed by Urology specialist, Dr George Choo Eang Leng.