Premature ejaculation occurs when a man has an orgasm sooner during intercourse than he or his partner wishes.
Causes, incidence, and risk factors
Premature ejaculation is a common complaint. It is only rarely caused by a physical problem. Premature ejaculation early in a relationship is most often caused by anxiety and too much stimulation. Guilt and other psychological factors may also be involved. The condition usually improves without treatment.
Getting Help
Diagnosis typically will involve a complete medical history, including any circumstances surrounding the onset of symptoms, and a physical examination. There usually are no abnormal findings with the condition. Dr. Alarcon can usually get more useful information from interviewing the patient alone or the couple together.
Symptoms and Severity
The timing related to when the man ejaculates prematurely is the best indicator of the condition and its severity. This may range from before penetration to a point just after penetration. It may leave the couple feeling unsatisfied.
Chronic premature ejaculation may be a sign of anxiety or depression. A psychiatrist or psychologist can help treat these conditions.
Reduced Feeling
You can apply a local anesthetic cream to the penis to reduce stimulation. Decreased feeling in the penis may delay ejaculation. Condom use may also have this effect for some men. If these distraction techniques cause difficulty maintaining an erection, medications used for erectile dysfunction may help.
Evaluation by a sex therapist, psychologist, or psychiatrist may help some couples. In most cases, the man is able to learn how to control ejaculation through education and by practicing the simple techniques outlined.
Treatment
Natural: Practice and relaxation should help you deal with the problem. Some men try to distract themselves by thinking nonsexual thoughts (such as naming baseball players and records) to avoid getting excited too fast. There are several helpful techniques to try.
The “stop and start” method: This technique involves sexually stimulating the man until he feels like he is about to reach orgasm. Stop the stimulation for about 30 seconds and then start it again. Repeat this pattern until the man wants to ejaculate. The last time, continue stimulation until the man reaches orgasm.
The “squeeze” method: This technique involves sexually stimulating the man until he recognizes that he is about to ejaculate. At that point, the man or his partner gently squeezes the end of the penis (where the glans meets the shaft) for several seconds.
Stop sexual stimulation for about 30 seconds, and then start it again. The person or couple may repeat this pattern until the man wants to ejaculate. The last time, continue stimulation until the man reaches orgasm.
Medications
Antidepressants such as Prozac may be helpful because one of their side effects is to prolong the time it takes to reach ejaculation.