Premature ejaculation (PE) is the number-one most frequently experienced sexual dysfunction worldwide, affecting almost one-third of adult men by some estimates.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293503b069-2290-452b-9bdd-7f57f5ff8b4fe60dc2a1-f33c-4a05-9b50-8e3e8e597629e1239de1-1d74-4b78-9edd-df4916c3ea12 If you are experiencing premature ejaculation, there are several medications and lifestyle changes that may help you manage your condition. Read on to learn more.
What Is Premature Ejaculation? Overview Premature ejaculation is when a male reaches climax (ejaculates semen during orgasm) sooner than wanted during sex. The World Health Organization (WHO) describes the disorder as “the inability to delay ejaculation sufficient to enjoy lovemaking.”e60dc2a1-f33c-4a05-9b50-8e3e8e597629d6067cdf-448a-49be-bef2-53ff7fd3a5a8 Some scientists suggest that ejaculation that occurs less than one minute after vaginal penetration is premature, while others say 4 minutes.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d6067cdf-448a-49be-bef2-53ff7fd3a5a8 There are two kinds of premature ejaculation, lifelong and acquired. Lifelong PE occurs if a person climaxes earlier than wanted starting with the very first time he has intercourse, while acquired PE develops over time.e60dc2a1-f33c-4a05-9b50-8e3e8e597629edbbdda4-207b-42cc-9bd9-58b62af33c09
Medications for Premature Ejaculation Medication A variety of medications and medication types are available for premature ejaculation, both over the counter and via a prescription. Discuss any treatment with a doctor before starting it. You can try the following: Erectile Dysfunction (ED) Medications For people who have PE related to their erectile dysfunction , doctors may prescribe ED meds, such as: Sildenafil (Viagra) Tadalafil (Cialis) Vardenafil (Levitra) Dapoxetine (Priligy) Avanafil (Stendra) If erectile dysfunction is not an issue for the person with PE, these medications could still be prescribed “off-label” (other than for their approved purpose) when other treatments have failed.e60dc2a1-f33c-4a05-9b50-8e3e8e59762960eba13b-5617-47d2-ba50-a478be74be52 Anesthetic numbing agents Topical anesthetics such as lidocaine and/or prilocaine in the form of a cream, a gel, or a spray are moderately effective in delaying ejaculation by diminishing sensitivity in the glans (head of the penis).e60dc2a1-f33c-4a05-9b50-8e3e8e5976293ac4c133-1b6e-4678-b5e4-82466bb0ba1d Antidepressant medications No oral drugs are specifically approved by the Food and Drug Administration (FDA) to treat premature ejaculation, but some medications may be prescribed “off-label.” In particular, antidepressants called selective serotonin reuptake inhibitors (SSRIs) have been shown to delay orgasm. “Doctors may prescribe SSRIs not because the patient is actually depressed, but because a lot of these medicines have a side effect of causing delayed ejaculation,” says Kian Asanad, MD , urologist with Keck Medicine of USC and director of the USC Fertility and Men’s Sexual Health Center. SSRIs include: Paroxetine (Paxil, Pexeva, Brisdelle) Escitalopram (Lexapro) Citalopram (Celexa) Sertraline (Zoloft) Fluoxetine (Prozac) Research suggests that paroxetine seems to be the most effective for premature ejaculation.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297c47a3e6-e5d5-4455-8492-d7f922a0d02d Opioids. The pain reliever tramadol (Ultram, Conzip, Qdolo) has been shown to be effective against PE when used sporadically. The drug is in a class of medications called opiate (narcotic) analgesics, and can be habit-forming with prolonged use.e60dc2a1-f33c-4a05-9b50-8e3e8e597629bdf64083-19d5-443d-9b0a-832c3da07b1a “It’s a weak narcotic and it does have properties that can delay ejaculation, but I rarely use it in my practice,” says Dr. Asanad.
Lifestyle Changes for Premature Ejaculations Lifestyle Changes Men with PE issues may improve their condition by changing their exercise habits and diet, and exploring techniques that can directly address the problem: Exercise Exercise benefits almost all aspects of health, including sex and ejaculation. Research consistently shows that men who work out regularly are less likely to have premature ejaculations compared to those who are sedentary. A study involving 105 men diagnosed with PE found that those who ran for 30 minutes five times a week had as much improvement as those who took the SSRI drug dapoxetine.e60dc2a1-f33c-4a05-9b50-8e3e8e59762965a42325-1a21-4138-ba0f-eb978139fe76 Some scientists theorize that as regular exercise boosts the metabolism, the nervous system involved in ejaculatory control also improves. In addition, physical activity enhances cardiovascular health, which in turn may improve blood flow to erections and decrease early climaxes.e60dc2a1-f33c-4a05-9b50-8e3e8e59762986dc5ee3-bb52-47b0-8fb8-d7d30c77553f Regular exercise helps with weight loss , and excess belly fat has been linked to imbalances in testosterone and estrogen levels, which can affect male sexual performance.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f58869fe-ccb1-4c46-97ae-363555af2984 Pelvic and Behavioral Therapy Pelvic floor exercises Research suggests that exercises to strengthen pelvic floor muscles ( Kegel exercises ) may extend ejaculation times.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d113e620-09d9-4033-ad3c-b7136c070a95 The “pause-squeeze” technique Your partner repeatedly squeezes your penis during sex until the urge to ejaculate passes.e60dc2a1-f33c-4a05-9b50-8e3e8e5976295d5e7cf5-1cd3-4992-abc5-db8dcac45333 The “stop and start” method This requires repeatedly stimulating the penis to the point of orgasm but then stopping.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a04fecb5-321b-4bc8-ab73-f57608f52fc8 Other Methods A few other possible approaches for delaying orgasm during sex:e60dc2a1-f33c-4a05-9b50-8e3e8e5976295d5e7cf5-1cd3-4992-abc5-db8dcac45333 Masturbating an hour or two before intercourse Wearing a condom to reduce sensitivity of the penis Focusing your mind on non-sexual distractionse60dc2a1-f33c-4a05-9b50-8e3e8e597629a04fecb5-321b-4bc8-ab73-f57608f52fc8 Stress Reduction Practicing relaxation techniques such as deep breathing, mindfulness , or yoga can also help to manage anxiety and promote better control over ejaculation, according to the International Society for Sexual Medicine.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d913208f-1883-4bc3-829d-214d396f7657 Intimacy Building Premature ejaculation can cause partners to feel less connected or hurt. Talking about the issue openly can help you and your partner explore the problem together and find a solution. This can also reduce stress, which does tend to make PE worse. “You might be surprised to find that most partners are accepting and open to learning how to get past it together,” says Raevti Bole, MD , a urologist at Cleveland Clinic. “In addition to your PE treatment, experts may recommend taking the time to focus on your partner and learning other ways to enhance intimacy together.”
Mental Health Treatment for Premature Ejaculation Mental Health In talking with your health care provider, you may find that your PE issues are due to psychological, emotional, or relationship problems that could be eased with the guidance of a mental health professional. PE can have psychological causes, such as early sexual experiences, sexual abuse, poor body image, depression , worrying about PE, and guilty feeligs that cause you to rush through sex.e60dc2a1-f33c-4a05-9b50-8e3e8e597629940b1bbf-445f-4808-973a-1211c43d0b4d General anxiety and relationship problems can also cause PE, and if the cause is issues with mental health, mental health treatment may also help to treat PE.e60dc2a1-f33c-4a05-9b50-8e3e8e597629940b1bbf-445f-4808-973a-1211c43d0b4d Therapy A therapist can work with you to identify problems in your sex life or personal relationship that may be influencing ejaculation, such as performance anxiety, depression, and stress. There are several types of mental health therapy that might work for you: Cognitive-behavioral therapy identifies and changes negative thoughts and beliefs about sexual performance Sex therapy will help you better understand the working of sexual anatomy and arousal Couples therapy improves communication and understanding with a partner General counseling to deal with depression, anxiety, or a past trauma may also help.
What Causes Premature Ejaculation? Causes There are several possible reasons for early sexual climax. They include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976290ddca1e2-abc5-47cb-afdc-1e8a2430271a Low Serotonin Levels This neurotransmitter chemical plays a significant role in premature ejaculation, and low levels in the brain increase the chances of having PE. For some men, antidepressants called selective serotonin reuptake inhibitors (SSRIs) boost serotonin levels and then extend the time to ejaculation.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d1df6186-730d-41fd-be2b-b46823cc4e9ce60dc2a1-f33c-4a05-9b50-8e3e8e5976296195b9e5-2a1c-49c9-ad69-74c990e7821a Psychological Issues Emotional and mental strain can take its toll on sexual activity. Stress can inhibit the ability to relax and focus during sex. If a man feels unfounded pressure to maintain a long-lasting erection, this could influence performance and in some cases bring about an early orgasm. “Guys with ED are worried about losing their erection, so they may try to ejaculate quicker,” says Justin Dubin, MD, a urologist and men’s health specialist with Memorial Healthcare System in Aventura, Florida. Or a male may feel nervous with a new partner, which can set off a premature reaction.e60dc2a1-f33c-4a05-9b50-8e3e8e5976290ddca1e2-abc5-47cb-afdc-1e8a2430271a Anxiety , depression , and lack of confidence may also disrupt normal ejaculation. A man with deep-rooted psychological issues—such as sexual repression—might feel a lack of control tied to bottled-up sexual thoughts and feelings.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b5455380-962e-4a30-8996-52720ccdac93 Age Factors While premature ejaculation is most often reported in men ages 18 to 30, older men can also experience this disorder.e60dc2a1-f33c-4a05-9b50-8e3e8e59762991701c20-5889-4046-9605-3e2c833f26e7 For some older men, low testosterone can lead to erections that may not be as firm or as large. With an erection not lasting as long as it once did, ejaculation can happen sooner than later. e60dc2a1-f33c-4a05-9b50-8e3e8e5976290ddca1e2-abc5-47cb-afdc-1e8a2430271a Other Related Health Issues Other physical conditions besides erectile dysfunction may be connected with premature ejaculation, including:e60dc2a1-f33c-4a05-9b50-8e3e8e597629f2724be3-3e93-4657-b9f4-6ebd3b21e208 Chronic Pelvic Pain. The aching in the pelvis area directly affects nerves and muscles involved in sexual function, leading to issues with ejaculatory control.e60dc2a1-f33c-4a05-9b50-8e3e8e59762999f8c728-82ba-40dd-8d1d-edd1d7eb7a05 Thyroid Disorders. An imbalance in thyroid hormones may contribute to sexual dysfunction and early orgasm.e60dc2a1-f33c-4a05-9b50-8e3e8e5976293d0a84c1-2e20-4009-81a5-817a15d4f9ab Substance Use Disorders: Drug use may be linked to low testosterone levels, erectile dysfunction and changes in mood that can trigger PE.e60dc2a1-f33c-4a05-9b50-8e3e8e597629637e1d2c-7fb2-4808-9e4e-1206a4056b46
How is Premature Ejaculation Diagnosed? Diagnosis While many men may recognize that they have premature ejaculation without a doctor’s consultation, a health care provider can help determine the possible cause and recommend best possible treatments. During diagnosis, a doctor typically asks about your sex life and health history. They may perform a physical exam, concentrating on the genitals and looking for any abnormalities in the penis, testicles, or surrounding areas. They may also consider any other physical or mental/emotional issues that could be contributing to the problem.e60dc2a1-f33c-4a05-9b50-8e3e8e597629f2b50952-cdd0-42fc-9983-18cadc41229d In some cases, a doctor will refer you to a urologist (a specialist who treats urinary tract and the reproductive system) or a mental health provider. For some men, getting help for a sexual problem can be difficult. “It’s very embarrassing to acknowledge that you have a problem,” says Dubin. He stresses that some men may have unrealistic depictions of sex from pornographic films, adding that premature ejaculation is only a problem if it interferes with your love life. “The issue has to cause distress for you or your partner,” he says. “Some people come in and say, ‘Listen, I last a minute and 30 seconds. I feel good, and my wife’s happy.’ If no one’s complaining, I’m not going to treat that.” Knowing you’re not the only one with PE may help. “One key that I start with in my practice to reduce the stigma about PE is to discuss the prevalence,” says Michael Eisenberg, MD, director of Men’s Health, Male Reproductive Health and Surgery at Stanford Medicine. “Knowledge of the disorder and how common this is can help.”
The Takeaway Premature ejaculation affects 1 in 3 adult men, according to some estimates.. Medical treatments are available to help delay orgasm, but patients may first want to explore at-home techniques and lifestyle changes that can often be just as effective. While premature ejaculation may be strictly a physical problem, it can be connected with psychological and emotional issues that may be resolved through counseling or therapy.
