Understanding Premature Ejaculation
Many Men Feel too Embarrassed About This to Seek Professional Advice
Jun 1, 2009
Premature ejaculation (referred to as PE) describes what happens when a man ejaculates ("comes") before he or his partner feels ready for this to happen. It is the result of the man being unable to control the timing of his ejaculation.
Commonest Male Sexual Complaint
The condition can affect men of all ages, and is the probably the commonest self-reported male sexual complaint. It has been estimated to affect about one in three men. It has been found to be more common in younger men, perhaps because younger men are less experienced sexually or are less secure with the situation in which they are having sex.
Ejaculation occurring without control, on or shortly after vaginal penetration and before the subject wishes it, can cause marked distress or interpersonal difficulties - and significantly impact a man's (and his partner's) quality of life. It not only causes anxiety and frustration, such anxiety increases as the affected man tries to find ways of improving the situation.
The important thing is to understand that there is no fixed or "normal" tiime for ejaculation. Premature ejaculation simply refers to the loss of control over ejaculation and the distress it causes a man and/or his partner - not the actual time which a man takes to ejaculate.
Treatments for Premature Ejaculation
Treatments include behavioural techniques as well as psychosexual counselling. Ideally, therapy should involve both the man and his partner. The primary aims of therapy are for the man to regain a sense of control over his ejaculation time and for him and his partner to feel satisfaction with sexual intercourse.Techniques to reduce penile sensation (such as local anaesthetic gels and creams, applied about half an hour before intercourse) can help. These should be used with a condom to prevent absorption of the cream by the partner.
Tablets for Premature Ejaculation
There are some oral medications that are available for treating PE. However, these medications were originally designed for treating depression, and one of the unintended side effects was found to be prolongation of ejaculation time. This side effect is now made use of to treat PE - but the efficacy usually lasts only as long as the man continues to take the anti-depressant medications on a daily basis. However, some men have found the tablets effective when taken on an "on demand" basis, shortly before intercourse.
Among the antidepressant medications that have been used to treat PE are
- Clomipramine: 25–50 mg daily OR 25 mg 4–24 hours before intercourse
- Paroxetine:10–40 mg daily OR 20 mg 3–4 hours before intercourse
- Sertraline: 25–200 mg daily OR 50 mg 4–8 hours before intercourse
Recently a new medication in tablet form has been developed specifically to treat PE. Called Dapoxetine, it has been shown to be quite effective. The new tablet is designed to be taken "on demand' and the research study showed that patient reported outcomes (such as satisfaction with sexual intercourse and perceived control of ejaculation) were improved.
