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Premature ejaculation occurs when a man orgasms during intercourse sooner 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 or structural problem.
Premature ejaculation early in a relationship is most often caused by anxiety and overstimulation. Other psychological factors such as guilt may also be relevant. The condition usually improves without formal treatment.
Ejaculation happens before the individual or couple would like (prematurely). This may range from before penetration to a point just after penetration, and may leave the couple feeling unsatisfied.
Signs and tests
Abnormal findings are unlikely to be associated with the condition. Useful information is more likely to be obtained from interviewing the person or the couple.
In general, practice and relaxation will help you deal with the problem. Some men try to distract themselves by thinking non-sexual thoughts (such as naming baseball players and records) to avoid becoming excited too fast. Some helpful techniques include the following:
The "stop and start" method:
The "squeeze" method:
Antidepressants such as Prozac and other selective serotonin reuptake inhibitors (SSRIs) may be helpful because they have a common side effect of prolonging the time it takes to achieve ejaculation.
Local anesthetic creams may be applied to the penis to decrease stimulation. Decreased feeling in the penis may prolong the time before ejaculation. Condom use may also have this effect for some men.
Evaluation by a sex therapist, psychologist, or psychiatrist may be helpful for some couples.
In most cases, the man is able to learn ejaculatory control through education and practice of the simple techniques outlined. Chronic premature ejaculation may be a sign of anxiety or depression, both of which could be helped by psychiatric intervention.
Calling your health care provider
Call for an appointment with your health care provider if premature ejaculation is causing a problem and does not respond to techniques such as those described above.
There is no prevention for this disorder, though relaxation can reduce the likelihood of its occurrence.
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