ejaculation is uncontrolled ejaculation either before or shortly after sexual
penetration. It happens with minimal sexual stimulation and before the person wishes. It
may result in unsatisfactory sex for both partners. This can
increase the anxiety that may add to the problem. It
is one of the most common forms of male sexual dysfunction. It has probably
affected every man at some point in his life.
What causes premature ejaculation?
Most cases of
premature ejaculation do not have a clear cause. With sexual experience and
age, men often learn to delay orgasm. Premature ejaculation may occur with a
new partner. It may happen only in certain sexual situations or if it has been a long time
since the last ejaculation. Psychological factors such as anxiety, guilt, or
depression can also cause it. In some cases, it may be related to a medical cause such as hormonal
problems, injury, or a side effect of certain medicines.
What are the symptoms?
The main symptom is an uncontrolled ejaculation either before or shortly
after intercourse begins. Ejaculation occurs before the person wishes it, with
minimal sexual stimulation.
How is premature ejaculation diagnosed?
doctor will discuss your medical and sexual history with you. He or she will do a
thorough physical exam. Your doctor may want to talk to your partner
also. Premature ejaculation can have many causes. So your doctor may order
lab tests to rule out any other medical problem.
How is it treated?
In many cases premature
ejaculation gets better on its own over time. Treatment may not be needed. Practicing relaxation techniques or using distraction methods may
help you delay ejaculation. For some men, stopping or cutting down on the use
of alcohol, tobacco, or illegal drugs may improve how well they can control
Your doctor may recommend that you and your partner
practice certain techniques to help delay ejaculation. For example, you may learn to identify and control the sensations that lead up to ejaculation. And you may learn to communicate with your partner to slow or stop stimulation. You can try using a
condom to reduce sensation to the penis. Or you can try a different position (such as
lying on your back) during intercourse. Counseling or behavioral therapy may
help reduce anxiety related to premature ejaculation.
Antidepressant medicines are sometimes used to treat premature ejaculation. These include medicines
like clomipramine (Anafranil) and paroxetine (Paxil). They are used because one of their side effects is inhibited orgasm, which helps delay
ejaculation. Tramadol (Ultram) is a medicine that has been used for many years to control pain. It can be used to delay ejaculation.
There are also creams, gels, sprays, and wipes that may be used to treat premature ejaculation by reducing sensation. These medicines are applied to the penis before sex. They include lidocaine and lidocaine-prilocaine. But some of these medicines can also affect a man's sex partner by reducing sensation for the partner. One option that won't affect a partner's sensation is a wipe that has 4% benzocaine.
Balon R, Segraves RT (2014). Sexual dysfunctions. In RE Hales et al., eds., American Psychiatric Publishing Textbook of Psychiatry, 6th ed., pp. 651â€“678. Washington, DC: American Psychiatric Publishing.
Mulhall JP (2012). Premature ejaculation. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 1, pp. 770â€“779 Philadelphia: Saunders.
ByHealthwise StaffPrimary Medical ReviewerE. Gregory Thompson, MD - Internal MedicineAdam Husney, MD - Family MedicineKathleen Romito, MD - Family MedicineSpecialist Medical ReviewerChristopher G. Wood, MD, FACS - Urology, Oncology