Premature Ejaculation

Premature ejaculation (PE) is a common male sexual dysfunction characterized by ejaculation that occurs sooner than desired, either before or shortly after penetration, with minimal sexual stimulation, and inability to delay ejaculation, causing distress or frustration.


Causes:

1. Psychological Causes:

• Depression
• Early sexual conditioning (e.g., rushing during teenage sexual experiences)
• Stress, guilt, or relationship issues
• Performance anxiety

2. Biological/Medical Causes:

• Abnormal levels of brain chemicals (e.g., serotonin)
• Hormonal imbalances
• Prostatitis or other urological conditions
• Erectile dysfunction (ED) may lead to rushing ejaculation

3. Lifestyle Factors:

• Excessive alcohol or drug use
• Lack of sexual experience or infrequent sexual activity

Risk Factors:

• Relationship problems
• Chronic stress
• Mental health disorders (anxiety or depression)
• Erectile dysfunction
• Age (younger men may experience PE more often)
• Medical conditions (e.g., prostatitis, thyroid disorders)

Treatment:

1. Behavioral and Psychological Approaches:

• Counseling or sex therapy – to address anxiety, stress, or relationship issues
• Start-stop technique – stopping stimulation before ejaculation, then resuming
• Squeeze technique – gently squeezing the penis head to delay climax
• Mindfulness and relaxation training

2. Medications:

a. Oral Medications:

• SSRIs (Selective Serotonin Reuptake Inhibitors): Dapoxetine – a short-acting SSRI approved specifically for PE

b. Topical Anesthetics:

• Lidocaine-prilocaine (Emla) cream: Numb the penis slightly to reduce sensitivity