How Do You Treat Premature Ejaculation?

Hypothetically,  let’s say you got a text from your long-time crush and she’s like, ‘hey, I’m coming over…

Instantly, you know what’s up and out of excitement, you begin to set the stage for action. She comes over and in less than 2mins, you’re down on sexual seizure with semen leaving your body sooner than expected. She’s left disappointed because she has always perceived you as an ‘alpha male’ and a destroyer in the bed. This is a common problem affecting 30% – 40% of men worldwide and it is often caused by a chemical imbalance, physical, emotional or other psychological factors.

Premature ejaculation or rapid ejaculation is a sexual abnormality that occurs when a man reaches climax and releases seamen sooner than anticipated. PE affects the quality of sex and it’s most common in men. Rapid ejaculation occurs in one out of every three males between the ages of 18 and 59 at some time in their lives.

Symptoms of Premature Ejaculation

The ejaculation itself is the primary sign of premature ejaculation. That’s, the inability to delay ejaculation for at least 3 mins. There are also secondary psychological symptoms that affect physical events. Secondary symptoms like:

• Mental discomfort
• Anxiety
• Depression

Facts about Premature Ejaculation

Here are a few facts on premature ejaculation you should know:

• Premature ejaculation in most men is associated with both biological and psychological problems.
• It may result in additional secondary symptoms including discomfort, poor self-esteem, melancholy, worry, and shame.
• Using products that reduce penile sensitivity can increase the time for ejaculation.

Diagnosis

For proper diagnosis, your urologist will begin by asking you questions related to your sex life, such as, ‘how long it takes for you to ejaculate. He will also perform some physical examinations to help them determine the right symptoms and make the right prognosis. The questions you might be likely asked include:

• How frequently do you experience premature ejaculation
• When did you notice this?
• How long have you had this issue?
• Does that always happen when you try to have sex?
• What type of sexual activity makes you ejaculate the most?
• How has it impacted your sexual life?
• So you ejaculate before penetration or immediately you penetrate?
• How has it affected your relationship and how does it make you feel?
• If you’ve multiple sex partners, does it happen with every one of them?

If after the physical examination and rounds of questioning, your urologist finds something. Then, laboratory testing might be carried out.

• Lack of self-worth
• Decreased confidence in your relationship

All of these secondary symptoms lead to quick ejaculation.

Frequently asked questions!

1. What causes premature ejaculation?

Certain psychological reasons may lead to premature ejaculation, however, there are no definitive solutions to this subject. Psychological factors like anxiety, stress, low self-esteem, depression, sexual inexperience etc. Besides the psychological causes, there might be other underlying medical causes too. Conditions like Diabetes, prostrate disease, neurological problems, thyroid disease, excessive alcohol consumption and illicit drug use can cause premature ejaculation.

2. What can I do to stop early ejaculation?

There are several ways to stop early ejaculation. Just like the home remedies, supplements, exercise and other treatment options listed or mentioned above. It’s also important you visit your doctor because In most cases, there might be an underlying medical condition that triggers this quick ejaculation that only a health practitioner can detect.

Treatment

The most frequent forms of treatment for premature ejaculation are behavioral therapy, counselling, and the use of medicines/medication. Your health care provider will decide the option best suited for you and in most cases, more than one type of treatment is implemented at the same time after diagnosis.

Behavioral Therapy

Behavioral therapy or technique uses exercise to train your body and delay ejaculation during sexual intercourse. Though it might be effective, it’s not a permanent solution. Here are the applicable home remedy exercises:

• Pelvic floor exercise

Pelvic exercise or kegel exercise helps to strengthen your pelvic muscles (pubococcygeal (PC) muscles) which makes it easier to delay ejaculation. To effectively engage the pelvic muscle for kegel exercise, try to stop yourself from urinating midway or tighten your pelvic muscle to keep you from passing gas.  Once you’ve identified the PC muscles, then you can engage them in pelvic manoeuvres in any position. But preferably lying. Hold in position for 3-4 secs and then relax for another 3-4 secs. And avoid holding your breath while you do this exercise. Breath freely. For best results, do it for 3 sets of 10reps per day.

Note: The result isn’t instant, it might take weeks or months depending on the origin of your problem.

• The Pause-squeeze technique

Starts by letting your spouse stimulate your penis or stimulate it yourself until you’re close to ejaculating. At that point, you or your lover should compress the head of your penis at the joint where the head joins the shaft. Squeeze for seconds until the urge for ejaculation passes. This method aims to give you more control over your ejaculation. Repeat 2-3 times.

• The stop-start method

This method is quite similar to the pause-squeeze technique. But in this case, after stimulating and almost climaxing, you let go until the urge dies down. And as you regain control, you start to stimulate again. Repeat the same cycle 3 times and ejaculate the fourth time. According to the American urological association, it’s recommended you try these simple home remedies three times a week until you’re able to regain control of your ejaculation.

Counselling or Psychological Therapy

This method involves talking to a health care provider about your relationship, feelings, emotions, experience and anxieties. The goal is to help the health care provider to understand the root of your underperforming and try to figure out ways to help you out through it. If the reason for your underperforming is related to anxiety, counselling can help you become more confident and provide other alternatives on how to sexually satisfy your partner and also boost your confidence. In most cases, counselling and medication go hand in hand for complete effectiveness.

Medications

This method involves the use of oral medications, penile topical numbing creams, PE wipes, condoms etc.

1. Oral medication

 There’s currently no approved drug by U.S food and drug administration for the treatment of premature ejaculation, but some drugs have proven to delay ejaculation in most men and it’s therefore administered to patients with premature ejaculation. These drugs include like tramadol (to be used intermittently and low dose), fluoxetine, paroxetine, sertraline and clomipramine and should only be prescribed by Specialists. Delayed orgasm is an adverse effect of several antidepressants. Due to this fact, most antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) like paroxetine, escitalopram, citalopram, sertraline and fluoxetine are used to treat premature ejaculation.

• Dapoxetine is one of the few selective serotonin reuptake inhibitor drugs that’s approved in most countries for the treatment of premature ejaculation aside from the United state.

Dapoxetine is only administered when there’s poor control over ejaculation for a long period. This medication’s side effects or disadvantages include nausea, vertigo, headaches, and diarrhoea.

Tramadol is a pain killer that can also be used to treat PE. Though it has a downside. It can be very addictive if not administered correctly. So it’s safe to explore other options instead. Drugs like sildenafil (Viagra), tadalafil, avanafil and vardenafil used to treat erectile dysfunction can also be used to treat premature ejaculation. In addition to dyspepsia, it may also lead to other side effects like headaches and face flushes. Most medical experts administer these drugs alongside SSRI drugs for maximum effect.

2. Topical products

These are creams or sprays you apply to the penis before sex to help reduce stimulation and sensitivity while prolonging orgasm. Examples of such include lidocaine or prilocaine. Products that contain lidocaine or prilocaine help to numb the penis when applied. When applied before sex, it delays sensation and therefore decreases the possibility of quick ejaculation. Note: Long-term usage of these anaesthetics might result in numbness and erection loss. If you must use these products, make sure to apply them to the head of your penis 30 mins before sex and then wash it off 10mins before sex. If it’s not washed off, it can cause numbness to the vaginal.

3. Condoms

Using condoms during sex can help reduce the sensation of the penis just like topical creams during sex. Additionally, it increases the duration of an orgasm. When used alongside topical creams, it drastically increases the time for an orgasm. Note: some specially designed condoms have numbing agents like benzocaine or lidocaine in them. While some condoms like ‘Durex Prolong’ are made with thicker latex to numb the penis.

4. Premature ejaculation wipes

Premature ejaculation wipes contain a topical anaesthetic called benzocaine which blocks the sodium channel that causes a sensation in the penis when it is used across the tip of the penis. A study carried out by the American Urological Association in 2017 showed that participants who used at least 2 months experienced significant improvement in IELT with a mean increase of 231.5 ± 166.9 seconds (95% confidence interval of 139-323 seconds), making their sexual experience less distressful. Additionally, it was noted that there were no serious negative effects after the study. But, you should talk to your doctor before usage due to benzocaine’s different effects on different individuals.

Supplements

The dietary supplements that are beneficial for treating early ejaculation include:

• Zinc

Though no evidence suggests that zinc reduces premature ejaculation, zinc has been known to be effective for men with lower testosterone. It improves libido and supports healthy immunity and cell growth. Zinc supplements can help to increase serum testosterone levels. Too much consumption of zinc supplements can also cause nausea, vomiting, diarrhoea, and other health issues.

• Magnesium

A magnesium supplement is another supplement to consider for robust sperm production. A review by the Asian Journal of Andrology in 2019 shows how low levels of magnesium can contribute to premature ejaculation. If you’re facing PE, it might be nice to tell your doctor to test your level of magnesium if it is low, then magnesium supplement might actually help out. Other supplements that can also help are copper, manganese, calcium and selenium.

Other supplements that can also help are copper, manganese, calcium and selenium but as you know the scientific evidence that this helps is actually not sufficient.