Premature ejaculation (PE)


PE is the most common ejaculatory disorder. It occurs when a man ejaculates before the men or his partner want climax to happen. For some men, the problem starts with their first sexual experience (primary PE). For others, it happens after a period of normal sexual functioning (secondary PE).

PE often becomes a problem for the couple. Many men with PE feel embarrassed, anxious, depressed, and worried about pleasing a partner. Single men sometimes avoid new relationships because of the stress of PE.


Causes of PE

Psychological factors may play a role, but some believe that a chemical imbalance or receptor sensitivity changes in the brain are the cause, at least for some men.

Low testosterone level contribute in poor control of ejaculation.

Infection in urinary tract and genital glans affect ability of ejaculation control.

PE diagnosis

PE is a self reported diagnosis, and can be based on sexual history alone

Three criteria for PE diagnosis: (1) Unable control ejaculation nearly of most times intercourse, (2) time for penetration in Vaginal short less than 3 minutes, (3) personal distress and relation shipp

Diagnosis depends on the situation. What is premature to one couple may be fine for another. The key to diagnosing PE is the level of personal distress involved. Most men who think they have PE ejaculate within two minutes of sexual contact.

PE treatment

There are a number of strategies men use to handle PE. They include:

Psychosexual counseling & Behavioural techniques

‘Stop-start’ and ‘squeeze’ techniques, extended foreplay, pre-intercourse masturbation, cognitive distractions, alternate sexual positions, interval sex and increased frequency of sex

Masturbating before intercourse. Many men find they have better control if they ejaculate shortly before starting sexual activity.

Using condoms. For some men, a condom makes the penis less sensitive.

Techniques are diffcult to maintain long-term

Address the issue that has created the anxiety or psychogenic cause

Address methods to improve ejaculatory control.

Distraction. Some men think about non-sexual topics during sex.

Therapy options include meditation/relaxation, hypnotherapy and neuro-biofeedback

Oral pharmacotherapy

A common side-effect of some selective serotonin reuptake inhibitors (SSRI) and tricyclic antidepressants is delayed ejaculation. SSRIs are now commonly prescribed for PE. A number of treatment regimens have been reported, including:

Fluoxetine hydrochloride: 20 mg/day

Paroxetine hydrochloride: 20 mg/day.

Sertraline hydrochloride: 50 mg/day or 100 mg/day

Clomipramine hydrochloride 50 mg/day

Local anesthesia medicines: Creams contain these medicines can be applied to the head of the penis before sex 5-10 minutes to reduce glans sensitivity.

PE now is an easy treatable disease, if men undergo this condition, he should be sturdy & confident to go the andrology clinic for treatment soon.

By Nguyen Ba Hung

Andrology and Fertility Hospital of Hanoi
? (+84) 1900 56 56 01
431 Tam Trinh Street, Hoang Mai District, Hanoi, Vietnam.

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