Premature Ejaculation: What It Is and How to Deal with It

male and female couple

Premature Ejaculation (PE), which is when semen is released from the penis before the man or his partner would prefer, affects about 29% of males. When it happen repeatedly, it can become enmeshed with negative thoughts and feelings such as “I’m an inadequate lover.” The more negativity involved, the more severe the distress. Shame and frustration on the part of either or both partners can result.

Premature Ejaculation Causes

  1. Though PE is not fully understood, serotonin may be part of the puzzle. High amounts of serotonin, a chemical produced by the nerves, increases the time from arousal to ejaculation.
  2. Mental health concerns like short-term relationship troubles, depression, stress and guilt can also be involved.
  3. PE can be a problem for men who are unable to get or keep an erection firm enough for intercourse. Since the erection usually ends after ejaculation, it can be difficult to ascertain if PE or Erectile Dysfunction (ED) is the culprit. ED should be addressed first. The premature ejaculation may disappear once the ED is gone.
  4. In men 50+, erections may be smaller, softer, or shorter-lasting. The length of time that ejaculation feels imminent may reduce. These changes can result in quicker ejaculation.

Premature Ejaculation Diagnosis

When PE gets in the way of sexual satisfaction, you should see your doctor. They will usually only give a diagnosis of PE after an exam and a discussion about the problem.

During the doctor visit, you may be asked questions like:

  • How frequently do you have PE?
  • How long has it been going on?
  • Does it happen only with one partner, or with all partners?
  • Does it happen every time you try to have sex?
  • What are your normal sexual activities? How often do you engage in these activities?
  • How has PE changed your sexual life?
  • How are your personal relationships going?
  • Does anything make the PE more or less severe?

Further testing is only needed if your provider finds something worrisome in the exam that requires further exploration.

Premature Ejaculation Treatments

Medications can help, but I have found them to be most effective when used with a psychosexual skills program. When medication is integrated into the couple’s sexual style of intimacy, pleasuring, and eroticism, my clients have found good results.

Many couples and men themselves have unrealistic expectations for male performance, and building psychosexual skills through sex therapy can make all the difference.

Talking about the problem is a first step. Mostly importantly, a couple should learn ways to relax. Worry only makes PE worse. Treatment does involve practicing and learning how to control the ejaculation. Some men have not learned control skills. Therefore, practicing is necessary alone or with a partner.

Therapy can help couples grow closer, reduce anxiety about the sex act, and increase your confidence and awareness to add to your partner’s enjoyment.

Drugs, creams, sprays and condoms

There are not any drugs that have been approved in the US for PE, but there are some treatments that prolong erections.

When doctors found that people on antidepressants had delayed orgasms, they began using t antidepressants to help men with PE.

These drugs can be taken daily, or only when you are ready to have sex. I have heard doctors suggest taking them several hours before intercourse. Again, most affective with newly learned psychosexual skills.

There are creams/sprays that can be put on the top of the penis a half-hour before intercourse, then washed off a few minutes before intercourse. It is important to remove these numbing agents before intercourse because, a.) if left on too long, they can kill an erection, and, b.) they can cause vaginal numbing.

The Good News?

About 95 percent of men can control PE. If the problem doesn’t resolve itself, keep working with your medical team to find a solution.

Here To Help In Cincinnati

If you are interested in discussing premature ejaculation issues and you are in the Cincinnati Ohio area, please contact Kim Ronk MA, LPCC, MED, RN to schedule a session through the online contact form.