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Premature Ejaculation

Release of seminal fluid from the penis that occurs before or immediately after penetration and with minimal stimulation

  • Most common in young, sexually inexperienced males
  • Early sexual encounters in rushed conditions may be a risk factor
  • Genetics is not a significant factor

Premature ejaculation is a very common sexual problem, particularly for young men. Ejaculation is considered to be premature when semen is released from the penis before or very shortly after penetration and with minimal sexual stimulation. Most sex therapists agree that the experience of premature ejaculation is part of the normal sexual learning curve; inexperienced men, particularly if they are young, often ejaculate prematurely. The problem may also occur in experienced men when they have intercourse after a long period of abstinence from sex.

Recurrent premature ejaculation can be a frustrating problem. Repeated episodes may make a man anxious about his performance and possibly result in erectile dysfunction. If premature ejaculation occurs repeatedly, medical advice should be sought.

What are the causes?

The causes of premature ejaculation are usually psychological. Problems may include anxiety about performance or result from early sexual experiences in which there was a fear of being discovered. Some men cannot recognize the physical sensations that they experience immediately before they ejaculate and therefore cannot control the timing of their orgasm. Premature ejaculation is more common during the early stages of a sexual relationship, when the partners may lack confidence and may be nervous about their performance.

Rarely, premature ejaculation may be caused by a physical disorder such as inflammation of the prostate gland (see Prostatitis) or may result from damage to the spinal cord.

What might be done?

If you experience recurrent problems with premature ejaculation, you should discuss the matter with your doctor. You will have an examination to look for a physical cause, and any underlying disorder will be treated.

If premature ejaculation does not have a physical cause, treatment of the disorder is aimed at teaching you how to recognize and control sexual arousal. Your doctor will probably recommend that you see a sex therapist, who can teach you exercises for managing arousal (see Sex therapy).

Exercises may include the start/stop technique, in which the man’s penis is stimulated by his partner. When the man feels that he is close to ejaculation, he asks his partner to stop stimulating him. After a few minutes, stimulation is resumed by his partner and then stopped again. When the stop/start exercise is repeated many times over a period of weeks, it can help men to achieve better control. The squeeze technique can be used together with the start/stop technique or used separately.

Some antidepressant drugs, such as sertraline, have the side effect of delaying ejaculation. They may be prescribed as a short-term measure to treat premature ejaculation because delaying ejaculation can boost confidence and assist in solving the problem.

The outlook is excellent: most men who seek help vastly improve their control over the timing of ejaculation.

Self-Help: Squeeze Technique

From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.

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