Premature Ejaculation

Overview of Premature Ejaculation

Premature ejaculation also known as (kabil az waqt inzal /قبل از وقت انزال) is the rapid release of semen from the penis during sexual intercourse. But ejaculation takes place faster than in normal conditions. 

It is a common sexual dysfunction. Almost 1 out of 3 men are experiencing this problem. It is also referred to

  • Early ejaculation
  • Rapid ejaculation
  • Premature climax

Both psychological and biological factors contribute to premature ejaculation. The majority of men feel shy to talk about this disease. It is managed through medications, counseling, and sexual techniques that help to delay ejaculation.

Prevalence of Premature Ejaculation 

Globally, about 30% of people are at risk of premature ejaculation all over the globe. It affects their mental, and physical health and also leaves a negative impact on their minds. 

Doctors Treating Premature Ejaculation

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Signs and Symptoms of Premature Ejaculation

The primary sign is the inability to delay ejaculation for more than one minute after penetration. Moreover, this problem may occur in all sexual activities or even masturbation.

It is divided into two major types:

  • Lifelong (Primary)

It is the type of premature ejaculation that a person can suffer from during the first sexual intercourse. According to the researchers, serotonin levels in the brain may be the reason for lifelong ejaculation. Antidepressants such as SSRIs increase the level of serotonin that ultimately controls ejaculation delay time. They suspect that this imbalance takes place genetically. So, lifelong is a hereditary disorder.

  • Acquired (Secondary)

A person suffers from this condition,  after experiencing several episodes of sexual intercourse without any problem and the individual loses control over ejaculation suddenly. There are multiple causes having this type of problems such as chronic prostatitis, sexual dysfunction, anxiety, or any psychological disorder.

Types of Premature Ejaculation

Causes of Premature Ejaculation

The exact root cause of premature ejaculation is still unclear, but ejaculation dysfunction in men is considered as the complex interaction of psychological and biological factors. 

Psychological Factors

Psychological factors that contribute to premature ejaculation are:

  • Depression
  • Sexual abuse
  • Early sexual experiences
  • Poor body image
  • Distressing about premature ejaculation
  • Feeling guilty
  • Anxiety
  • Relationship issues
  • Erectile dysfunction

Biological Factors

Various biological factors may involve in premature ejaculation, which are:

  • Abnormal hormone levels
  • Abnormal levels of brain neurotransmitters
  • Inflammation and infection of the prostate or urethra
  • Genetic problem
Happniness

Risk Factors of Premature Ejaculation

There are a number of factors that can increase the risk of ejaculation. Some of these are as follows:

  • Erectile Dysfunction: Individuals with premature ejaculation are conscious of maintaining an erection constantly. 1 out of 10 men suffers from this. In this, men are unable to maintain an erection during intercourse.
  • Stress: When a person is emotionally or mentally distressed it can also lead to premature ejaculation. 

Health Complications of Premature Ejaculation

Studies reveal different health complications which are caused by premature ejaculation. This condition results in stress and relationship problems. Meanwhile, it may lead to infertility problems due to a lack of ejaculation.

Happniness

Prevention

Happniness

Diagnosis

A sexologist will ask about the medical history and sex life of a person to diagnose the main cause of sexual dysfunction. After this, the doctor will recommend some tests and even check the mental health of a patient. Various blood tests, serology tests, and semen analyses would help in proper diagnosis.

  • Blood Tests: It is conducted to check the level of serum testosterone and prolactin in the body which helps to identify the health status of the penis.
  • Semen Analysis: It is also known as the sperm count test. It is conducted to check the viability and health of the sperm.

Treatment of Premature Ejaculation | When to Consult a Doctor

Various treatment options are used to treat premature ejaculation. These treatments include home remedies, behavioral techniques, topical anesthetics, medications, and counseling. Combination therapy works the best for example behavioral treatment and drug therapy are considered as the most effective course.

Best Home Remedies for Premature Ejaculation

Some of the simple home remedies helpful for premature ejaculation are as follows:

  1. Lady Finger:  Adding ladyfinger to the diet is helpful for men. It helps them with better sexual health.
  2. Water-Melon: Watermelon contains a phytonutrient named citrulline that increases the libido in people. You can consume it in various ways. 
  3. Asparagus and Milk: Asparagus milk is beneficial for producing testosterone, increasing sperm count and blood circulation in the body. Take two tsp of asparagus powder and put it into 1 cup of milk. Boil the mixture for 15 minutes. After that, strain the milk and drink it at least 3 times a day. 
  4. Saffron, Almonds, Ginger, and Cardamom: A mixture of these four ingredients is helpful in maintaining immunity and improving sexual health.

This mixture is prepared in the following way:

  • Firstly, soak ten almonds in water overnight.
  • Blend the almonds and put them into the lukewarm milk.
  • Add ginger, cardamom, and saffron to it.
  • Drink it daily in the morning.

Behavioral Techniques

Maintaining behavior is necessary for improving and treating the issue of premature ejaculation. It will help in easing the patient’s mind as well as help in maintaining focus. During this, your doctor may also recommend avoiding intercourse or any other sexual activity.

       Pelvic Floor Exercises (Kegel exercises)

Sometimes, pelvic muscles in men are weakened and it may delay ejaculation. Kegel exercises are recommended for strengthening the muscles. 

Once a person pinpoints the exact location of muscles, you can start practising Kegel exercises. These can easily be done while standing, sitting, or lying down.

Steps to Perform Kegel Exercises:

  1. Firstly tighten your pelvic floor muscles
  2. Hold the contraction for a three seconds
  3. Relax them for a three seconds
  4. Do it for a few minutes in a row a day

During Kegel exercises, be careful not to move your thigh, abdominal or buttock muscles instead you need to move your pelvic floor muscles. Also, breathe freely during exercises instead of holding your breath.

A doctor may instruct the patients to perform these exercises at least 3 times a day for 10 days.

Condoms

Using condoms may decrease penis sensitivity which can help to delay ejaculation. Some condoms are available in the market that acts as numbing agents and control the ejaculation problem such as:

  • Benzocaine 
  • Lidocaine 

Medications

Various medications are also available in the market to treat premature ejaculation:

  • Topical Anesthetics: Anesthetic creams and sprays: Act as a numbing agent, such as:
  • Benzocaine
  • Lidocaine 
  • Prilocaine

Before sexual intercourse, apply these medications on the penis for about 10 to 15 minutes to reduce sensation and delay ejaculation.

  •  Lidocaine-Prilocaine Cream: It is a prescription drug for premature ejaculation. Lidocaine sprays are available as over-the-counter medication.

Although topical anesthetic agents are effective and well-tolerated, they cause potential side effects. For example, some men reported a temporary loss of sensitivity and decreased sexual pleasure. Periodically, female partners also have reported these effects.

  • Oral Medications: The oral medications that are FDA approved used for the treatment of premature ejaculation are:
  • Antidepressants
  • Analgesics
  • Phosphodiesterase-5 inhibitors

These medications might be prescribed for either on-demand or daily use and might be prescribed alone or in combination with other treatments.

  • Antidepressants: These are used to cure depression. But in this disease, antidepressants can cause a delayed orgasm. This however helps in the treatment of premature ejaculation.

Selective serotonin reuptake inhibitors (SSRIs) are most preferable such as: 

  • Escitalopram (Lexapro)
  • Sertraline (Zoloft)
  • Paroxetine (Paxil) 
  • Fluoxetine (Prozac, Sarafem)

Paroxetine is the most effective of all. The complete course is usually 5 to 10 days or 2 to 3 weeks, depending upon the condition. 

If SSRIs don't work then a tricyclic antidepressant is prescribed which is clomipramine (Anafranil). There are other side effects of antidepressants that might include:

  • Nausea
  • Perspiration
  • Drowsiness 
  • Decreased libido
  • Analgesics: These medications help to treat pain. For example, Tramadol (Ultram) medicine. Other severe side effects include:
  • Nausea
  • Headache
  • Sleepiness
  • Dizziness

Tramadol can't be given in combination with SSRI but is prescribed only when SSRIs have not been effective.

  • Phosphodiesterase-5 Inhibitors: Good for erectile dysfunction treatment. Examples are:
  • Sildenafil (Viagra)
  • Tadalafil (Cialis, Adcirca) 
  • Vardenafil (Levitra, Staxyn)

Some undesired side effects are:

These medications give the best results when given in combination with SSRIs.

(Note: Use Medications only after Doctor’s Consultation)

Patient Counseling

It is an effective approach to talk to a doctor about your mental health problem that deals with any aspect of your life. The counseling session helps to reduce stress, anxiety, or depression and is a better way to cope with it. It is proven to be quite helpful when an interactive counseling session is given with drug therapy for the rapid treatment of premature ejaculation.