What is premature ejaculation (PE)?

Premature ejaculation (PE) is a very common medical condition that results in orgasm and ejaculation prior to a desired time which causes distress. There is not a specific time allowance that defines normal ejaculatory time. It is all relative to how much it bothers the man and/or his partner.

It is estimated that 1 in 3 men will experience PE in his lifetime and it is the most common sexual dysfunction in men!

PE can be a lifelong condition (Lifelong PE) or a new diagnosis (Acquired PE). It can also be very embarrassing for patients to acknowledge and discuss. PE can result in depression, erectile dysfunction (ED), and avoiding sexual situations out of concern for failure. As a result, PE can cause significant relationship issues.

What causes PE?

There are many things that can cause or exacerbate PE. Things such as a chemical or emotional imbalance can lead to early ejaculation. Sometimes the chemical signals in the brain that regulate ejaculation are to low which can result in rapid ejaculation. The good news is that PE is generally treatable and rarely caused by anything dangerous.

Do I need to any special diagnostic test or labs drawn to help evaluate me for PE?

Generally speaking, men do not need any xrays or lab tests when being evaluated for PE. Men are often concerned that PE might be a Low T (low testosterone) problem. While it is reasonable to check a testosterone level it is unlikely to be the main cause. Men can have low T and PE, but they should generally be viewed as separate issues. Treating low T is unlikely to result in improvement of PE.

What are my treatment options?

There are several different forms of therapy available to treat PE.

  • 1) SSRI (selective serotonin re-uptake inhibitors) are a family of medications that are commonly used to treat PE. SSRIs are FDA approved to treat depression, but not premature ejaculation. That being said they are very safe and very effective at delaying ejaculation. Delayed ejaculation is a common side effected reported by men who take SSRIs for depression and anxiety. While this side effect can be bothersome to some men, it can be very helpful for men struggling with PE. These medications can be taken on demand or daily. Patients must remember these medications cannot be stopped cold turkey. Instead, the provider can help you wean off.

  • 2) Topical creams or sprays can be applied to the penis to help decrease sensitivity. Promescent spray is an over the counter medication that is very effective at decreasing sensitivity without transferring the medication to the partner.

    Emla cream is a numbing cream that is applied to the penis typically 20-30 minutes prior to sex. It works best when the man also wears a condom to make sure that he does not transfer the numbing cream to his partner.

  • 3) Sexual health counseling is a great option for many patients. Some patients will combine counseling with medical therapy. Stress and anxiety as a result of PE often exacerbate the underlying problem only making things worse. Working with a counselor to help solve these issues can be very beneficial.

  • 4) Behavioral therapy helps men become more aware of the stimulation leading to early ejaculation. Sexual health counselors will often work with patients to train their body to ultimately increase control.

  • 5) Erectile dysfunction medications such as Viagra or Cialis can also be very helpful for men struggling with PE. While erectile dysfunction (ED) and PE are generally separate issues some patients will report ejaculatory improvement with this class of medication as well as improved erection quality.

  • 6) Condoms are another simple alternative to help men delay ejaculation. There are certain condoms that already contain agents to help decrease sensitivity of the penis without transferring the medication to the partner.

 

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