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Premature Ejaculation

Topic Overview

What is premature ejaculation?

Premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration. It happens with minimal sexual stimulation and before the person wishes. It may result in unsatisfactory sex for both partners. This can increase the anxiety that may add to the problem. It is one of the most common forms of male sexual dysfunction. It has probably affected every man at some point in his life.

What causes premature ejaculation?

Most cases of premature ejaculation do not have a clear cause. With sexual experience and age, men often learn to delay orgasm. Premature ejaculation may occur with a new partner. It may happen only in certain sexual situations or if it has been a long time since the last ejaculation. Psychological factors such as anxiety, guilt, or depression can also cause it. In some cases, it may be related to a medical cause such as hormonal problems, injury, or a side effect of certain medicines.

What are the symptoms?

The main symptom is an uncontrolled ejaculation either before or shortly after intercourse begins. Ejaculation occurs before the person wishes it, with minimal sexual stimulation.

How is premature ejaculation diagnosed?

Your doctor will discuss your medical and sexual history with you. He or she will do a thorough physical exam. Your doctor may want to talk to your partner also. Premature ejaculation can have many causes. So your doctor may order lab tests to rule out any other medical problem.

How is it treated?

In many cases premature ejaculation gets better on its own over time. Treatment may not be needed. Practicing relaxation techniques or using distraction methods may help you delay ejaculation. For some men, stopping or cutting down on the use of alcohol, tobacco, or illegal drugs may improve how well they can control ejaculation.

Your doctor may recommend that you and your partner practice certain techniques to help delay ejaculation. For example, you may learn to identify and control the sensations that lead up to ejaculation. And you may learn to communicate with your partner to slow or stop stimulation. You can try using a condom to reduce sensation to the penis. Or you can try a different position (such as lying on your back) during intercourse. Counseling or behavioral therapy may help reduce anxiety related to premature ejaculation.

Antidepressant medicines are sometimes used to treat premature ejaculation. These include medicines like clomipramine (Anafranil) and paroxetine (Paxil). They are used because one of their side effects is inhibited orgasm, which helps delay ejaculation. Tramadol (Ultram) is a medicine that has been used for many years to control pain. It can be used to delay ejaculation.

There are also creams, gels, sprays, and wipes that may be used to treat premature ejaculation by reducing sensation. These medicines are applied to the penis before sex. They include lidocaine and lidocaine-prilocaine. But some of these medicines can also affect a man's sex partner by reducing sensation for the partner. One option that won't affect a partner's sensation is a wipe that has 4% benzocaine.

References

Other Works Consulted

  • Mulhall JP (2012). Premature ejaculation. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 1, pp. 770–779 Philadelphia: Saunders.

Credits

Current as ofSeptember 26, 2018

Author: Healthwise Staff
Medical Review: E. Gregory Thompson, MD - Internal Medicine
Adam Husney, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Christopher G. Wood, MD, FACS - Urology


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