Premature Ejaculation or the Vicious Cycle and What You Can Do About It

Premature ejaculation is felt to be the most common male sexual dysfunction affecting 20-30% of all men. There is no single definition of PE but most agree that it is a lack of control of ejaculation and inability to maintain intercourse long enough to sexually satisfy oneself or ones partner.  It's important  to recognize that PE is not ED although they frequently exist together. It's not uncommon for a man to complain of an inability to maintain his erection but on further questioning he is experiencing PE and he then loses his erection. While PE is not associated with depression many men with PE experience anxiety over having the condition and report a lack of confidence and self esteem.

There are several ways to treat PE. Ideally the mans' partner should be included in the treatment discussion. It's important to remove the anxiety associated with PE and give the man a chance to break the cycle of anticipating the inevitable outcome that he's been experiencing. Restoring confidence is of the utmost importance.

As of today the quickest and most common treatment is the use of the SSRI class of antidepressant medications such as Lexapro, Zoloft and Paxil. The reason for their use is not treating depression but taking advantage of the side effect which delays ejaculation. In my experience most men have a good response to these medications especially is taken daily.

Another approach a couple approach such as the stop-start or squeeze technique popularized by Masters and Johnson (reference). This technique is well described by following this link.....

Another treatment is desensitizing cream known as SS cream which has been shown to desensitize the penis and significantly delay ejaculation. This is not yet approved by the FDA but the use of topical anesthetic cream which are available can be used.

The best advise I have is to have patients, relieve the anxiety associated with PE and be willing to spend some time with any of the above treatment options to help alleviate the problem.

 

 

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