Premature Ejaculation

Premature ejaculation is a very common condition that affects approximately twenty to thirty percent of all men in the United States. Commonly referred to by healthcare practitioners as PE, it's also frequently called premature climax, rapid climax, early ejaculation or rapid ejaculation by many people. Yet whatever name PE is called by, it's simply a medical condition in which a man climaxes and ejaculates too quickly and earlier than he or his partner would like him to do.

The Diagnosis of Premature Ejaculation

Obviously, the definition of PE is sometimes a very subjective issue. So let's take into consideration some of the following factors:
- The condition can be differentiated into two types, premature ejaculation that occurs from the time a male begins puberty, or premature ejaculation that is acquired later in a man's life. Many men say that they start to experience an increase in the occurrence as they age, but often times the actual issue is that their erections may simply not be as firm or as "large". These men may actually be suffering from erectile dysfunction (commonly called ED).
- One out of every three men experiences PE at some in their lives. The diagnosis must take into account the frequency of the patient's PE frequency, or how often the condition occurs for each individual during sexual intercourse. For many males it is a "once in a while" occurrence, while for others it may be the norm for all of their sexual intercourse activity.
- Many experts agree that premature ejaculation can be defined as any sexual activity by a man that lasts less than two minutes (or 120 seconds). Others classify PE as ejaculation that occurs anywhere between thirty seconds and four minutes into sexual activity. One recent study documented that the average time for sexual intercourse lasted between five to six minutes (the median was actually 5.4 minutes in the study). However, PE is really defined by what the man and his sexual partner feel that the required time for satisfaction should be, so this can obviously vary from person to person.
- Additional factors that are sometimes cited by certain experts are culture and country. However, a recent study released by the NCBI (The National Center for Biotechnology Information) showed no significant difference in occurrence when comparing European men (from five countries in Europe) versus men living in the United States.

The bottom line is that premature ejaculation is diagnosed by a qualified doctor or urologist who must take into consideration an individual's sexual history. The physician must consider the patient's actual issues: rapid ejaculation, poor control over his ejaculation, plus the dissatisfaction that's experienced by both the patient and their sexual partner.

Possible Causes of Premature Ejaculation

The possible causes of PE can be broken down into three categories: psychological, trauma and biological (or medical).

Psychological

Many instances of PE are due to a patient's psychological circumstances or mental condition. These cases are often times referred to as secondary PE (or acquired PE). These obviously can vary from individual to individual, but often times one or more of the following may be observed:
- Excessive stimulation or over-excitement
- Anxiousness or anxiety
- Stress (sometimes referred to as "relationship stress")
- Depression and feelings of guilt or shame
- An individual's sexual inexperience
- Feeling inadequate (sometimes associated with low self esteem or issues with body image)
- The unfamiliarity often experienced in a brand new relationship

Trauma

More persistent cases of premature ejaculation can sometimes be caused from trauma that a patient has experienced early in their life. Examples include:
- Extremely strict sexual upbringing by a patient's parents or other family members
- Traumatic and/or extremely embarrassing sexual experiences during childhood or teenage years
- Teenage conditioning - where a young man learns to climax quickly to avoid being exposed while masturbating

Medical Causes

Possible biological or physiological conditions that may be associated with PE include:
- Prostate disease
- Thyroid disease or issues
- Diabetes
- MS (multiple sclerosis)
- Drug abuse
- Alcohol (drinking excessively)

Treatments for Premature Ejaculation

Premature ejaculation can be treated in various ways. First and foremost, it's critically important to remove all of the anxiety that a patient may be feeling about the issue. Restoring the individual's confidence, and even breaking the cycle of anticipation that's often associated with premature ejaculation, can sometimes lead to alleviation of the condition. Counseling by a qualified sex therapist or psychologist may also help a patient to reduce the stress and anxiety associated with PE.

Medications are often times used very successfully to treat PE. The most common and quickest treatment for premature ejaculation is currently the SSRI (selective serotonin re-uptake inhibitors) class of antidepressant medications. These include Lexapro, Paxil and Zoloft, which all have been shown to effectively delay ejaculation. Most patients experience a good response to these medications, especially if they are taken daily. Side effects are minimal, but may include drowsiness and nausea (which usually decrease and disappear after a week or two). The painkiller Tramadol has also been used in patient's where antidepressants weren't effective. However, this medication can be addictive, so for many men it is not a real option.

Some additional treatment options include the use of the "Stop-and-Start" or "Squeeze Technique" by Masters and Johnson, or the desensitizing cream known as SS cream, which can be used to desensitize the penis and significantly delay ejaculation (although this has not yet been approved by the FDA).

Questions about PE Treatments? Contact Philadelphia Urology Associates For Answers

At Philadelphia Urology Associates, Dr. Bruce Sloane is a nationally renowned specialist in Men's Health issues and Age Management Medicine. Throughout Philadelphia and the surrounding areas, patients seek his expertise to treat premature ejaculation and other sexual performance issues. Using state-of-the-art equipment and having extensive specialized education and training, Dr. Sloane will find the treatments and solutions that will work for you.

If you have any questions about the treatments available for premature ejaculation (PE) or other urological disorders, we urge you to contact us now online or call us at (215) 563-1199 today to discuss how we can help you!

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