Overcoming Premature Ejaculation: Effective Treatments for Lasting Confidence

Premature ejaculation refers to the phenomenon where ejaculation occurs earlier than desired during sexual activity, affecting both the man and his partner. It is known to be the most common sexual disorder in men, causing distressing sexual dysfunction that can impact an individual’s self-esteem and interpersonal relationships. Its causes can be complex, ranging from psychological factors to physical conditions. However, there are effective treatments available that can help individuals regain control and confidence in their sexual health and well-being.

Understanding premature ejaculation

Premature is defined as an inability to delay ejaculation, leading to sexual dissatisfaction. This condition can cause the female partner to be deprived of enjoyment in lovemaking, manifested by either an occurrence of ejaculation before or very soon after the beginning of intercourse or ejaculation. Some experts suggest that ejaculation occurring less than 1 minute after vaginal penetration is automatically considered premature, while others suggest intravaginal time should be at least 4 minutes normally. Premature ejaculation is a multifaceted issue that can occur at any adult age, and approximately 30% of adult men aged 18 to 59 report this condition. While there is no permanent cure, certain medical treatments and behavioural therapy can provide assistance.  

Premature ejaculation classification

Premature ejaculation can be classified in several ways:

• Primary ejaculation: This type is associated when an individual becomes sexually active, typically involving an intravaginal ejaculation latency time of less than 1 minute.
• Secondary or acquired premature ejaculation: This type develops later in life and usually has an intravaginal ejaculation latency time of less than 3 minutes.
• Variable premature ejaculation: It is generally considered normal.  
• Premature-like ejaculatory dysfunction: It occurs when individuals become overly concerned or preoccupied with their ejaculatory control despite having a normal IELT.

Causes

Causes or reasons for premature ejaculation may involve several factors ranging from psychological to physical causes.

Psychological factors

• Performance anxiety: Due to nervousness with a new partner, anxiousness after a long period of abstinence or being overly excited
• Stress: A feeling of stress due to workload, handling of relationships, life transitions or other
• Poor self-esteem: Issues with body image or lack of confidence
• Depressive thoughts: Feeling of being guilty or overwhelmed

Physical factors

• Genetics: Some may have a genetic tendency to ejaculate more quickly.
• Hormonal variations: Conditions affecting hormonal levels, such as low testosterone levels, can lead to premature ejaculation.
• Inflamed prostrate: Conditions like prostatitis can affect the sexual function.
• Neurological problems: Problems with the nervous system, such as hyperexcitability of the ejaculatory reflex, can lead to premature ejaculation.

Lifestyle factors

• Poor sexual techniques: Lack of experience or poor sexual techniques can also lead to premature ejaculation.
• Lack of communication: Inadequate communication with the partner about sexual preferences and needs can lead to performance issues.
• Substance abuse: Overconsumption of alcohol intake or drug use can impact sexual performance.

Symptoms and complications

Premature ejaculation does not have other symptoms apart from ejaculating soon. However, this can lead to relationship issues and psychological complications like stress, distress and dissatisfaction. Individuals with this condition may experience feelings of embarrassment and inadequacy, resulting in decreased self-esteem and confidence. This also impacts intimate relationships and can be significant, as it may create friction between partners, ultimately affecting overall relationship quality.  

Seeking help for premature ejaculation is crucial, as healthcare providers can offer tailored treatment to address the underlying causes and improve sexual health and satisfaction.

Diagnosis

Lab tests are generally not needed unless an underlying health condition is suspected. For persistent ejaculation or if the condition is causing anxiety and depression, it is important to seek a healthcare professional. The clinician or referred urologist will conduct a complete evaluation of medical history followed by sexual experience. Here are some of the questions that can be discussed:

• Duration of the problem
• Circumstances and frequency of occurrence
• Whether it happens with all partners or during masturbation
• Issues with maintaining an erection
• Honest answers are crucial for accurate diagnosis. Your doctor will also inquire about other medical conditions, medications and substance use.

Premature ejaculation treatment

To treat premature ejaculation, a doctor might suggest several treatment options depending on the cause, which include:

• Behavioural techniques: This technique is designed to help men gain better control over their ejaculation. Here is how it works
• Stimulation: The male or their partner stimulates their penis until the feeling of impending climax is strong.
• Pause: At the point of near climax, the stimulation is stopped, allowing the sensation to subside completely.
• Repeat: Once the feeling of impending orgasm subsides, stimulation is resumed. The process is repeated several times, stopping just before the point of no return.

By practising this cycle, men can become more attuned to the sensations that precede orgasm. This increased awareness can make it easier to recognise and control the timing of ejaculation, ultimately improving sexual performance and satisfaction.

Squeeze therapy: Squeeze therapy involves stimulating the penis until you are close to the point of orgasm. At this point, gently squeeze the head of the penis for about 30 seconds to reduce the sensation and begin to lose your erection. This procedure is to be repeated often before you can achieve an actual orgasm. Consistent practice can help you gain better control over the timing of your ejaculation.

• Distracted thinking: This technique involves redirecting your focus to nonsexual thoughts during sexual activity. For example, you can visualise naming all the businesses you pass on your drive to the gym or listing all the players on your favourite sports team. By concentrating on these ordinary tasks, you can reduce the intensity of sexual arousal and delay ejaculation.
• Pelvic floor exercises: Kegal exercise may be recommended to strengthen the pelvic floor muscles and improve control over ejaculation.  
• Medications: Your health care provider can prescribe antidepressants that can delay ejaculations or anaesthetic creams or sprays, which can reduce penile sensitivity.  
• Counselling: Proper counselling from a psychologist, a psychiatrist or a sex therapist can help the patient to educate about the condition and understand the available treatment options. Seeking professional help can boost confidence and improve interpersonal relationships.
• Lifestyle changes: Reducing alcohol and drug abuse and practising a healthy lifestyle, such as proper diet, physical exercise and stress management techniques, can improve overall health.

Conclusion

Premature ejaculation is a condition wherein ejaculation occurs sooner than expected. It is one of the common sexual dysfunctions in men. Many men fail to seek medical opinion due to shame and embarrassment, which often results in the deterioration of their relationship with their partner. However, premature ejaculation can be treated with several therapies, sexual techniques and medications that improve sexual intimacy. Hence, it is recommended to seek the right healthcare provider, either urologist, psychiatrist or clinician, when symptoms appear to lead to emotional distress.