Ejaculation is the release of semen from the body and usually occurs simultaneously with orgasm (sexual climax). Premature ejaculation (PE) is when a man ejaculates sooner during sex than he or his partner would like. The average man reaches orgasm in about 5-6 minutes, while women take closer to 20 minutes. This creates an “orgasm gap” in the amount of time it takes a man to reach orgasm compared to a woman and accounts for why 80% of women say they would like their man to last longer in bed.
Severe PE occurs with sexual stimulation before or within 1 to 2 minutes after penetration. Less severe PE occurs later during intercourse, but before the partners want it to.
As long as it happens infrequently, it’s not cause for concern. But, if it occurs often, it certainly can make sex less satisfying and enjoyable and can negatively impact a man’s emotional well being and relationships.
Men with PE tend to feel less confident, frustrated, ashamed, disappointed and embarrassed. PE causes emotional distress and relationship difficulties. It can lead to decreased satisfaction for either one or both partners and can result in the avoidance of intimacy, affection and intercourse.
Premature ejaculation is an extremely common sexual complaint that can happen at any age.
There are two different types of premature ejaculation:
- Primary (lifelong) is when a man has not had control of ejaculation from the time of his first sexual experience and it has been a persisting issue. If left untreated, the premature ejaculation will continue for the rest of his life.
- Secondary (acquired) is usually when there has been a period of normal functioning before the premature ejaculation problem begins.
Acquired premature ejaculation can arise due to:
- Medical conditions such as diabetes, erectile dysfunction, chronic prostatitis and overactive thyroid.
- Psychological issues such as anxiety, stress, relationship problems, intimacy issues, sexual inexperience, levels of excitement
- Situational issues such as infrequent sexual activity, a new partner, new sexual position/circumstance, length of time from the last ejaculation, extent of foreplay, relationship/ intimacy issues.
It is estimated that 1 out of every 3 men between age 18 and 60 suffer from PE. Although many men (and their doctors) feel embarrassed talking about it, PE is a very treatable condition. Until recently PE was thought to be a psychological problem for which the best treatment was behavioral modification or sexual control techniques. However, these methods have historically been disappointingly unsuccessful.
We now know that ejaculation is a complex reflex under spinal, supraspinal and peripheral control. It does not lend itself well to voluntary control. It involves the interplay of various neurotransmitters including serotonin.
Certain medications used to treat other problems involving an imbalance of these neurotransmitters, have been noted to have the “side effect” of preventing or delaying orgasm. These medications can be prescribed “off-label” to treat PE. At the Charleston Men’s Clinic, we use SSRI’s (selective serotonin reuptake inhibitors used to treat anxiety and depression) as well as PDEI’s (phosphodiesterase inhibitors used to treat ED) combined with tramadol and dextromethorphan to effectively treat PE in some individuals.
The Charleston Men’s Clinic also specializes in providing a PE treatment, which not only provides a full erection, but allows you to maintain your erection even after you ejaculate. A dose of FDA- approved ED medication, formulated and adjusted specifically for you, can be painlessly injected (using insulin administration technology) by you or your partner just prior to or during sex. It will produce a safe, predictably firm erection lasting anywhere from 20 minutes to over 2 hours. You decide how long you want your erection to last!
We also offer a metered dose topical anesthetic spray to help you improve control and close the O-Gap. Just the right amount of medication can be applied to a small area of your penis 5-10 minutes before penetration and will provide you with next-tonormal sensitivity, doesn’t transfer to your partner and lasts up to an hour.
PE is a very treatable problem. Call us to schedule a consultation and find out which treatment best suits your needs.