Sexual Health

Premature Ejaculation

Premature Ejaculation (PE) is the most common male sexual dysfunction, characterized by ejaculation that occurs sooner than desired, either before or shortly after penetration, causing distress to one or both partners. PE can be lifelong (primary) or acquired (secondary) and is highly treatable.

Symptoms

Ejaculation occurring within 1-2 minutes of penetration consistently

Inability to delay ejaculation during intercourse

Distress, frustration, or avoidance of sexual intimacy

Relationship tension due to sexual dissatisfaction

Reduced sexual confidence

Causes

Serotonin imbalances in the brain (neurobiological)
Psychological factors: performance anxiety, early sexual experiences, guilt
Relationship issues and communication problems
Erectile dysfunction (rushing due to fear of losing erection)
Hormonal factors (thyroid disorders, abnormal hormone levels)
Prostatitis or urethritis
Genetic predisposition

Diagnosis

Diagnosis is primarily clinical, based on sexual history and self-reported ejaculatory latency time. The doctor will assess frequency, duration, level of distress, and impact on relationships. Physical examination and lab tests may be done to rule out medical causes.

Treatment Options

Dapoxetine (Priligy) — on-demand SSRI specifically for PE

Daily low-dose SSRIs (paroxetine, sertraline) for daily treatment approach

Topical anesthetics (lidocaine/prilocaine creams)

Behavioral techniques: start-stop technique, squeeze technique

Psychosexual therapy

Pelvic floor exercises (Kegels)

Treatment of underlying erectile dysfunction if present

Couples therapy

When to Seek Help

Seek help if premature ejaculation is consistent and causing distress, if it is affecting your relationship, if you've tried self-help techniques without improvement, or if PE is accompanied by erectile dysfunction.

Your Action Plan

1.Step 1: Know it's common and treatable — PE affects 20-30% of men

2.Step 2: Get evaluated by a certified sexologist — rule out underlying causes (ED, prostatitis, thyroid)

3.Step 3: Try behavioral techniques: start-stop method (stop stimulation before the point of no return, rest, resume)

4.Step 4: Consider medication: Dapoxetine (on-demand, taken 1-3h before) or daily SSRI

5.Step 5: Desensitizing products (lidocaine spray/cream) can help as an adjunct

6.Step 6: Pelvic floor exercises (Kegels) — strengthen the muscles involved in ejaculatory control

7.Step 7: Communicate with your partner — silence creates distance, openness enables solutions

8.Step 8: Address performance anxiety if present — the pressure to 'last longer' often worsens the problem