Premature ejaculation is the most common form of sexual dysfunction. Typically defined as ejaculation with loss of erection prior to or shortly after (within 2 minutes of) penetration. Sexually active men are typically able to maintain erections for 5 to 15 minutes or longer after penetration.
Premature Ejaculation Causes and Solutions
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Common Causes For Premature Ejaculation (PE) are:
- infrequent sex with lack of opportunity to practice control
- physical or mental fatigue at the time of sex (i.e. late at night).
- anxiety
- problems in the relationship
- Biological Hormone issues such as Low T levels
Basic Solutions for PE are:
- stopping all motion immediately after penetration
- stop, start, withdrawal and pinching head of penis to cause minor discomfort
- mental distancing during stop periods (thinking non-sexual thoughts or even negative thoughts)
- and, use of topical local anesthetics and then applying a condom.
Of course the idea in all of these methods is to “back off” from the “point of no-return”, that is, the moment at which ejaculation is so close that nothing you can do will stop it.
Kegel Exercises For Men
Use of exercises to tighten the pelvic floor muscles, called Kegel exercises, can help some men to gain this control. This type of control can also be practiced during foreplay or during masturbation to improve control after sexual penetration, so as to minimize frustration of the partner.
Antidpressants (SSRI’s) For Premature Ejaculation Treatment
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Usually, both the man and his partner are so frustrated when they finally present to the doctor for treatment of PE that they demand a guaranteed fix. For this reason, the use of low dose antidepressants called SSRI’s (selective serotonin reuptake inhibitors) has become a popular and effective treatment in 70 % of cases.
Medications in this class include generic versions of zoloft, prozac, paxil, and celexa to name just a few. They have minimal side effects, mostly sleepiness, so that this is decreased by taking them at bedtime. These are prescription medications only to be used by doctors knowledgeable in this field.
Erectile Dysfunction (ED) Medications and Therapy
Since recovery time for the next usable erection after ejaculation becomes longer as men age, an additional therapeutic approach is to use the ED meds such as Viagra, Levitra, Cialis and Stendra to decrease the recovery time for the next usable erection after an ejaculation. Combination therapy with both medication types is often very successful. In addition, if low T is a part of the diagnosis, then treatment of the low T will also decrease the time for recovery from one erection to the next usable erection after ejaculation.
Finally, in cases where these measures have failed, small amounts of erection assuring medications can be injected with a tiny painless needle into the side of one of the erection cylinders within the shaft of the penis that will maintain a lasting erection of 1-2 hours duration even should the man ejaculate early. Although this sounds too tender to try, we have saved many relationships with this relatively painless, low cost and easy treatment.