Premature ejaculation:
what you need to know

Premature ejaculation is a common sexual dysfunction. But it shouldn’t be dismissed on the grounds of being common, as it can have many side effects. Solutions do exist to help you toward a more satisfactory sex life.

What is premature ejaculation?

Premature ejaculation (“PE”), also called “rapid” or “early” ejaculation, is when orgasm is reached too quickly after minimal sexual stimulation. Generally, the man, unable to hold himself back, ejaculates too soon for his liking. PE can then inflict psychological distress on the man and lead to other difficulties, possibly for both partners.

Specialist M.D. Waldinger defines a premature ejaculator as a man whose IELT* (time from start of penetration to ejaculation) is less than one minute in 90% or more of his coital experiences, independent of his age or the maturity of the relation. An indicative figure yielded by an international study shows the median IELT to be 5.4 minutes. This study took place across 5 countries and involved 500 different couples (1).

Premature ejaculation is a frequent problem regardless of sexual orientation and occurs among 20% to 30% of men. It’s the foremost sexual dysfunction for men under 30. Its incidence remains relatively steady with age.
More broadly, whether afflicted by PE or not, 60% of men would like sex to last longer before they ejaculate!

* IELT: Intravaginal ejaculation latency time

Please note: for many newcomers to sex, or men having sex with a new partner, it’s quite normal if their excitement runs out of control and they ejaculate. That’s not what we mean by premature ejaculation.

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Early ejaculation: what are the facts?

What causes premature ejaculation?

Several factors can be involved in premature ejaculation (PE):

Psychological factors

Anxiety can increase the likelihood of PE, especially performance stress. Such anxiety can block the pre-ejaculatory sensations. Depression and infrequent sexual activity can also play a role.

Behavioural factors

If a sexual novice skips through all the sensations leading up to actual orgasm, it can impede his voluntary control of the body’s ejaculatory reflex in subsequent relations.

Anatomical factors

A penile frenulum that is too short, an oversensitive penis, and hyper-excitability of the ejaculatory reflex have been implicated in a number of studies (2), (3).

Neurobiological factors

Hyper- or hypo-sensitivity of the cerebral receptors can be implicated. Also in the brain, nerve message processing disorder can be the PE culprit.

Other associated illnesses or conditions

Inflammation of the prostate (chronic prostatitis), anomalies in the thyroid gland, and erectile dysfunction can also be catalysts of PE.

Find out more:

What are the causes of premature ejaculation ?

How do we diagnose and treat premature ejaculation?

Methods exist for determining whether a person has premature ejaculation (PE) issues. One notable method is the self-questionnaire, such as the Premature Ejaculation Profile, Male Health Sexual Questionnaire, or PEDT (premature ejaculation diagnostic tool)(4). These however are no real substitute for diagnosis through medical consultation.
Premature ejaculation can lead to many everyday annoyances and difficulties. There are nonetheless solutions to help you:

The psycho-sexological approach

Supervised by a sex therapist or trained practitioner, this helps understand the nature of the complaint and the context from which it arose. It also teaches some specific physical behaviours.

The pharmacological approach

Anaesthetics like lidocaine work by locally anaesthetizing the glans penis. They can be obtained in cream or spray form. These products delay the ejaculatory reflex by attenuating sensitivity. Their efficacy and safety have been demonstrated over many years of use(5).

There are also more radical treatments such as dapoxetine, which belongs to a family of drugs called selective serotonin reuptake inhibitors (SSRI). It passively increases the time required to reach ejaculation and can improve self-control over the moment of release. It is taken 1 to 3 hours before sex, which means the coital union must be planned in advance.

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How to deal with premature ejaculation?

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