Premature ejaculation (PE) is a very common problem amongst men but, like many other conditions, one that is often not treated as well as it could be. It effects about one in four men although this could easily be an underestimate. In addition a lot of medical doctors don’t feel comfortable or aren’t very interested in this condition. Premature ejaculation, more than many other conditions, has been one that has been used to exploit men with false advertising and treatments that are both expensive and not effective.
How do you know if you have premature ejaculation?
There aren’t any tests that need to be done to diagnose premature ejaculation and it can usually be diagnosed easily enough by simply asking if a man ejaculates earlier than he would like to when he is having sex. Most of these men will have premature ejaculation although in some cases the man or their partner might be worried they ejaculate to early when in truth they take about as long to ejaculate as men who don’t have have premature ejaculation.
There is no set period of time that defines premature ejaculation although this is definitely something that is considered in diagnosis. If, after penetration, ejaculation almost always happens in less than 1 minute then that makes premature ejaculation very likely. Men will still seek and benefit from treatment if the time to ejaculation is less than 2 or 3 minutes. A normal time to ejaculation is probably around 5-6 minutes which may be shorter than some men and their partners think.
What non-medication treatments work for premature ejaculation?
Some men seeking treatment for premature ejaculation will actually have a fairly normal ejaculatory time or they might only ejaculate prematurely some of the time. In a lot of cases there is no intensive treatment that is required and there might be some simple strategies to delay ejaculation that are used.
If the premature ejaculation has been present from the very first sexual encounter and if it happens almost all of the time (Lifelong PE) then it’s common to use medications in combination with non-medication treatments as this form of PE is harder to treat.
In Acquired PE the problem is one that has come on at some point in life but that wasn’t always present. The approach to treatment is essentially the same as Lifelong PE except that non-medication approaches are used first. These include things like mindfulness or better awareness of the body during sex (this actually works much more effectively than many men realise), breathing techniques, different sex positions, ejaculation rehabilitation exercises and pelvic floor exercises. These techniques don’t work overnight but with practice they can be very effective.
Other quicker non-medication options include wearing a condom or wearing a ‘numbing’ condom. These help but the downside can be erectile dysfunction and sex that isn’t as pleasurable as many men might like.
What about medication options for premature ejaculation?
There are a few different medication options and they all have their own pros and cons
Numbing sprays are a good first line option as they are safe and they usually work well. The problems are related to loss of sensation causing problems with sexual pleasure and maintaining an erection, transference of the numbing to the partner which might reduce their pleasure and reactions on the skin of the penis.
In many cases premature ejaculation is caused by or made worse by erectile dysfunction. Men can be too concerned with maintaining an erection that they don’t realise how close they are to ejaculating and in an attempt to keep their erection they overstimulate the penis. Treating the erectile dysfunction (with medication or other treatments) will usually solve the premature ejaculation.
Other medications are either anti-depressants or based on anti-depressants which have a side effect of delaying ejaculation. While effective these medications can have other side effects including a reduced interest in sex. These medications have proven effectiveness and they can be combined with non-medication treatments as well.