Premature Ejaculation / PE

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Premature ejaculation is ejaculation that occurs before either of the partners is ready for it.

Premature ejaculation (PE) is a sexual dysfunction that often affects young men aged below 40 years. It could be described as male climax or ejaculation occurring before either of the partners is ready for it.

When a couple has sex, they go through the phases of desire, followed by arousal and the act culminates in the climax or the orgasm. A gratifying sexual experience is one in which both partners climax simultaneously. In the case of the male, the climax occurs with ejaculation. In women, there is no definite ‘event’ signalling the high point.

In a case of premature ejaculation, the male ejaculates before penetration or sometimes shortly after penetration, leaving the partner with no time to attain orgasm.

The International Society of Sexual Medicine, 2013 defines premature ejaculation as “A male sexual dysfunction characterized by ejaculation which always or nearly always occurs prior to or within one minute of vaginal penetration, either present from the first sexual experience or following a new bothersome change in ejaculatory latency, and the inability to delay ejaculation on all or nearly all vaginal penetrations, and negative personal consequences, such as distress bother, frustration and/or the avoidance of sexual intimacy.”

(Source: (http://www.issm.info/images/uploads/PE_Guidelines_v12_-_FEB_2014.pdf)

Premature ejaculation is very often thought to be psychological in origin, where a man who is very anxious or has oversensitive genitals ejaculates before penetration or too soon after penetration, and that it does not yield the desired satisfaction to the couple. It has also been associated with abuse or traumatic experiences related to sex in childhood or anxious individuals. It could at times be secondary to hormonal problems or problems related to the prostate gland.

Premature ejaculation could lead to frustration, lack of enjoyment from sex, and finally depression and lack of self-esteem. It is a known cause for broken relationships.

A detailed history of the man’s sex habits, prior sexual trysts, as well as that of the partner must be elicited while treating a couple affected by premature ejaculation.

Treatment lies in both partners understanding the problem, and approaching it in a relaxed manner. Various exercises, positions and maneuvers are recommended to delay the ejaculation for a little longer. A psychologist may also be able to help to deal with issues related to the condition.

Medications useful for this condition are anti-depressants, which actually delay ejaculation as a side effect and not as a primary effect. Local anesthetic creams are available which when applied over the penis, numb it and thereby delay the stimulation and ejaculation process.