Premature ejaculation problems are common. Most men experience occasional episodes. And because every couple decides what ‘premature’ means to them, it’s not always flagged up and it doesn’t always affect men negatively. However, when about half of your sexual encounters are thwarted by premature ejaculation, it’s not unreasonable to seek medical help. If you do, you may find that your health professional prefers to refer to it as ‘rapid ejaculation’.
Types and Causes of Premature Ejaculation
Some of the most common causes of premature ejaculation have to do with the prostate, the thyroid gland, stress, depression, anxiety, relationship issues, the use of recreational drugs, alcoholism, or a combination of these physical and psychological factors. In these cases, the problem is acquired, and health professionals refer to it as ‘secondary premature ejaculation’.
In other cases, men may experience nothing but premature ejaculation throughout their lives. This is known as ‘primary premature ejaculation’. It may be due to increased sensibility in the penis. But more often than not, the cause is psychological. It can be due to strict upbringing, religious beliefs, or traumatic early sexual experiences.
Premature Ejaculation Treatment
There are several ways to treat or at least have more control over premature ejaculation, depending on the root cause:
Self-help tricks to counteract conditioning
To lower the risks of ejaculating too early, some men find that masturbating an hour or two before having sex can help. Other common tricks are to desensitize the penis using a thick condom, control your breathing, and let your partner take the lead and slow down when you’re too close to ejaculating.
Couples therapy for relationship and anxiety issues
When anxiety and relationship issues cause people to have problems ejaculating, they feel trapped in a vicious circle. Couples therapy can help them break the cycle and hardwire normal behaviour into their brains, so that they never cause themselves to ejaculate too early. Besides learning to cope with relationship issues, in couples therapy partners are taught various masturbation techniques. This includes ‘stop-go’ and ‘squeeze’ – which is similar to the first, but involves squeezing the head of the penis for a few seconds just before climax, waiting for half a minute, and then resuming.
Medication to fight physical causes
One of the most common types of premature ejaculation treatment is the selective serotonin reuptake inhibitor (SSRI). It comes in many shapes and sizes, but the best-known SSRIs are paroxetine, fluoxetine, and sertraline. These are essentially antidepressants, and they start to work in about a fortnight.
There is one exception: dapoxetine. This SSRI is widely available on the NHS, and it doesn’t require long-term use to be effective. In fact, people are not allowed to take more than one dose per day. The advantage is that it can be used ‘on demand’, a few hours prior to sex. However, dapoxetine can interact with other medications and it’s not recommended to people with a variety of organ problems.
Sildenafil, commonly known as Viagra, is a phosphodiesterase-5 inhibitor. Though it’s primarily used to treat erectile dysfunction, it’s also been shown to help men with premature ejaculation. This medication is no longer available on the NHS, but it is available to buy over-the-counter. Before a pharmacist can sell it to you, though, they will carry out a brief consultation to rule out serious health conditions.
If you don’t respond well to dapoxetine, you may find some relief from ‘off-label’ medication. That’s a roundabout phrase for drugs that were not developed primarily for your issue, but may work anyway. Your GP may be able to help.
Another common remedy for premature ejaculation is a topical anaesthetic. Lidocaine 5% numbing ointments are helpful, but they’re bound to be transferred to your partner, causing them to experience a decrease in sensation and sexual stimulation. They can also be used in combination with condoms to reduce sensitivity.