Premature Ejaculation: Fact or Fiction?
Are you quick to quip? Do you get there before everyone else? Eat faster than those around you? Finish other people’s sentences? All kinds of things in life can happen too quickly for our taste. Even in bed.
Premature ejaculation is loosely defined as ejaculation occurring sooner than desired, either before or shortly after penetration, causing distress to either or both partners. Although there are hints of possible ties with hormones such as thyroid, prolactin and testosterone, premature ejaculation has not been clearly linked to any disease. However, there are links to memories of early sexual experiences and mood disorders such as anxiety or depression.
Given that it’s the most common sexual dysfunction in men, occurring in about 30% of us, you probably know somebody with this problem. Yet, as common as it is, most of medicine doesn’t really consider it a “disease.” The FDA has even refused to approve drugs that delay ejaculation for precisely this reason.
So, is early ejaculation really a problem? As a men’s health specialist, I say “Absolutely, Yes!” Okay, so it won’t kill you, but neither do many full-fledged diseases such as psoriasis and infertility. Like these diseases, early ejaculation can be distressful, bothersome, and frustrating. And perhaps more importantly, it often leads to an avoidance of sex.
Getting There Early
Let me clarify things a bit. There are two forms of early ejaculation: primary, or “lifelong”; and secondary, or “acquired.” If the condition has been present since the onset of sexual maturity, it is considered lifelong. If it develops after an interval of normal sexual function, then it is deemed acquired. What I ask to tell the difference is: “Have you had this issue with every partner, or with only a few partners?”
With lifelong early ejaculation, all relationships are affected. Many of these men are exhausted by their condition as they might be with any chronic disease.
If early ejaculation occurs at the start of a new relationship or with highly anticipated sex, then this could be quite normal. Who ever said that a man’s response to sexual stimulation has to be the same each time he has it? We begin to think of it as a problem if men consistently ejaculate within 1 minute of intercourse (believe it or not, the average time to ejaculation in U.S. men is 6 minutes!) or if either partner is bothered by what’s happening. When we delve more deeply into cases of acquired early ejaculation, we often find an underlying problem with an inability to maintain erections or issues with painful sex with either partner. With failing erections or painful sex, men tend to hasten the pace of sex to complete the act before the erection falls or pain worsens.
Help Is on the Way
Acquired early ejaculation is quite treatable if the cause of quick sex can be determined. The erectogenic agents Viagra®, Cialis® and Levitra® work wonders for falling erections. The use of lubricants, pelvic physiotherapy, acupuncture or correction of definable anatomic issues can solve the issue of pain-related early ejaculation. And controlling mood disorders can be very helpful. Treatment of lifelong premature ejaculation involves decreasing penile sensitivity and increasing one’s control over the ejaculation process. You can’t stop the process after it starts but you can learn how to avoid the point of no return. Low-dose antidepressants and anesthetic sprays and creams can help decrease penile sensitivity, but they are really just “patch” therapy. If you’d like a cure, take a more holistic approach: behavioral therapy is the single best way to “own” all aspects of the ejaculatory reflex.
So, don’t suffer in silence because the world doesn’t believe that premature ejaculation is a disease. We do. Give us a shout,we can help!