Ejaculation occurs when a man reaches sexual climax and semen is ejected from his penis. Premature ejaculation is:
Many men experience premature ejaculation at one time or another. For example, some men experience it after not having had sex for a long period of time. Premature ejaculation is only a problem when it becomes a persistent condition. Persistent premature ejaculation usually results from a man's inability to recognize that he is about to ejaculate. (Ejaculation occurs automatically after a certain degree of sexual stimulation.) This inability prevents him from taking steps to delay the process.
Psychological factors that may contribute include:
In rare cases, premature ejaculation can be caused by:
A risk factor is something that increases your chance of getting a disease or condition. Risk factors for premature ejaculation include:
The primary symptom is persistent episodes of premature ejaculation during sex. Secondary symptoms may include:
Most men experiencing premature ejaculation will notice the condition themselves. If you see a doctor about the condition, the doctor will ask about your symptoms and medical history, and perform a physical exam.
The doctor may search for an underlying medical cause if:
Treatments may include:
This aims to improve your ability to:
It may include:
Counseling may be offered for an individual or for a couple. It is aimed at identifying and treating:
In some cases, a doctor may prescribe a desensitizing cream that a man can apply to his penis to lessen sexual stimulation.
In other cases, a doctor may prescribe an antidepressant medicine such as Zoloft or Prozac , or Clomipramine. Such antidepressants have been found to prolong the interval from intromission to ejaculation. However, these drugs do not cure the underlying cause of premature ejaculation and they need to be taken daily.
Another medication that showed some promise in treating the condition is dapoxetine. Contrary to other anti-depressants it is taken 1-3 hours before intercourse. Its use for premature ejaculation has not been FDA approved.
RESOURCES:
American Urological Association
http://www.auanet.org
Men's Health Network
http://www.menshealthnetwork.org
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca/index_e.html
Sex Information and Education Council of Canada
http://www.sieccan.org/
References:
American Academy of Family Physicians website. Available at: http://www.aafp.org/online/en/home.html . Accessed March 25, 2007.
American Psychiatric Association website. Available at: http://www.psych.org/ . Accessed March 25, 2007.
American Urological Association website. Available at: http://www.urologyhealth.org/adult/index.cfm?cat=11&topic=670 . Accessed March 25, 2007.
Montague, DK, Jarow, J, Broderick, GA, et al. AUA guideline on the pharmacologic management of premature ejaculation. J Urol 2004; 172:290.
Pryor, JL, Althof, SE, Steidle, C, et al. Efficacy and tolerability of dapoxetine in treatment of premature ejaculation: an integrated analysis of two double-blind, randomised controlled trials. Lancet 2006; 368:929.
The Merck Manual of Medical Information—Home Edition . Simon and Schuster, Inc.; 2000.
Last reviewed November 2008 by Adrienne Carmack, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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