Premature Ejaculation

Generally, premature ejaculation is defined as a lack of control of ejaculation when having a sexual intercourse of less than 1 min or when it cannot sustain through intercourse to sexually satisfy both the female partner and him. Sometimes, it may even happen before penetration or just at the time of penetration. It is more common in younger patients, especially when they are associated with:

  • Fast-paced, ‘high stress’ work

  • High expectations during sex

  • Non-frequent sex but needing to do it for some reasons

Several studies have concluded that premature ejaculation is the most common male sexual dysfunction and it affects up to 20-30% of men. The prevalence is higher if the above mentioned exist, especially in a fast-paced society with high expectations.

Causes

  • Psychological factors

  • Performance anxiety

  • Sensitive glans penis

  • Medical illness e.g. diabetes mellitus, stroke

  • Associated with erectile dysfunction

  • Medication

Impacts  

  • Sexual satisfaction for both parties involved

  • Self-confidence

  • Anxiety about sex

  • Relationship stress

Prevention

  • A healthy life style

  • Having a relaxing environment for having sex

  • Choosing not to work under pressure

  • Having proper sexual expectations

  • Do not rush in having sex

 

Treatment

Before starting any treatment, a thorough discussion of the effectiveness and side-effects of the treatment must be carried out to manage patients’ expectations. Psychosexual and behavioral therapy were once the mainstays of treatment, but now, topical and systemic medications have demonstrated success too.

 

Medications:​

1. Topical medication therapy

-   Lidonocaine jelly (numb the penis and lubricate especially with patients with sensitive glans penis)​

2. Systemic medication therapy

-   Selective serotonin reuptake inhibitors (SSRIs) e.g. Zoloft, etc. taken 4 hours before sex or one day before and follow by 4 hours before sex.

-   Tramadol

Generally, the SSRI is the most common treatment modality and it has shown successful outcomes in our patients with premature ejaculation.​

Disclaimer: This is not a guide to self-diagnose. We encourage to seek urologist advice further.

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