Premature Ejaculation

What causes Premature Ejaculation?

Although it’s a common complaint, premature ejaculation is rarely caused by a physical problem.

Premature ejaculation early in a relationship is most often caused by anxiety, depression, or overstimulation. Other psychological factors such as guilt may also be relevant.

What are the symptoms of Premature Ejaculation?

The primary symptom is an uncontrolled and undesired ejaculation, with minimal sexual stimulation. This may range from before penetration to a point just after penetration and may leave the couple feeling unsatisfied.

How is Premature Ejaculation diagnosed?

Your Michigan Institute of Urology physician will conduct a thorough exam, including a discussion about medical and sexual history. Semen, urine, and blood tests may rule out more serious medical problems in the rare case that those are the cause.

How is Premature Ejaculation treated?

Abnormal findings are unlikely to be associated with the condition. Useful information is more likely to be obtained from interviewing the person or the couple.

• Behavioral changes: Relaxation or distraction exercises can help delay ejaculation; counseling or behavioral therapy may be advised. Cutting down on alcohol, tobacco, or drugs may also help.
• Medication: Certain antidepressants may be used to treat premature ejaculation because these medications inhibit or delay orgasm as a side effect.
• Topical therapy: Anesthetic creams and sprays that contain a numbing agent, such as prilocaine or lidocaine, are sometimes used to treat premature ejaculation. These products are applied to the penis 10 to 15 minutes before sex to reduce sensation and help delay ejaculation. They can be available over the counter or by prescription.

Some helpful techniques include the following:

• Some men try to distract themselves by thinking non-sexual thoughts (such as naming baseball players and records) to avoid becoming excited too fast.
• The “stop and start” method: This technique involves sexual stimulation until the man recognizes that he is about to ejaculate. The stimulation is then removed for about thirty seconds and then may be resumed. The sequence is repeated until ejaculation is desired, the final time allowing the stimulation to continue until ejaculation occurs.
• The “squeeze” method: This technique involves sexual stimulation until the man recognizes that he is about to ejaculate. At that point, the man or his partner gently squeezes the end of the penis (where the glands meet the shaft) for several seconds, withholding further sexual stimulation for about 30 seconds, and then resuming stimulation. The sequence may be repeated by the person or couple until ejaculation is desired, the final time allowing the stimulation to continue until ejaculation occurs.