Opinion article
Premature ejaculation: what it is and how it’s treated
Premature ejaculation is ejaculation that happens sooner than wanted, usually within a very short interval after penetration, combined with an inability to control or delay it and with distress, frustration or avoidance of intimacy. It’s the most common male sexual dysfunction.
Types
- Lifelong: present since the very first sexual experiences.
- Acquired: develops after a period of normal sexual function, often linked to anxiety, untreated erectile dysfunction, or changes within the relationship.
Causes
It involves biological factors (heightened sensitivity of the serotonin receptors involved in the ejaculatory reflex), psychological factors (performance anxiety, stress, early sexual experiences) and, sometimes, undiagnosed erectile dysfunction, which leads to rushing intercourse out of fear of losing the erection.
Treatment
- Behavioural techniques, such as the stop-start technique or the squeeze technique.
- Topical anaesthetics, which reduce local sensitivity.
- Selective serotonin reuptake inhibitors, used off-label for this purpose, or dapoxetine where available.
- Pelvic floor physiotherapy and sex therapy, especially when anxiety or relationship factors are involved.
Combining approaches, behavioural, pharmacological and psychological, tends to work better than any single one on its own.
This article is for information only and does not replace a medical consultation.
Sources
- McMahon CG, Jannini EA, Serefoglu EC, et al. An Update of the International Society of Sexual Medicine’s Guidelines for the Diagnosis and Treatment of Premature Ejaculation (PE). Sexual Medicine. 2016.
- International Society for Sexual Medicine