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Premature ejaculation

 

Premature ejaculation is when a man has an orgasm sooner during intercourse than desired.

Causes

Premature ejaculation is a common complaint.

It is thought to be caused by psychological factors or physical problems. The condition often improves without treatment.

Symptoms

 

The man ejaculates before he or his partner would like (prematurely). This may range from before penetration to a point just after penetration. It may leave the couple feeling unsatisfied.

 

Exams and Tests

 

Your health care provider may do a physical exam and talk with you about your sex life and medical history. Your provider also may do blood or urine tests to rule out any physical problems.

 

Treatment

 

Practice and relaxation can help you deal with the problem. There are helpful techniques you can try.

The "stop and start" method:

This technique involves sexually stimulating the man until he feels like he is about to reach orgasm. Stop the stimulation for about 30 seconds and then start it again. Repeat this pattern until the man wants to ejaculate. The last time, continue stimulation until the man reaches orgasm.

The "squeeze" method:

This technique involves sexually stimulating the man until he recognizes that he is about to ejaculate. At that point, the man or his partner gently squeezes the end of the penis (where the glans meets the shaft) for several seconds. Stop sexual stimulation for about 30 seconds, and then start it again. The person or couple may repeat this pattern until the man wants to ejaculate. The last time, continue stimulation until the man reaches orgasm.

Antidepressants, such as Prozac and other selective serotonin reuptake inhibitors (SSRIs), are often prescribed. These medicines can increase the time it takes to reach ejaculation.

You can apply a local anesthetic cream or spray to the penis to reduce stimulation. Decreased feeling in the penis may delay ejaculation. Condom use also may have this effect for some men.

Other medicines used for erectile dysfunction may help. Some studies show that using a combination of behavioral techniques and medicines may be most effective.

Evaluation by a sex therapist, psychologist, or psychiatrist may help some couples.

 

Outlook (Prognosis)

 

In most cases, the man is able to learn how to control ejaculation. Education and practicing simple techniques are often successful. Chronic premature ejaculation may be a sign of anxiety or depression. A psychiatrist or psychologist can help treat these conditions.

 

Possible Complications

 

If a man ejaculates very early, before entering the vagina, it may prevent a couple from getting pregnant.

A continued lack of control over ejaculation may cause one or both partners to feel sexually dissatisfied. It may lead to sexual tension or other problems in the relationship.

 

When to Contact a Medical Professional

 

Call your health care provider if you are having a problem with premature ejaculation and it does not get better using the methods described above.

 

Prevention

 

There is no way to prevent this disorder.

 

 

References

Cooper K, Martyn-St James M, Kaltenthaler E, et al. Behavioral therapies for management of premature ejaculation: a systematic review. Sex Med. 2015;3(3):174-88. PMID: 26468381 www.ncbi.nlm.nih.gov/pubmed/26468381.

McMahn CG. Disorders of male orgasm and ejaculation. In: Wein AJ, ed. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 29.

Shafer LC. Sexual disorders and sexual dysfunction. In: Stern TA, Fava M,Wilens TE, Biederman J, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 36.

 
  • Male reproductive system

    Male reproductive system - illustration

    The male reproductive system, viewed from a sagittal section.

    Male reproductive system

    illustration

    • Male reproductive system

      Male reproductive system - illustration

      The male reproductive system, viewed from a sagittal section.

      Male reproductive system

      illustration

    A Closer Look

     

      Self Care

       

        Tests for Premature ejaculation

         

           

          Review Date: 1/21/2015

          Reviewed By: Scott Miller, MD, urologist in private practice in Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Editorial update: 02/12/2016.

          The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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