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Sexual Health

Understanding The Ins & Outs Of Premature Ejaculation

Premature ejaculation, the unexpected sprint to the finish line in the bedroom, can be vexing. This article discusses this sexual disorder as a multifactorial health problem. There is no one-size-fits-all treatment, but it can be tackled wisely and scientifically. 

Jun 4, 2024

4 min read

Written by Dr Medha Gupta
Medically Reviewed by 

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It is a movie with an early climax; you reach the end before the story really begins. This ‘oops’ moment in the bedroom can be a damper to what could have been a passionate moment. You, like many others, wish to hold off longer before finishing in bed, but premature ejaculation (PE) has been an unwelcome twist.

Premature ejaculation - The background story

The International Society for Sexual Medicine (ISSM) says that men with PE usually ejaculate within a minute or less of vaginal penetration. Others may finish without any apparent stimulation, too. What’s heartbreaking is that men often shy away from discussing their sexual health issues. It’s emasculating and socially stigmatised, especially in Asian patriarchates like India, Pakistan, Nepal, Iraq, and more. 

Let us tell you straight up: there isn’t a one-size-fits-all way to increase stamina in bed. What we can do is tap into the root causes and craft personalised treatment options for PE, but for that, you need to start talking. 

Stay tuned, as today’s read will get you past the “just relax and meditate before sex” kind of advice and push through the taboo surrounding PE to the beautiful crescendo you deserve. 

The causes of premature ejaculation

Pinning the early cause of ejaculation with specificity is troublesome.  Premature ejaculation (PE) is multifactorial, with a combination of biological and mental causes.  Here is a list of the factors that may lead to PE in the descending order of their prevalence:

1. Hormonal factors

Serotonin, a brain hormone, is at the centre stage of the ejaculation process. Research shows that serotonin chiefly operates by slowing ejaculation via certain nerve pathways from the brain, through the spinal cord, to the penis. Irregularities in serotonin levels can be genetic or a physiologic dysfunction that often leads to early ejaculations. 

2. Health Issues

PE may occur hand-in-hand with Erectile Dysfunction (ED), another major sexual issue concerning erection difficulties. Apart from that, thyroid disorders, inflammation or infection in the prostate or urethra (the urinary tract) can also impact ejaculation patterns.

3. Mental Health

Have you encountered an early drop when you are stressing over climaxing? That could possibly be a problem there.  Men with erectile dysfunction, or PE, often rush to ejaculate due to anxiety about holding onto that erection. Such anxiety has a reverse effect and causes an early climax.  Other anxiety-inducing factors like ongoing relationship problems, depression, rage, infidelity, and deep-seated guilt with a partner can also influence premature ejaculation.

4. Age

Teens and young adults often have heightened penile sensitivity and often reach climax more quickly when we are specifically talking about PE.

5. Excessive Masturbation

Masturbating too often sensitises the penis to an early and different form of climax. The body may be unable to differentiate between intercourse and ‘self-help techniques’ walking its way up to an early climax. You should also keep in mind that PE might be a transient effect of alcohol or prolonged drug addiction, too.

Unfortunately, men often see PE as a scar on their masculinity rather than a health issue. As a result, they refrain from discussing it. With many personalised treatment plans available today, you do not have to battle PE alone.

Premature ejaculation treatment

Whether PE began suddenly or has gradually crept into your bedroom, you need to contact a doctor for the best advice. A thorough health check-up is the first thing to begin with. It helps find the root cause of PE in your case and tailor a premature ejaculation treatment plan that will show results.

It is important to note that the following methods do not cure premature ejaculation; they provide immediate relief without side effects and should be used with a doctor-prescribed treatment plan/therapy that fixes the underlying medical conditions and mental issues.

Behaviour conditioning techniques:

To begin with, the stop-and-start technique is when the feeling of ejaculation is imminent, you cease sexual activity and redirect focus. Resume sex once arousal subsides. The squeeze method states that when you are about to ejaculate, gently squeeze the penis to reduce arousal, allowing sexual intercourse to slowly get back after a pause. Both techniques are aimed at interrupting sexual activity just before ejaculation and resuming after arousal decreases. This helps you hold longer.

Masturbation before intercourse and "second try" coitus:

These practices capitalise on the refractory period after ejaculation to delay subsequent ejaculations. So you finish fast on your first attempt, but your subsequent encounters are better at the same time. 

Dealing with mental health:

Opting for stress reduction techniques, such as using non-verbal arousal and pleasure signals from the partner for sexual interest, can be a great way to keep you going.  You can also opt to reach out to relationship counsellors or personal therapists to deal with the matter better.

Adopting a healthy lifestyle:

Meditation, yoga, regular exercise, and healthy eating can help you stay physically fit and reduce stress, including performance anxiety. This may work well when tackling PE in the long run. Certain specific workouts that target the pelvis, such as Kegels, may prolong ejaculation.

Healing begins with speaking up

Dealing with premature ejaculation is like trying to win a race with a false start. You have the energy; it just needs to be harnessed the right way. Knowledge alone can influence perception. So, knowledge of PE and its probable causes is perhaps the first step towards solving the problem. You need to feel comfortable in your skin and set out to discuss PE.

Talking openly with your physician or therapist might help you explore deeper emotional issues that may be the cause of your PE. Famous urologist Fabio Castiglione Urologo Londra states in his personal LinkedIn post that “open communication and a willingness to explore different solutions are key to managing this sexual health issue effectively.”

Medically reviewed by:
Dr Vikas Bhise, Urologoist

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