Premature ejaculation or early ejaculation is a sexual performance complication that impacts the sex life of 1 out of every 3 men in the United States at some time in their lives. It can be caused by limited sexual experience, individual variation, medical conditions like hyperthyroidism and erectile dysfunction, or mental health conditions that might benefit from behavioral therapy.

​Psychological Factors

Many sexual problems are connected to psychological factors related to sexual intercourse, performance anxiety, and sexual experience. Treatment options include open communication in sexual relationships and consulting a sex therapist. These sex therapy approaches include discussing any sexual history or relationship problems that might be affecting sexual health or sexual function.

Additional treatment options that are available for the management of premature ejaculation, include how to control ejaculation through breathing or kegel exercises. Frequently ejaculating by masturbating, delay ejaculation techniques like the squeeze method or squeeze technique, and the stop-start or stop method are also ways to delay ejaculation.

Causes

The exact cause of premature ejaculation isn’t known. While it was once thought to be only psychological, doctors now know premature ejaculation involves a complex interaction of psychological and biological factors.

Psychological Causes

Psychological factors that might play a role include:

• Early sexual experiences
• Sexual abuse
• Poor body image
• Depression
• Worrying about premature ejaculation
• Guilty feelings that increase your tendency to rush through sexual encounters

Sexual Medicines

Medical treatments can be prescribed by a urologist following a physical exam. Selective serotonin reuptake inhibitors(SSRIs) are the most common types of medication prescribed for the treatment of premature ejaculation. These include clomipramine, dapoxetine, escitalopram (Lexapro), sertraline (Zoloft), paroxetine (Paxil) or fluoxetine (Prozac, Sarafem), Viagra, and Cialis.

Clomipramine can only be used to treat premature ejaculation. It is not proven effective for men with premature ejaculation and erectile dysfunction. Common side effects of SSRIs might include nausea, headache, sleepiness, and dizziness.

Another option is anesthetic creams like lidocaine or prilocaine. There are also topical wipes, apply to the most sensitive parts of your penis, wait five minutes to dry and you’re ready to go.

The 4% benzocaine in these swipes reduces overstimulation without eliminating sensation altogether, improving your endurance.

Condoms

Condoms might decrease penis sensitivity, which can help delay ejaculation. “Climax control” condoms are available over the counter. These condoms contain numbing agents such as benzocaine or lidocaine or are made of thicker latex to delay ejaculation. Examples include Trojan Extended, Durex Performax Intense and Lifestyles Everlast Intense.

Medications

Topical Anesthetics

Anesthetic creams and sprays that contain a numbing agent, such as benzocaine, lidocaine or prilocaine, 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.

A lidocaine-prilocaine cream for premature ejaculation (EMLA) is available by prescription. Lidocaine sprays for premature ejaculation are available over-the-counter.

Although topical anesthetic agents are effective and well-tolerated, they have potential side effects. For example, some men report temporary loss of sensitivity and decreased sexual pleasure. Sometimes, female partners also have reported these effects.

When To See A Doctor

Talk with your Toowoomba urology specialist if you ejaculate sooner than you wish during most sexual encounters. It’s common for men to feel embarrassed about discussing sexual health concerns, but don’t let that keep you from talking to your doctor. Premature ejaculation is a common and treatable problem.

For some men, a conversation with a doctor might help lessen concerns about premature ejaculation. For example, it might be reassuring to hear that occasional premature ejaculation is normal and that the average time from the beginning of intercourse to ejaculation is about five minutes.