Premature ejaculation, medically speaking is reduced interval between penetration and ejaculation during intercourse. It is a cause of dissatisfaction in a relationship and may be associated with feeling of incompetence and shame. There is also feeling of insecurity. The specific time accepted medically is if it is less than 1 or 2 minutes. This depends on the authority one is citing. The reduced time, lack of control and sexual dissatisfaction are enough to make a diagnosis.
Classification of Premature Ejaculation
This condition may be lifelong if it starts and persists since the man became sexually active. In others, the problem is acquired meaning that it starts after months or years of normal sexual performance. The problem may be situational in context, meaning that the individual experiences premature ejaculation with a new partner or some specific situations but not most of the time. If an individual has premature ejaculation on all attempts irrespective of the partner or circumstance, then it is a global problem
It is important to note that some may have unrealistic expectations having no idea of what the average time to ejaculation is. This heightened expectation may be from “beer parlour” talk or unrealistic sources of information which often boast for reasons of social capital or financial motives. These cases may be resolved by counselling.
Causes of Premature Ejaculation
The cause of the problem is subject to debate as some divide it into psychogenic and organic. Some psychogenic causes include early sexual experience, anxiety, infrequent intercourse, etc. The organic causes are increased sensitivity of the penis in certain individual and low ejaculatory threshold in the brain or increased sensitivity of the reflex pathway involved in sexual arousal.
Treatment of Premature Ejaculation
The treatment of premature ejaculation is divided into behavioural management or use of medications but frequently both are used together. The medications are topical therapies which are applied locally on the penis, and oral therapies. Most topical therapies aim to reduce sensitivity of the penis and must be applied 30 minutes before intercourse.
The oral medications used are groups of drug called tricyclic antidepressants or selective serotonin reuptake inhibitors. These drugs take up to 2 weeks to become effective and their effect stops if discontinued. It is important to be aware of the common side effects of these medications. Due to the side effects of these two classes of drugs (dry mouth, sedation, blurred vision, constipation, hepatitis, rapid pulse rate, etc), newer medications that can be used only on demand, that is few hours before intercourse, have been developed. These newer ones have less side effects.
In conclusion, premature ejaculation is a treatable condition and the individuals can achieve satisfaction in their sexual life.
Dr Benjamin Odusanya is a Consultant Urologist. He is a Fellow of The West African College of Surgeons (FWACS) and The Medical College of Surgeons (FMCS). He works at The General Hospital, Marina, Lagos. He can be contacted on firstname.lastname@example.org.