Premature Ejaculation

What is Premature Ejaculation?

Premature ejaculation (PE) is a condition in men that involves ejaculation before penetration or within one minute of sexual penetration. Duration of sex varies from couple to couple and there’s no one right duration. However, any sex resulting in disappointment, feelings of embarrassment and damage to confidence should be addressed.

According to a study, between 21-31% of adult males will experience premature ejaculation. It’s further stated that the actual number of people with the condition is likely much higher. The condition is commonly not reported and undertreated due to feelings of embarrassment or shame among men suffering from the condition. 

There are two types of PE, those who experience life long premature ejaculation and those who have acquired premature ejaculation. Most importantly, both types of premature ejaculation can be helped, which can drastically improve relationships and mental wellbeing. 

What Causes Premature Ejaculation?

The causes of PE can be both physical and psychological.

Physical Causes of PE

High Sensitivity

Sometimes men have a larger number of nerves in the penis and a lower threshold to ejaculate. This large number of nerves paired with a lower threshold means that pleasure can be intensified during sexual activity. This heightened sensitivity makes it more difficult to control the timing of ejaculation, leading to life long premature ejaculation. 

Erectile Dysfunction

Difficulty maintaining an erection or erectile dysfunction can sometimes lead to PE. This can be due in part to feelings of anxiety about losing an erection mid-sex. This leads men to rush ejaculation to avoid this perceived embarrassment.

The starting treatment for this type of PE is actually treating erectile dysfunction. It's important to note that the use of tablets for ED and PE together is NOT recommended and if both need to be treated it is important you speak with your GP.

Alcohol and Drugs

Drinking in moderation should not cause PE. It’s overdrinking alcohol that has been proven to cause issues with sex drive, erectile dysfunction, and yes premature ejaculation. Similarly, recreational drugs have also been shown to result in these sexual dysfunctions.

Medicines

Prescription drugs can cause PE, particularly those that also change hormones and mood such as steroids and antidepressants. If your treatment may be causing your PE, please speak to your health professional before making any changes to your treatment.

Psychological Causes of PE

Anxiety

The biggest reason for premature ejaculation can be anxiety. This includes performance anxiety and the fear of rejection, losing an erection, or being caught in the act. This can be due to past traumatic sexual experiences with both your current or previous sexual partners. 

PE due to anxiety tends to go away after the underlying cause is resolved. If the anxiety persists long term PE may take longer to address but should still improve with proper management techniques.

New Relationships

It is normal in new sexual relationships to have feelings of anxiety. Anxiety around the start of a relationship commonly results in PE, particularly in those who have experienced little sexual activity recently. This anxiety, tension and resulting PE should go away once you feel comfortable with the new partner. If PE doesn’t go away after you become comfortable with a partner, it is recommended to seek treatment.

Guilt

Not everyone has a healthy relationship with sex and sexuality. Cultural and religious beliefs around sex can result in feelings of guilt and discomfort. This can be true even if a person has left the restrictive culture or religious belief. Being able to move past this guilty feeling around sex can be achieved through sex therapy from a sexual therapist.

Premature Ejaculation Treatment Options

The first question most people have is does premature ejaculation have a cure? Yes, most of the time acquired premature ejaculation can be cured with the right treatment of the underlying cause. Even life long PE can be adequately managed in most people with the right treatment. Here are the major solutions for both short and long term treatment of premature ejaculation.

Please note that Australian law prevents us from naming specific prescription treatments. After completing an assessment, you will be presented with the treatment options our doctors can prescribe. Our doctors will then assess whether the treatment is suitable for you. You can also seek advice from your local GP or pharmacist.

Creams and Sprays for Premature Ejaculation

Typically the first treatment tried by men is numbing sprays and creams. These are local anaesthetic products that aim to decrease the sensitivity of the penis in order to delay ejaculation. 

Side effects of spray for premature ejaculation

Over application of the numbing agent can lead to a lack of situation during sex, making it difficult to ejaculate. 

Pills for Premature Ejaculation

Begin Assessment

This treatment is usually the second medicated treatment used by men after the use of numbing agents fails. The most common tablet to treat premature ejaculation belongs to a family of drugs called selective serotonin reuptake inhibitors (SSRI). 

This drug works by improving control over ejaculation and reducing distress and anxiety relating to PE. This results in an increase in time before ejaculation occurs. They are usually taken 1-3 hours before sex and just when required. These can be effective in both acquired and long term PE.

Side effects of premature ejaculation pills

The most common side effects associated with this treatment is dizziness, headaches and nausea. As such they may not be appropriate for people who have problems with dizziness, particularly upon standing. You must disclose any medicines or medical conditions to your doctor before using this drug.

Psychological Therapy

Sexual therapists are the most effective treatments for PE caused by psychological reasons. Performance anxiety around sex, in particular, should be treated this way in conjunction with medicated treatments for the best result. Addressing the underlying cause (anxiety or trauma) will likely result in curing premature ejaculation and the reduction of medicine use. Therapy can be done alone if sexual partners are causal or together with long term partners for more specific advice. 

Lifestyle Treatment for Premature Ejaculation

Treatment of PE doesn’t need to involve tablets or therapy if the problem is physical. It may be able to be improved using the following changes and techniques.

The Stop-Start Technique

This technique is done how it sounds. Once ejaculation gets close, stop or slow down the sex until the feeling goes away then begin again. This can interrupt the flow of the sex, however, can be effective if the partner is understanding.

The Squeeze Technique

This technique involves applying pressure below the head of the penis by squeezing the shaft between the thumb and index finger. After 10-20 seconds the urge to ejaculate will go away and you can continue.

Pre-Sex Masturbation

This involves masturbating an hour or two hours before sex with a sexual partner. According to research, there is a lack of data backing up the effectiveness of this technique. This can also lead to decreased sexual desire and possibly erectile dysfunction if too close to sex with a partner.

Pelvic Floor Exercises

These exercises are known as Kegels. They aim to improve control over the muscles around the penis involved in gaining an erection and ejaculation. Increasing strength and control of these muscles can result in better control holding and prolonging ejaculation.