Alternative Names: Rapid ejaculation.
Premature ejaculation is the most common male sexual problem. Affected males are unable to last as long as they would like to during sex, regardless of the time or number of strokes. A high percentage of teenage boys suffer from this condition, while many men over the age of 55 suffer from the opposite problem – delayed ejaculation. There is no precise definition of what is too premature/rapid but it is generally accepted that reaching orgasm less than thirty seconds into sex is too quick.
Premature ejaculation is very rarely caused by a physical or structural problem but, if so, would also be associated with other symptoms.
Infrequent sex generally affects ejaculation control. Even a man with normally good control may reach orgasm quickly after a long period of time without sex. Premature ejaculation is also common the first few times that a man has sex with a new partner. Men with good ejaculatory control can enjoy sustained levels of sexual arousal before choosing to ejaculate. A man without this control tends to go from zero excitement to orgasm without leveling off in-between.
The results of a physical examination are usually normal and any abnormal findings are unlikely to be associated with the condition.
If the simple techniques below do not improve performance, then psychological intervention may be needed.
In general, practice and relaxation is all that is necessary to deal with this problem. Most men can gain better control by learning the "start-stop" or "squeeze" techniques.
In the early 1990s, doctors noted that many depressed men refused to take their medications because it prevented them from reaching a climax, so they prescribed antidepressants, such as Anafranil, Paxil, Prozac or Zoloft to premature ejaculators, who then reported better performance. A recent study from the Netherlands shows that 20mg of Paxil 1-4 hours before the event may be the most effective treatment. [Journal of Clinical Psychopharmacology, 2001, Vol 21, Iss 3, pp293-297.] The U.S. FDA has not approved these drugs for this purpose.
Rather than a physical exam, useful information is more likely to be obtained from interviewing the man or the couple. Premature ejaculation is most often a function of anxiety and overstimulation. Other psychological factors, such as guilt, may also be relevant if the prematurity develops later in a relationship as opposed to earlier.
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