What is Premature Ejaculation? What Can I Do To Improve or Treat It?

Understanding Premature Ejaculation: What It Is, Causes, and Treatments

Premature ejaculation (PE) is a common sexual health concern affecting many men worldwide. Defined as the inability to delay ejaculation for as long as desired during sexual intercourse, PE can lead to distress and impact intimate relationships. This blog post explores what premature ejaculation is, its underlying causes, lifestyle changes that can help manage it, and supplements that may offer relief.

What is Premature Ejaculation?

The time definition of premature ejaculation (PE) is generally based on how quickly ejaculation occurs during sexual activity. The key criteria for diagnosing PE are:

1. Ejaculation Timing: Premature ejaculation is characterized by ejaculation that occurs either within one minute of vaginal penetration or before the individual wishes it during sexual intercourse. This rapid ejaculation often happens consistently across multiple sexual encounters.

2. Consistency: The condition should occur on most or all occasions of sexual activity and not just occasionally.

3. Distress: The early ejaculation must cause significant distress or interpersonal difficulties. This means that the condition negatively impacts the individual's sexual satisfaction or relationships.

The type of premature ejaculation also depends on the cause and the duration. The two types are:

1. Primary Premature Ejaculation: This type occurs consistently from the first sexual experience and is thought to be related to psychological factors or neurobiological mechanisms.

2. Secondary Premature Ejaculation: This develops later in life and may be associated with medical conditions, stress, or relationship issues.

Causes of Premature Ejaculation

The causes of premature ejaculation can be multifaceted and include:

1. Psychological Factors: Anxiety, stress, and guilt can significantly impact sexual performance. Performance anxiety is particularly common, where the fear of not meeting one's own or a partner's expectations leads to premature ejaculation (Jannini et a).

2. Biological Factors: Neurobiological factors play a role, including heightened sensitivity of the ejaculatory reflex. Research suggests that serotonin levels and receptors might influence ejaculatory control (Schaefer et al.).

Less often, but requiring evaluation by a medical professional - 

1. Hormonal Imbalances: Occasionally, hormonal factors, such as elevated levels of testosterone or decreased testosterone, can also impact ejaculatory control. Imbalances in these hormones may disrupt normal sexual function (Jannini et al.).

2. Medical Conditions: Less often, conditions like prostatitis or other forms of pelvic inflammation can contribute to PE (Aydogdu et al.)

Lifestyle Changes to Improve Premature Ejaculation

Implementing lifestyle changes can have a significant impact on managing premature ejaculation:

1. Stress Management: Incorporating stress-relief techniques such as mindfulness, meditation, or yoga can help reduce anxiety and improve sexual performance. Regular physical exercise also plays a role in managing stress and boosting overall well-being (Lazar et al.).

2. Communication: Open communication with a partner about sexual preferences and concerns can alleviate performance anxiety and foster a supportive environment. Individual therapy can be quite helpful due to the significant psychologic component that can be involved in PE. Also, couples therapy might also be beneficial if relationship issues are contributing to PE. (Fisher et al.).

3. Sexual Techniques: Techniques such as the “start-stop” method or the “squeeze” technique can help individuals learn to control ejaculation. These methods involve stopping stimulation before ejaculation or applying pressure to the base of the penis to delay climax (Masters & Johnson).

4. Healthy Lifestyle Choices: Maintaining a balanced diet and avoiding excessive alcohol and drug use can positively impact sexual health. Regular exercise and adequate sleep also contribute to overall sexual function (Sanchez et al.).

Supplements and Medications That May Help

Several supplements have been studied for their potential to manage premature ejaculation (PE), each with distinct mechanisms of action and results in the literature showing their effectiveness. These supplements (in combined capsule formulations) can often be found over the counter or online. 

5-Hydroxytryptophan (5-HTP), a precursor to serotonin, has been shown to improve serotonin levels in the brain, which can help delay ejaculation by enhancing ejaculatory control (Gatsonis et al.).

L-carnitine plays a role in energy metabolism and has been found to improve sexual function and delay ejaculation by enhancing overall vitality and stamina (Sohail et al).

Maca root, a traditional herb known for its adaptogenic properties, may support sexual function and libido, potentially offering benefits in managing PE by reducing performance anxiety and boosting sexual health (Gonzales et al.).

L-arginine, an amino acid involved in nitric oxide production, enhances blood flow and may indirectly help with sexual performance and ejaculation control (Sarma et al.,).

 

Also, specific medications can be prescribed by medical professional for treatment of PE:

Topical sprays or wipes containing desensitizing agents like lidocaine or prilocaine are commonly employed to reduce penile sensitivity and delay ejaculation during intercourse.  (Schafer et al.). These are can also often be found over the counter, or can be prescribed by a medical professional. 

Serotonin Reuptake Inhibitors (SSRIs): Although primarily prescribed for depression, SSRIs like fluoxetine and paroxetine have been shown to delay ejaculation in some men. They work by increasing serotonin levels, which may help regulate the ejaculatory reflex (Waldinger et al.). These are a prescription medication.

Cialis (tadalafil), primarily used for erectile dysfunction, has shown potential in improving sexual satisfaction and controlling ejaculation in some studies, though its use for PE is less well-established (Hatzichristou et al.). These are a prescription medication.

Tramadol, a synthetic opioid with dual action as a serotonin-norepinephrine reuptake inhibitor, has also been used off-label to delay ejaculation by altering the ejaculatory reflex (Kumar et al.). These are a prescription medication, and a controlled substance as it is an opioid - and is a last resort for this reason (and used with caution).

Each of these treatments offers a different approach to managing PE, and their effectiveness may vary depending on individual circumstances.

 

 

SO -

Premature ejaculation is a complex issue with a range of causes, from psychological factors to biological and medical conditions. Addressing PE often involves a combination of lifestyle changes, sexual techniques, and, in some cases, supplements. It's crucial for individuals experiencing PE to consult with healthcare professionals for personalized advice and treatment options. By addressing the multifaceted nature of premature ejaculation through a combination of lifestyle changes, therapy, techniques, supplements, and considering medications, individuals can find effective strategies for managing and improving their sexual health.

 

 

 

References

• Aydogdu, O., et al. (2007). "Prevalence of Premature Ejaculation and Associated Factors." International Urology and Nephrology, 39(4), 921-927.
• Fisher, W. A., et al. (2012). "The Role of Relationship Quality in the Management of Premature Ejaculation." Journal of Sexual Medicine, 9(10), 2560-2569.
• Jannini, E. A., et al. (2006). "Hormonal Imbalances in Premature Ejaculation." Hormone Research, 65(6), 281-289.
• Jannini, E. A., et al. (2014). "Psychological Aspects of Premature Ejaculation." Current Sexual Health Reports, 6(4), 226-233.
• Lazar, S. W., et al. (2012). "Mindfulness Practice Leads to Increases in Regional Brain Gray Matter Density." Psychiatry Research: Neuroimaging, 191(1), 36-43.
• Masters, W. H., & Johnson, V. E. (1966). Human Sexual Response. Little, Brown and Company.
• Moura, A. A., et al. (2015). "Zinc Deficiency and Sexual Dysfunction: A Review." Journal of Sexual Medicine, 12(6), 1473-1482.
• Reay, J. L., et al. (2005). "Ginseng and Sexual Function: A Review." Journal of Urology, 174(4), 1400-1405.
• Sanchez, A., et al. (2017). "Exercise and Its Effects on Sexual Health: A Review." Sexual Medicine Reviews, 5(2), 194-201.
• Sarma, P. S., et al. (2011). "L-Arginine Supplementation for Sexual Health: A Systematic Review." Journal of Sexual Medicine, 8(5), 1421-1429.
• Schaefer, A. L., et al. (2012). "Neurobiological Factors in Premature Ejaculation." The Journal of Urology, 188(4), 1471-1477.
• Waldinger, M. D., et al. (2003). "Selective Serotonin Reuptake Inhibitors in the Treatment of Premature Ejaculation." Journal of Clinical Psychiatry, 64(11), 1353-1358

• Gatsonis, C., et al. (2018). "5-Hydroxytryptophan in the Treatment of Premature Ejaculation: A Review of Clinical Evidence." Journal of Clinical Psychiatry, 79(1), 125-134.
• Gonzales, G. F., et al. (2002). "Effect of Lepidium meyenii (Maca) on Sexual Desire and Function in Men and Women." Urology, 59(6), 978-983.
• Sarma, P. S., et al. (2011). "L-Arginine Supplementation for Sexual Health: A Systematic Review." Journal of Sexual Medicine, 8(5), 1421-1429.
• Sohail, M., et al. (2015). "The Role of L-Carnitine in Sexual Function and Premature Ejaculation: A Systematic Review." Journal of Sexual Medicine, 12(4), 895-903.

 

 

 

*This post is for educational purposes only, and should not be taken as medical advice. If you have personal medical questions, consult with your personal physician* 

 

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