Premature Ejaculation: Meaning, Causes, Treatment & Impact on Fertility

What is Premature Ejaculation?

Usually, ejaculation happens in two natural steps. First, the sperm travel and mix with fluids to form semen. This is called emission. Following that, rhythmic muscle contractions push the semen out of the body. This is known as expulsion and usually happens at the same time as orgasm.

Premature ejaculation is defined as the ejection of semen from a man during sexual intercourse before or within one minute of vaginal penetration. Simply put, it is a male ejaculation disorder in which ejaculation occurs way sooner than the person or his partner would prefer.

Occasional premature ejaculation is usually not a cause for concern. But if it occurs more often and starts to put a strain on one's sexual relationship, then one must consult with an expert physician to treat the condition. It is important to understand that when left untreated or if the patient doesn't talk about his condition to an expert, it might cause the man to feel anxious or guilty or avoid intimacy altogether, which can strain relationships.

Types of Premature Ejaculation

Premature ejaculation can be of a few different types:

1. Primary Premature Ejaculation (Lifelong)

This type of PE becomes apparent from the man’s first-ever sexual encounter itself. Primary PE is often due to psychological or physiological factors and may require long-term treatment.

2. Secondary Premature Ejaculation (Acquired)

Acquired PE may develop later in life. This means that the man may have had a normal sex life, and then later, at some point, he started to experience ejaculation happening earlier than usual. It may be linked to causes like stress, relationship issues, or health conditions such as diabetes, thyroid imbalance, or prostate problems.

3. Natural variable: premature ejaculation

Men can sometimes ejaculate earlier than usual. However, this won't be the norm with them, and they will have a normal ejaculation time, mostly. This is not a clinical condition and is considered a normal variation in time. Moreover, it does not need any treatment.

4. Subjective premature ejaculation (premature-like ejaculatory dysfunction)

This basically refers to the situation when a man believes he ejaculates too quickly, even though his timing is normal. It’s usually more about how he feels than an actual medical problem, often influenced by stress, worry, or personal expectations.

What are the symptoms of Premature Ejaculation?

One of the main symptoms of Premature Ejaculation is consistent early ejaculation that occurs within about one minute of penetration or before the man desires during sexual activity. Some other signs of a problem with ejaculation timing may include lack of control over ejaculation, emotional distress, frustration, or avoidance of intimacy. Premature ejaculation can often have negative effects on relationships for both partners, as sexual satisfaction and intimacy don't occur as desired.

Diagnosis

It is normal for men to sometimes ejaculate before they desire. This does not require a medical diagnosis. However, if this is something that occurs too often or is causing stress or relationship issues, then one must not hesitate to consult with an expert doctor.

To determine whether what you are experiencing is indeed Premature Ejaculation or part of another issue, the doctors will take a detailed medical history. If the doctors suspect some other cause or a related sexual disorder, they may order some lab tests. You may also be referred to a urologist who specialises in sexual disorders or a mental health expert based on the medical exam.

Treatment and Management Options

How your doctors will approach Premature Ejaculation treatment will depend mainly on the recognised cause, severity, and associated medical conditions. In most cases, patients often respond well to a combination of behavioural techniques, medication, and counselling.

1. Behavioural Techniques

Doctors will suggest behavioural techniques and exercises that patients will be asked to repeat a few times over time. Some of the most common techniques and exercises are as follows:

• Start-stop method : Pausing stimulation before climax, then restarting.
• Squeeze technique : Applying gentle pressure to the penis to delay ejaculation.
• Kegel exercises : These can help strengthen pelvic floor muscles for better control.

All the above methods are meant to delay climax and ejaculation.

2. Medical Treatments

• Topical anaesthetic creams : these will aim to reduce sensitivity and prolong the start of ejaculation.
• Oral medications : medicines such as SSRIs (antidepressants like sertraline or paroxetine) may be prescribed that delay ejaculation.

3. Therapy

Cognitive-behavioural therapy (CBT) or sex therapy to manage anxiety.

4. Counselling and Partner Support

Professional counselling can address performance anxiety and strengthen communication between partners, improving emotional closeness and confidence.

Lifestyle Modifications to Help Manage Premature Ejaculation

Scientific studies have found measurable links between healthy lifestyle choices and reduced symptoms of premature ejaculation. Along with medical treatment, it is beneficial to make lifestyle changes to support the treatment prescribed by your doctors. Some of these tips are mentioned below:

• Maintaining healthy eating habits and avoiding highly processed and fried foods can have a positive effect on your overall health.
• Exercise regularly to boost circulation and reduce stress. Kegel and pelvic exercises, along with some level of strength training, are also advised.
• Smoking and alcohol consumption should be avoided as much as possible
• A healthy sleep cycle, stress and anxiety management, and a healthy emotional relationship with your partner can help overcome PE, along with medical treatment.
• If you are into pornography, then limiting pornography consumption will help drastically, as unrealistic expectations can worsen anxiety.

Conclusion

Premature ejaculation is nothing to be embarrassed about. It is a medical condition with perfectly safe, treatable options. This issue affects several men globally. Thankfully, PE awareness has been on the rise in recent years, giving many men the strength to talk about their issues with a medical expert. Untreated PE can have lasting effects on your mental and physical well-being. It can also affect your relationships. One must treat PE for what it actually is: a medical condition that can be treated easily. After treatment, PE has a 95% success rate. So do not hesitate to reach out for help.