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ejaculation is uncontrolled ejaculation either before or shortly after sexual
penetration, with minimal sexual stimulation and before the person wishes. It
may result in an unsatisfactory sexual experience for both partners. This can
increase the anxiety that may contribute to the problem. Premature ejaculation
is one of the most common forms of male sexual dysfunction and has probably
affected every man at some point in his life.
Most cases of
premature ejaculation do not have a clear cause. With sexual experience and
age, men often learn to delay orgasm. Premature ejaculation may occur with a
new partner, only in certain sexual situations, or if it has been a long time
since the last ejaculation. Psychological factors such as anxiety, guilt, or
depression can cause premature ejaculation. In some cases, premature
ejaculation may be related to a medical cause such as hormonal
problems, injury, or a side effect of certain medicines.
The main symptom of
premature ejaculation is an uncontrolled ejaculation either before or shortly
after intercourse begins. Ejaculation occurs before the person wishes it, with
minimal sexual stimulation.
doctor will discuss your medical and sexual history with you and conduct a
thorough physical exam. Your doctor may want to talk to your partner
also. Premature ejaculation can have many causes. So your doctor may order
laboratory tests to rule out any other medical problem.
In many cases premature
ejaculation resolves on its own over time without the need for medical
treatment. Practicing relaxation techniques or using distraction methods may
help you delay ejaculation. For some men, stopping or cutting down on the use
of alcohol, tobacco, or illegal drugs may improve their ability to control
Your doctor may recommend that you and your partner
practice specific techniques to help delay ejaculation. These techniques may
involve identifying and controlling the sensations that lead up to ejaculation
and communicating to slow or stop stimulation. Other options include using a
condom to reduce sensation to the penis or trying a different position (such as
lying on your back) during intercourse. Counseling or behavioral therapy may
help reduce anxiety related to premature ejaculation.
Antidepressant medicines such as clomipramine (Anafranil) and dapoxetine (Priligy) are sometimes used to treat premature ejaculation. These medicines
are used because one of their side effects is inhibited orgasm, which helps delay
ejaculation. Tramadol (Ultram), which has been used for many years to control pain, is another medicine that can delay ejaculation.
There are also creams, gels, and a spray that may be used to treat premature ejaculation by reducing sensation. These medicines, such as lidocaine or lidocaine-prilocaine, are applied to the penis before sexual intercourse. But some of these medicines can also affect a man's sexual partner by reducing sensation for the partner.
Other Works Consulted
Becker JV, Stinson JD (2008). Premature ejaculation section of Human sexuality and sexual dysfunctions. In RE Hales et al., eds., The American Psychiatric Publishing Textbook of Psychiatry, 5th ed., pp. 711–728. Washington, DC: American Psychiatric Publishing.
Mulhall JP (2012). Premature ejaculation. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 1, pp. 770–779 Philadelphia: Saunders.
September 7, 2012
E. Gregory Thompson, MD - Internal Medicine & Christopher G. Wood, MD, FACS - Urology, Oncology
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