Sex - premature ejaculation

Premature ejaculation is the most common sexual problem for men. It is a lack of control over ejaculation so that it often happens sooner than the man or his partner would want. How soon depends on the individual.

Some men ejaculate as soon as foreplay starts. Others lose control when they try to insert their penis, while some ejaculate very quickly after penetration. Whatever the case, premature ejaculation can create tension between a man and his partner.

Occasionally losing control is normal
Premature ejaculation is only a problem if it happens all the time. It’s important to remember that most men occasionally reach orgasm sooner than they’d like. For example, it is normal for a man to ejaculate quickly the first time he has sex. It is also normal if a man hasn’t ejaculated for a long time. The occasional loss of control doesn’t mean the man has a sexual problem.

The causes are psychological
There doesn’t seem to be any physical cause for premature ejaculation. Although the exact cause is unknown, it is suspected that the problem is psychological. Some factors include:

• Depression or anxiety, particularly about performance
• Feeling anxious about rejection
• Expecting failure
• Feeling afraid of harm (some men have an irrational fear that penetration can cause injury to the penis)
• Negative sexual experiences in childhood
• Religious beliefs
• Stress
• Problems within the relationship.

• The Masters and Johnson method – named after the famed sex researchers, this technique involves learning to control the sensations prior to orgasm. The idea is to repeatedly bring yourself close to orgasm, then stop and rest. If you do this often enough, you will learn to recognise your ‘point of no return’. These exercises can be done alone or with a partner.
• Kegel exercises – these exercises are designed to strengthen the pelvic floor. To identify the muscles of your pelvic floor, stop yourself from urinating in midstream. This is the action you need to practise when your bladder is empty. Tightly contract the muscles and hold for 10 seconds. Repeat 10 times, three times a day.
• Psychotherapy and counselling – with the guidance of an experienced sex therapist, any underlying anxieties about sex can be explored and eased.
• SSRIs and tricyclic antidepressants – a side effect of these medications is to slow ejaculation. Dapoxetine is a short-acting SSRI that has been approved in a number of countries for the treatment of premature ejaculation.

• Your doctor
• Sexual health clinic
• Sex therapist

• Premature ejaculation is the most common sexual problem in men.
• Occasionally losing control is normal. Most men orgasm sooner than they would like from time to time.
• There is a variety of treatments to choose from including exercises, therapy and drugs.

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