Do you rush to smudgement, finish first in the 1 peter dash, and serve hasty pudding? Does your sperm red-light on the prostate dragstrip? Do you drop your coins in front of the slot machine, open presents on Christmas eve, activate the sprinkler during the national anthem, or sell your wine before its time? All of these euphemisms are used to soften the blow of a serious problem that can affect up to one-third of men at one time or another. This sexual health problem I will address is known officially as Premature Ejaculation.

Sexual Health Overview

Premature ejaculation occurs when a man ejaculates (cum) too soon. It can be as early as the thought of sex or if it occurs less than 2 minutes after your penis enters your partner. Premature ejaculation is a common sexual complaint of both men and women. Up to one-third of men can experience this sexual dysfunction at one time or another for various reasons.

As long as it is not the pattern of usual performance it is generally not a cause for concern. The diagnosis of premature ejaculation requires the man to feel distressed and if you can answer yes to the following questions:

• Do you always or nearly always ejaculate within one minute of penetration/ stimulation?
• Are unable to delay ejaculation during sexual stimulation or intercourse all or nearly all of the time? Is it different when you are masturbating?
• Do you tend to avoid sexual intimacy as a result of premature ejaculation?

Both psychological and biological factors can play a role in premature ejaculation. Although many men feel embarrassed talking about it, premature ejaculation is a common and treatable condition.

Partners of men who shame them for this phenomena tend to perpetuate the avoidant behavior and prolong the amount of time needed to treat it.

Sometimes medications are helpful in the short term. Counseling and sexual techniques that delay ejaculation can help expand your sexual prowess while improving sex for you and your partner.

Symptoms

The main symptom of premature ejaculation is the inability to delay ejaculation for more than one minute after penetration. However, the problem might not occur in all sexual situations, even during masturbation.

Premature ejaculation:

• Lifelong (primary). Lifelong premature ejaculation occurs all or nearly all of the time beginning with your first sexual encounters.
• Acquired (secondary). Acquired premature ejaculation develops after you’ve had previous sexual experiences without ejaculatory problems.

Many men feel that they have symptoms of premature ejaculation, but the symptoms don’t meet the diagnostic criteria for premature ejaculation. Instead, these men might have natural variable premature ejaculation, which includes periods of rapid ejaculation as well as periods of normal ejaculation.

When to see a primary care provider or sexual health expert?

1. The first step is to get a physical exam including a prostate check and urinalysis.
2. Also, a review of your health history, medications, and a frank and detailed sexual history. If you ejaculate sooner than you wish during most sexual encounters you likely have premature ejaculation.

It is not uncommon for men to feel embarrassed about discussing premature ejaculation, but it should not keep you from dealing with the problem head-on.  Premature ejaculation is a common and treatable problem.

For some men, a conversation with a nurse practitioner trained in sex therapy might help lessen concerns about premature ejaculation. Some basic facts about premature ejaculation include:

Occasional premature ejaculation is normal and the average time from the beginning of intercourse to ejaculation is about five minutes.

Premature ejaculation can be caused by a variety of situations but usually, it is specific anxiety or a learned habit.

Psychological factors that might play a role in premature ejaculation include:

• Early sexual experiences
• Sexual abuse
• Poor body image
• Depression/ Anxiety
• Worrying about premature ejaculation
• Guilty feelings that increase your tendency to rush through sexual encounters

Other factors that can play a role in premature ejaculation include:

• Erectile dysfunction – Men who are anxious about obtaining or maintaining an erection during sexual intercourse might form a pattern of rushing to ejaculate, which can be difficult to change.
• Many men with premature ejaculation also have problems with anxiety — either specifically about sexual performance or related to other issues.
• Relationship problems – If you have had satisfying sexual relationships with other partners in which premature ejaculation happened infrequently or not at all, interpersonal issues between you and your current partner may be contributing to the problem.

Medical factors that can cause premature ejaculation include:

• Several biological factors might contribute to premature ejaculation, including:
• Abnormal hormone levels
• Abnormal levels of brain chemicals called neurotransmitters
• Inflammation and infection of the prostate or urethra
• Genetic predisposition
• Risk factors

Various factors can increase your risk of premature ejaculation, including:

• Erectile dysfunction – You might be at increased risk of premature ejaculation if you occasionally or consistently have trouble getting or maintaining an erection. Fear of losing your erection might cause you to consciously or unconsciously hurry through sexual encounters.
• Emotional or mental strain in any area of your life can play a role in premature ejaculation, limiting your ability to relax and focus during sexual encounters.

Is premature ejaculation a problem or a feature? That depends on how the condition is affecting you. This is treatable and more common than you think. Let’s make an appointment to talk about your sexual health.

About Metro Medical Direct

Dr. Raymond Zakhari is the owner and operator of Metro Medical Direct and provides Telehealth and in-home visits. He also provides in-home alcohol and drug rehabilitation. Book an appointment here and check out the rest of this site for more information about concierge medicine.

Also, check out Dr. Ray’s Podcast The Psychology of it All here. Also available on Apple Podcasts.