What is this Condition?

Premature ejaculation refers to a man’s inability to control his ejaculatory reflex during sexual intercourse, resulting in persistently early ejaculation. This common sexual disorder affects men in all age­groups.

What Causes it?

Premature ejaculation may result from anxiety and is often linked to previous sexual experiences. Other psychological factors may include ambivalence toward or unconscious hatred of women, a negative sexual relationship in which the man unconsciously denies his partner sexual fulfillment, and guilty feelings about sex.

Premature ejaculation can also occur in emotionally healthy men with stable, positive relationships. Rarely, it may be linked to an underlying neurologic disorder, such as multiple sclerosis, or to an inflammatory process such as prostatitis.

What are its Symptoms?

The man with this disorder may be unable to prolong foreplay, or he may be able to prolong foreplay but ejaculates as soon as penetration occurs. Some men may exhibit signs of severe inadequacy or self­doubt in addition to general anxiety and guilt. With other men, the complaint lies solely with the sexual partner, who may believe that the male is indifferent to her sexual needs.

How is it Diagnosed?

The physical exam and lab test results are usually normal because most men with this complaint are quite healthy. However, a detailed sexual history can be valuable in making a diagnosis. A history of adequate ejaculatory control without evidence of psychological problems suggests an organic cause.

How is it Treated?

Masters and Johnson have developed a highly successful, intensive program that combines insight therapy, behavioral techniques, and experiential sessions involving both sexual partners. The program designed to help the man focus on the sensations of an impending orgasm, continues for 2 weeks or longer and typically includes:

• mutual physical exam, which increases the couple’s awareness of anatomy and physiology while reducing shameful feelings about sexual parts of the body

• sensate focus exercises, which allow each partner to caress the other’s body, without intercourse, and to focus on the pleasurable sensations of touch

• Semans squeeze technique, which helps the man gain control of ejaculatory tension by having the woman squeeze his penis every few minutes during a touching exercise that is designed to delay ejaculation.

Another method, called the stop-and-start technique, involves intercourse with pelvic thrusting by the woman, who is in the superior position. She continues thrusting until orgasmic sensations start, then stops and restarts to help her partner control ejaculation. Eventually, the couple is allowed to achieve orgasm.

What can a Man with Premature Ejaculation do?

• Be aware that this is a common disorder that does not reflect on your masculinity.

• Be aware that the condition is reversible