Premature Ejaculation

Premature ejaculation

Premature ejaculation (PE), also known as early ejaculation or “cumming too fast”, affects many men.  This can be very embarrassing for men and frustrating for their sexual partners.

It is thought that between 20 and 40% of men are affected by premature ejaculation.

This condition is a complex issue that is, from a medical standpoint, still poorly understood.  It is both difficult to diagnose (due to the subjective and private nature of the issue) and to treat.

From a strictly biological view, ejaculating quickly allows the male of any species to mate with many partners and procreate.  Thus it is actually beneficial in terms of disseminating genetic material.

However, human sexual behavior is not simply for the purpose of procreating.  There are psychosocial aspects to the sexual behaviors of humans including bonding with a sexual partner and sexual satisfaction.

As males develop sexually and mature sexually their time to ejaculation tends to increase.

Ejaculation control and time to ejaculation varies with a lot of factors.

It is difficult to ascertain what is the appropriate length of time to ejaculation.  Social media, pornography and other influences may create an unrealistic expectation of how long it should take to achieve climax.

Even though it is thought that 20 to 40% of males may be effected by premature ejaculation, only about 4 to 5% fit the medical diagnostic definition of PE.

There are two neurological reflexes that are involved in ejaculation.  The two coordinated reflexes are emission and ejection.

Emission is the process of the seminal vesicals and prostate contracting to discharge sperm and seminal fluid into the back of the urethra (tube running through the penis that also evacuates urine from the body).

Ejection involves the pulsating compressions of the bulbospongiosus muscle and the pelvic floor muscles for the purpose of expelling the sperm and seminal fluids from the penis.

These processes involve complex nervous system pathways.

Inflammation of the prostate may be one of the causes of premature ejaculation.  Inflammation of the prostate (prostatitis) may alter the sensitivity and lead to a more sensitive ejaculatory reflex.  Prostatitis due to bacteria can be treated with antibiotics.

Other treatments for early ejaculation include:

  • dapoxetine
  • selective serotonin reuptake inhibitors (SSRIs) – these include drugs such as sertraline and fluoxetine
  • tramadol
  • topical local anesthetics (desensitizing agents)
  • psychotherapy

To learn about other embarrassing health issues visit our Conditions page.