"No large term studies have been done, but in some trials, success rates on selected patients are high, around 60%.I'm 32 married and I just got my first testicular sonogram. Prescribing Viagra is still controversial, but we think it may reduce sympathetic tone and cause the smooth muscles in the genital system to relax, delaying one of the first steps that lead to ejaculation. "Another trend is to treat erectile dysfunction as a part of PE. Similarly, 50 mg of the painkiller tramadol two hours before intercourse can also help by increasing the amount of serotonin in the nervous system. "We tend to trial patients on dapoxetine since it is shorter-acting and isn't thought to cause as many side-effects, especially when stopping the medication. "Selective serotonin reuptake inhibitors (SSRIs) delay ejaculation by increasing serotonin in the nervous system," explains Yap. It's worth noting that dapoxetine is fairly new and isn't always available through the GP. A single episode of prostatitis, known as acute prostatitis, usually responds to a course of antibiotics: chronic prostatitis, diagnosed if the condition persists for at least three months, may respond to antibiotics but does sometimes need specialist referral.īoosting levels of the hormone serotonin using antidepressants such as fluoxetine, and a drug called dapoxetine, is also thought to help patients with PE. Hyperthyroidism is usually treated with a medication called carbimazole, radioiodine treatment, or surgery to remove some or all of the thyroid gland. "PE is very common but it can sometimes be perceived as premature when in fact it is within a normal range," says Saddington. Typically, a GP will start by asking the patient to complete a questionnaire about their sexual history in order to find out if they are actually experiencing PE or worrying unnecessarily. The good news is that both the physical and psychological causes of PE are eminently treatable. "Overall, the biggest impact is likely to be an increase in anxiety and/or creating a subject that is taboo, and this is not healthy for a relationship." "They can feel shame and embarrassment, and that their masculinity is being judged or evaluated by not being able to ejaculate as 'other' men. "A lot of men are more upset and worried than their partners," says Saddington. A study of 500 couples from five different countries found that the average time taken to ejaculate during intercourse was around five-and-a-half minutes, but it is important to remember every relationship is different, and that there are no hard and fast rules governing how long sex should last. "Exploring your partner's body in a non-sexual way can retrain the brain and body, as well as reducing anxiety," he says.Įxposure to pornography may lead some men to have a skewed view of what constitutes 'normal' ejaculation. Saddington believes that getting couples to experiment with different forms of touch could be key to treating PE. Anxiety is the key emotion that affects the condition. "If the condition manifests later in life, it can be because of anxiety over a new relationship, a difficult experience, illness or trauma. "PE can start early in life as a result of being worried about sex or masturbation - either learning to masturbate quickly or never learning - or not experiencing sex that is more relaxed and managed differently," says Peter Saddington, a practice clinical supervisor for Relate. In addition to anxiety, other psychological factors such as depression, stress, and childhood sexual trauma are also thought to be linked to both lifelong and acquired PE. "Psychological factors have been implicated, whereby the sympathetic nervous system is activated by anxiety, resulting in an earlier emission of semen, which then triggers ejaculation." "One school of thought says that circumcision leads to less gland sensitivity and so it is better for PE, while the other argues that circumcision denudes the penis, exposing the glands and resulting in a higher incidence of the condition," says Tet Yap, consultant urologist at the Princess Grace Hospital, part of HCA Healthcare UK. Another theory explores the potential link between PE and penile sensitivity caused by circumcision. PE is also linked with chronic infection of the prostate, known as prostatitis, and successful treatment is proven to significantly increase the time it takes the patient to ejaculate. Research shows that men with an overactive thyroid ( hyperthyroidism) are more likely to suffer from PE and that once the hyperthyroidism is treated the chances of experiencing it are reduced.
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