Most cases of premature ejaculation do not have a clear cause. With sexual experience and age, men often learn to delay orgasm. Premature ejaculation may occur with a new partner, only in certain sexual situations, or if it has been a long time since the last ejaculation. Psychological factors such as anxiety, guilt, or depression can cause premature ejaculation. In some cases, premature ejaculation may be related to an underlying medical cause such as hormonal problems, injury, or a side effect of certain medicines.
What are the symptoms?
The main symptom of premature ejaculation is an uncontrolled ejaculation either before or shortly after intercourse begins. Ejaculation occurs before the person wishes it, with minimal sexual stimulation.
How is premature ejaculation diagnosed?
Your health professional will discuss your medical and sexual history with you and conduct a thorough physical examination. Your doctor may want to talk to your partner as well. Because premature ejaculation can have many causes, your health professional may order laboratory tests to rule out any underlying medical problem.
How is it treated?
In many cases, premature ejaculation resolves on its own over time without the need for medical treatment. Practicing relaxation techniques or using distraction methods may help you delay ejaculation. For some men, stopping or cutting down on the use of alcohol, tobacco, or illegal drugs may improve their ability to control ejaculation.
Your health professional may recommend that you and your partner practice specific techniques to help delay ejaculation. These techniques may involve identifying and controlling the sensations that lead up to ejaculation and communicating to slow or stop stimulation. Other options include using a condom to reduce sensation to the penis or trying a different position (such as lying on your back) during intercourse. Counseling or behavioral therapy may help reduce anxiety related to premature ejaculation.
Certain antidepressant medicines called selective serotonin re uptake inhibitors (SSRIs), such as fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft), are sometimes used to treat premature ejaculation. These medicines are used because a side effect of SSRIs is inhibited orgasm, which helps delay ejaculation. The use of SSRIs for the treatment of premature ejaculation is not related to depression and is considered an "off-label" use
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