If it happens often and causes problems, your health care provider can help. In the U. The problem is often thought to be psychological, but biology may also play a role. Ejaculation is controlled by the central nervous system. When men are sexually stimulated, signals are sent to your spinal cord and brain. When men reach a certain level of excitement, signals are then sent from your brain to your reproductive organs.
This causes semen to be ejected through the penis ejaculation. Emission is when sperm moves from the testicles to the prostate and mixes with seminal fluid to make semen. The vasa deferentia are tubes that help move the sperm from the testicles through the prostate to the base of the penis.
When you are talking about just 1 of these tubes, it is called a vas deferens. Expulsion is when the muscles at the base of the penis contract. This forces semen out of the penis. Mostly, ejaculation and orgasm climax happen at the same time. Some men climax without ejaculating. In most cases, erections go away after this step. Sometimes PE is a problem for men who have erection problems erectile dysfunction or ED.
This is when men are not able to get or keep an erection that's firm enough for sex. Since an erection goes away after ejaculation, it can be tough to know if the problem is PE or ED. ED should be treated first. Premature ejaculation may not be a problem once the ED is treated.
Though the exact cause of PE is not known, serotonin may play a role. Serotonin is a natural substance in your body made by nerves. High amounts of serotonin in the brain increase the time to ejaculation. Low amounts can shorten the time to ejaculation, and lead to PE. PE can happen at any age. Aging is not a direct cause of PE, though aging does cause changes in erections and ejaculation.
For older men, erections may not be as firm or as large. Erections may not last as long before ejaculation occurs. The feeling that ejaculation is about to happen may be shorter. These changes can lead to an older man ejaculating earlier. With PE, you may feel you lose some of the closeness shared with a sexual partner. You might feel angry, ashamed or upset, and turn away from your partner.
Premature ejaculation may not only affect you, it may also affects your partner. PE can cause partners to feel less connected or feel hurt.
Talking about the problem is an important step. Couples counseling or sex therapy can be helpful. Exercises, such as the squeeze technique, may be helpful for you and your partner to prolong an erection see the treatment section of this article for details. Most importantly, a couple should learn ways to relax.
If you're in a long-term relationship, you may benefit from having couples therapy. During these sessions, the therapist will:. In the squeeze technique, your partner masturbates you, but stops before the point of ejaculation and squeezes the head of your penis for between 10 to 20 seconds.
They then let go and wait for another 30 seconds before resuming masturbation. This process is carried out several times before ejaculation is allowed to occur. The stop-go technique is similar, but your partner does not squeeze your penis. Once you feel more confident about delaying ejaculation, you and your partner can begin to have sex, stopping and starting as required. Selective serotonin reuptake inhibitors SSRIs are designed to treat depression, but they also delay ejaculation.
SSRIs used for this purpose include:. Some men may experience an improvement as soon as treatment begins. However, you'll usually need to take the medicine for 1 to 2 weeks before you notice the full effects. It acts much faster than the SSRIs mentioned above and can be used "on demand". Your response to the treatment will then be reviewed after 4 weeks or after 6 , and again every 6 months.
Dapoxetine is not suitable for all men diagnosed with premature ejaculation. For example, it is not recommended for some men with heart, kidney and liver problems. It can also interact with other medicines, such as other antidepressants. Phosphodiesterase-5 inhibitors, such as sildenafil sold as Viagra , are a class of medicine used to treat erectile dysfunction. Research has found that they may also help with premature ejaculation. Because of changes in regulations, you no longer need a prescription to get sildenafil.
But you will have to have a consultation with the pharmacist to make sure it's safe for you to take it. Read more about sildenafil including information on how and when to take it.
The use of topical anaesthetics such as lidocaine or prilocaine can help but may be transferred and absorbed to the vagina, causing decreased sensation. Condoms can also be used and are effective, particularly when combined with local anaesthesia. Like premature ejaculation, delayed ejaculation can be caused by psychological and physical factors. Possible psychological causes of delayed ejaculation are similar to those of premature ejaculation — for example, early sexual trauma, strict upbringing, relationship problems, stress or depression.
Delayed ejaculation can suddenly start to happen after previously having no problems, or less commonly the man may have always experienced it. It can occur in all sexual situations, or only in certain situations. For example, you may be able to ejaculate normally when masturbating, but not during sex. When ejaculation only occurs in certain situations, there's usually a psychological cause. Sex therapy is a form of counselling that uses a combination of psychotherapy and structured changes in your sex life.
This can help to increase your feeling of enjoyment during sex, and help make ejaculation easier. Availability can vary widely depending on where you live. You can also pay privately. The College of Sexual and Relationship Therapists website provides information about private sex therapists and how to find a therapist in your local area.
The relationship counselling service Relate also offers sex therapy at a number of its centres. You'll need to pay for each session. During sex therapy, you'll have the opportunity to discuss any emotional or psychological issues related to your sexuality and relationship, in a non-judgemental way. Activities may also be recommended for you to try at home while you're having sex with your partner you should never be asked to take part in any sexual activities during a session with the therapist.
In: Ferri's Clinical Advisor Elsevier; Accessed August 19, Saitz TR, et al. Advances in understanding and treating premature ejaculation. Nature Reviews Urology. Gur S, et al. Current therapies for premature ejaculation. Drug Discovery Today. Wein AJ, et al. Disorders of male orgasm and ejaculation. In: Campbell-Walsh Urology. Philadelphia, Pa. Accessed Sept. Althof SE, et al. An update of the International Society of Sexual Medicine's guidelines for the diagnosis and treatment of premature ejaculation PE.
The Journal of Sexual Medicine. Cooper K, et al. Behavioral therapies for management of premature ejaculation: A systematic review. Sexual Medicine. Serefpglu EC, et al.
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