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    Premature Ejaculation

    Premature Ejaculation

    Topic Overview

    What is premature ejaculation?

    Premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration, with minimal sexual stimulation and before the person wishes. It may result in an unsatisfactory sexual experience for both partners. This can increase the anxiety that may contribute to the problem. Premature ejaculation is one of the most common forms of male sexual dysfunction and has probably affected every man at some point in his life.

    What causes premature ejaculation?

    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 a 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 doctor will discuss your medical and sexual history with you and conduct a thorough physical exam. Your doctor may want to talk to your partner also. Premature ejaculation can have many causes. So your doctor may order laboratory tests to rule out any other 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 doctor 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.

    Antidepressant medicines such as clomipramine (Anafranil) and dapoxetine (Priligy) are sometimes used to treat premature ejaculation. These medicines are used because one of their side effects is inhibited orgasm, which helps delay ejaculation. Tramadol (Ultram), which has been used for many years to control pain, is another medicine that can delay ejaculation.

    There are also creams, gels, and a spray that may be used to treat premature ejaculation by reducing sensation. These medicines, such as lidocaine or lidocaine-prilocaine, are applied to the penis before sexual intercourse. But some of these medicines can also affect a man's sexual partner by reducing sensation for the partner.

    Other Places To Get Help

    Organizations

    AUA Foundation: The Official Foundation of the American Urological Association
    1000 Corporate Boulevard
    Linthicum, MD21090
    Phone: 1-800-828-7866
    Phone: (410) 689-3700
    Fax: (410) 689-3998
    Email: auafoundation@auafoundation.org
    Web Address: www.urologyhealth.org

    UrologyHealth.org is a website written by urologists for patients. Visitors can find specific topics by using the "search" option.

    The website provides information about adult and pediatric urologic topics, including kidney, bladder, and prostate conditions. You can find a urologist, sign up for a free quarterly newsletter, or click on the Urology A?Z page to find materials about urologic problems.


    National Kidney and Urologic Diseases Information Clearinghouse
    3 Information Way
    Bethesda, MD20892-3580
    Phone: 1-800-891-5390
    TDD: 1-866-569-1162
    Fax: (703) 738-4929
    Email: nkudic@info.niddk.nih.gov
    Web Address: www.kidney.niddk.nih.gov

    The National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) provides information about diseases of the kidneys and urologic system to people with these problems and to their families, to health professionals, and to the public. NKUDIC answers inquiries; develops, reviews, and distributes publications; and works closely with professional and patient groups and government agencies to coordinate resources about kidney and urologic diseases.

    NKUDIC, a federal agency, is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NIDDK is part of the National Institutes of Health under the U.S. Department of Health and Human Services.


    References

    Other Works Consulted

    • Becker JV, Stinson JD (2008). Premature ejaculation section of Human sexuality and sexual dysfunctions. In RE Hales et al., eds., The American Psychiatric Publishing Textbook of Psychiatry, 5th ed., pp. 711?728. Washington, DC: American Psychiatric Publishing.
    • Mulhall JP (2012). Premature ejaculation. In AJ Wein et al., eds. Campbell-Walsh Urology, 10th ed., vol. 1, pp. 770?779 Philadelphia: Saunders.

    Credits

    By Healthwise Staff
    Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
    Specialist Medical Reviewer Christopher G. Wood, MD, FACS - Urology, Oncology
    Last Revised September 7, 2012

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