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What is premature ejaculation?

Premature ejaculation (PE) is the most common ejaculation problem in men.(1) PE is characterised by a man ejaculation ‘too quickly’ during sexual intercourse. But agreeing what ‘too quickly’ means is challenging and depends largely on a couple’s own view of their sex life. There is no ‘correct’ duration for satisfactory sexual intercourse. People’s experience and views of how long sexual intercourse does and should take vary significantly. So, what does the science tell us is ‘normal’ and when might ‘normal’ stray into what can be accurately called PE?

There are two main categories of PE, lifelong PE (arising at an early age and usually independent of any health issues) and acquired PE (usually arising at a later age and often related to other health concerns, e.g. obesity).(2)

In 2013-14, an international group of doctors and researchers who specialise in sexual health used existing research to agree that PE should be defined as:(2)

• Time

o Lifelong PE: Ejaculation nearly always occurring within 1 minute of penetration

o Acquired PE: A reduction in past time to ejaculation (usually to 3 minutes or less) which is clinically significant or impacting the patient’s life

• Control

o The inability to delay ejaculation on all or nearly all occasions

• Impact

o Negative personal consequences in the individual’s life

These definitions are useful, as they help doctors to diagnose PE and therefore access support and treatment services for people with this condition. In contrast to these definitions, a study that involved 500 couples from different parts of the world, estimated that the average duration of sexual intercourse is five and a half minutes.(1)

What causes premature ejaculation?(1)

PE can be caused by a range of things, varying widely from a traumatic experience in childhood to an overactive thyroid gland and depression. Broadly, PE can have psychological causes, physical causes or a mixture of the two. It is important to be aware that PE is often a symptom of a wider issue such as declining physical and/or mental health and that dealing with PE could require dealing with underlying issues.

Managing PE

The good news is that there are a range of support and treatment options for PE. The right approach for you will depend on the cause of your PE and should be discussed with your GP.

For many people, couple’s therapy or individual counselling with a psychologist can make a big difference. While others will benefit from improvements in overall health such as weight loss.(1,3)

As part of the mix of options available to you, a group of medicines called selective serotonin reuptake inhibitors (SSRIs) are routinely used to treat PE and have been shown to prolong time to ejaculation. As with all medications, these treatments have potential side effects which should be fully understood and considered.(1,3)

For more information on managing PE, visit the NHS website:

MedExpress

MedExpress is an expert, online doctor and pharmacy service. MedExpress can provide access to treatment for PE in the right circumstances which can be posted to your door. Click here to find out more about the treatments which can be accessed and how: https://www.medexpress.co.uk/clinics/premature-ejaculation/priligy

REFERENCES:

1. NHS Health A-Z. Ejaculation Problems. Available at: https://www.nhs.uk/conditions/ejaculation-problems/ Accessed February 2019.

2. Serefoglu EC, McMahon C, Waldinger MD et al. An Evidence-Based Unified Definition of Lifelong and Acquired Premature Ejaculation: Report of the Second International Society for Sexual Medicine Ad Hoc Committee for the Definition of Premature Ejaculation. Sex Med. 2014; 2: 41-59.NHS. Can premature ejaculation be controlled? Available at:
3. Can premature ejactulation be controlled? Accessed February 2019.