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PREMATURE EJACULATION: CAUSES AND TREATMENT OPTIONS THAT WORK

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Cumming too early during sex is something that men cannot stand to bear. Interestingly, premature ejaculation is the most common sexual dysfunction that affects 20 – 40% of the male population at a point in their lives. Trust me, if it was rather a woman-thing, I doubt if anyone would complain because it would be considered a positive or great thing. I mean, how many women get to cum during sex even? Anyway, it isn’t the same with men because being great in bed is associated with lasting long, but not too long. 

How long is sex supposed to last anyway? 

Truth is, so many people have unrealistic expectations of how long sex should last because of ignorance and misinformation. There is a normal duration of sex and there’s an abnormal duration (too short or too long). To check, it’s best to use a stopwatch and you start from the moment the penis penetrates the vagina till you ejaculate.

Here’s the standard:

  • Less than 3 minutes = TOO SHORT 
  • 3 minutes – 13 minutes = NORMAL
  • 7 – 13 minutes = DESIRABLE 
  • 10 – 30 minutes = LONG (sometimes considered ‘too long’ but it can be fun when the woman is having a good time)
  • Above 30 minutes = TOOOOO LONG 

On the average, here’s how the duration (ejaculation time) varies with age:

  • 18 – 20 years = 6.5 minutes 
  • 32 – 50 years = 5.4 minutes 
  • Above 50 years = 4.3 minutes

PREMATURE EJACULATION

Premature ejaculation affects men of all ages because of the absence or loss of control over ejaculation. Hence, the least thing can make them cum, and right after penetrating the vagina, they tend to ejaculate in no time. It could be seconds, less than a minute, or less than 3 minutes. Such men can ejaculate during kissing, lap dance, or nipple sucking and it can be so embarrassing.

Sex with such men can be considered unenjoyable because they are unable to please their partners well enough before ejaculation. Premature ejaculation causes so much distress. It can create problems in relationships, lead to sexual frustration/sexual dissatisfaction, and make men lose interest in sex altogether. 

THE TYPES

There are two main types: Lifelong Premature Ejaculation and Acquired Premature Ejaculation. 

LIFELONG PREMATURE EJACULATION

The lifelong condition is caused by genetic factors, so such men are born with it. Right when they start having sex, they ejaculate in less than 1 minute and they never get to experience how it feels to last long until they seek treatment. 

1 minute is the benchmark

ACQUIRED PREMATURE EJACULATION

Acquired premature ejaculation starts with a reduction in how long a man takes to cum during sex to 3 minutes or less. Right after, it becomes a thing for the man to always or consistently ejaculate in less than 3 minutes each time he penetrates a vagina. Such men used to take longer to cum, so lasting under 3 minutes becomes unusual.

It doesn’t count as premature ejaculation if it happens just once or in one-off situations. It has to happen consistently for some (6) months for you to be diagnosed with P.E. 

Acquired premature ejaculation has several underlying causes that need to be identified and treated before the man can notice a delay in ejaculation. 

Psychological Causes:

  • Performance anxiety
  • Psychosexual or relationship issues 
  • Sexual conditioning
  • Traumatic sexual experiences
  • Stress

Other Causes/Risk Factors:

  • Erectile dysfunction
  • Penile hypersensitivity
  • Lower urinary tract infection
  • Inflammation of prostate or prostate infection
  • Diabetes
  • Opioid (narcotics) withdrawal
  • Poor overall health
  • Hormonal imbalance 
  • Early/limited experience (virgin)
  • Sex drought

TREATMENT OPTIONS 

The most common treatment options that have been proven to be the most effective in delaying ejaculation include (in ascending order):

Viagra, Anti-Depressants, and the Pause-and-Squeeze technique.

BEHAVIOURAL THERAPY 

This treatment method includes psychotherapy and behavioral/physical exercises. Doing either of the two alone might not be as successful or effective in treating premature ejaculation as combining both. So, if you really want to last longer, make use of both. 

  • PSYCHOTHERAPY

You need to see a psychotherapist for this! The psychotherapist makes use of cognitive therapy to improve communication between the man and his partner(s), increase his self-confidence, reduce anxiety associated with sex, and increase his sexual skills. 

Psychotherapy alone provides a short-term improvement in the duration of sex before ejaculation but it requires a few things for it to work effectively: the man needs to be very motivated, hopeful, be in a monogamous relationship, and have a very cooperative partner.

  • PHYSICAL EXERCISES THAT HELP

STOP-START TECHNIQUE or EDGING

During sex, all you need to do is stop when it gets very intense and you feel you might cum soon. Once you get a hint to stop, you can pull out and relax for a while. You need to wait for the sensation to die down before penetrating again and you keep going until you need to stop again. Repeat the process a number of times till you’ve made your partner cum or you feel you’ve lasted long enough before letting yourself go for an orgasm.

In doing this, you can focus on something else when you stop or you can squeeze your butt for a while until the sensation diminishes before penetrating again. If you are thinking of giving it a try, do it during masturbation and master the ability to stop when the pleasure intensifies before trying it during sex. Over time, it can give you control over ejaculation

PAUSE-AND-SQUEEZE TECHNIQUE

This technique is similar to the stop-start technique because it requires you to stop when sex starts to feel too good. Once you stop, you need to squeeze the top or base of the penis (check the image) until you can no longer feel the sensations before continuing with penetration. You don’t always have to do it yourself if you have a cooperative and understanding partner. She can squeeze it for you and make it much bearable. 

Once again, if you are thinking of giving this a try during sex, you should try it during masturbation and master it for it to be easier to do during sex.

Behavioral therapy is a short-term treatment and requires you to keep doing the exercises as often as you can till you get back your ejaculatory control.

TIPS TO MAKE THE PHYSICAL EXERCISES EASIER TO DO:

Use a timer! 

Masturbate and use a stopwatch to determine how long it takes you to cum. Do it a number of times (three or more) and check the average. Do the same during sex for a few sessions (three), and check the average. 

If you arrive at 2 minutes, all you need to do is to set your timer to 1 minute, 40 seconds. During sex, right when you penetrate the vagina, you need to start the timer and have fun until you hear the alarm. Right then, you need to stop or pull out and squeeze till the sensation diminishes before you start all over again. 

Over time, it helps you get enough control to stop on your own and you will no longer need the timer. 

TREATMENT WITH DRUGS 

  • ANTIDEPRESSANTS 

Two types of antidepressants are effective in delaying ejaculation in men: Short-acting SSRIS (dapoxetine) and long-acting SSRIs. This is because delayed ejaculation is a side-effect of taking them, so it makes sense to use them to treat premature ejaculation. 

SSRIs = Selective Serotonin Reuptake Inhibitors)

DAPOXETINE TREATMENT 

Dapoxetine is the main drug used to treat premature ejaculation because it is fast-acting. It can increase the time it takes you to ejaculate by 3 – 4.3 times/folds. So, if initially, it took you 2 minutes, it can make you last 6 – 8 minutes before cumming. Luckily, you can purchase it without prescription in Ghana and it’s available under so many brand names (Priligy, Longride, etc.). You just need to go to the pharmacy and ask for Dapoxetine. If one pharmacy doesn’t have it, you can check another. 

The only issue with this treatment is that it isn’t long-term, so it requires you to take the drug every single time you are about to have sex. Also, the side-effects can very uncomfortable and it can make you not want to take the drug again if you aren’t fortunate enough.

The side-effects: 

  • Nausea
  • Diarrhea
  • Headache 
  • Dizziness

LONG-ACTING ANTIDEPRESSANTS 

These drugs include:

  • Paroxetine (Common brand: Paxil)
  • Clomipramine (Anafranil)
  • Sertraline (Zoloft)
  • Fluoxetine (Prozac)

To effectively treat premature ejaculation, the right dose of the drugs is taken daily for 10 – 15 days or maybe earlier, before the man can start to see results. 

Paroxetine is the most effective at delaying ejaculation because it has been proven to delay it by up to 8.8 times the initial ejaculation length. So, let’s say you used to last 1 minute during sex, after taking it for like 10 days, you start to last up to 8 minutes, 48 seconds. Isn’t that great? 

Taking the long-acting drugs daily for a long time have been proven to work great in treating the dysfunction, so it’s a great treatment option for anyone with premature ejaculation (excluding men with a history of bipolar depression because it worsens their illness).

The Side-Effects:

  • Fatigue 
  • Yawning
  • Nausea
  • Perspiration
  • Loose stools 

The above side-effects are usually minor. You might notice them a week after you start treatment but after 2 or 3 weeks, they should disappear because your body gets used to the drug intake. 

In rare cases, these side-effects are noticed

  • Loss of libido 
  • Erectile dysfunction

Abrupt cessation of the drug intake can result in the man having drug-withdrawal symptoms that can be very unpleasant. 

  • TRAMADOL

Taking 50 mg of tramadol 1 to 2 hours before sex has been proven to delay ejaculation up to 12.7 times longer than the initial length. So, if you used to last a minute, it can make you last about 12 minutes before cumming during sex. For this reason, it can be abused, and sadly, it’s an illegal drug that can only be purchased legally with a prescription in so many countries, so unless a doctor prescribes it to you, you might never come by it. 

The Side-Effects: 

  • Addiction
  • Somnolence
  • Pruritus
  • Nausea
  • Serotonin syndrome if it’s used with SSRI

The safe/required dose for premature ejaculation is 25 mg and it delays ejaculation by 7 minutes. 

 NOTE: 

The above drug treatments are not effective in treating premature ejaculation when the man has erectile dysfunction. In this case, the erectile function needs to be improved with drugs like Viagra and Vardenafil [Phosphodiesterase-5 inhibitors (PDE5i)] before premature ejaculation can be treated.

  • VIAGRA & VARDENAFIL

Sildenafil is what’s sold under the brand name Viagra, but there are other brand names too! Vardenfil is also sold under the brand names Levitra, Staxyn, and Vivanza.

These drugs are used in treating premature ejaculation when the man has erectile dysfunction (he is unable to get or maintain an erection). In some cases, he might get an erection but it’s never firm enough (a soft erection) and it can come along with premature ejaculation where he ejaculates quickly and is unable to get hard after. 

  • Viagra (Sildenafil) delays ejaculation by 2.7 – 3.9 fold. So let’s say initially you used to ejaculate in 2 minutes, after treatment, you might last 6 – 8 minutes long during sex. 
  • Vardenafil delays ejaculation by 6.5 fold. So let’s say initially you used to last 2 minutes, after treatment, you might last up to 13 minutes before ejaculating during sex. 

How Viagra (Sildenafil) and Vardenafil Improves Sex Life: 

  • You get to stay hard after ejaculating 
  • It reduces your refractory period (how long it takes you to get hard after cumming)
  • It improves performance anxiety
  • It gives you better and harder erections

The Side-Effects:

  • Headache
  • Nasal congestion
  • Nasopharyngitis
  • Dyspepsia
  • Back pain and myalgia
  • Prolonged erections that last longer than 4 hours 
  • Priapism (painful erections that last longer than 6 hours) which can damage penile tissues when it’s not treated
  • Sudden loss of vision (can happen when a man has risk factors like- hypertension, diabetes, and hyperlipidemia)
  • Sudden loss of hearing or decrease in hearing 

If you notice a decrease in hearing, a sudden loss of vision and/or any other adverse side-effect, you need to stop taking the drug. 

  • TOPICAL TREATMENT: NUMBING CREAMS, GELS, OR SPRAYS

These products contain numbing agents like lidocaine & prilocaine and they are applied on the penis to make the glans less sensitive for a delay in ejaculation. They make you last longer and they aren’t supposed to alter the sensation of ejaculation (it still feels good).

They need to be applied like 20 minutes before penetration, so you can apply it before long foreplay and make sure you go past 15 – 20 minutes before inserting the penis in the vagina. You also need to make sure that you don’t go past 45 minutes, else it won’t work.

SIDE-EFFECTS

They can make the penis abnormally less sensitive and make it extremely harder for the man to be aroused or get pleasure from sex. It can also be absorbed into the vagina and make it less sensitive over time to cause anorgasmia (inability to get orgasms) when it’s used too often by the man. 

Don’t use it when your partner is pregnant! And always use a condom when you use them to prevent your partner from getting the side-effects.

  • DELAY/PERFORMA CONDOMS

These condoms contain lubricants made of numbing products or anesthetics, so they tend to work like the delay creams or sprays. You just need to put on the condom, and the glans of the penis becomes less sensitive because it absorbs the numbing agent. On the plus side, the woman is protected from the side-effects of the anesthetic and it doesn’t interfere with her ability to get pleasure from sex.

WHAT SOME MEN DO TO DELAY EJACULATION 

These might or might not work for you: 

  • Masturbation right before sexual intercourse
  • The use of multiple condoms (2 or more) to reduce penile sensitivity (risky because the condoms can easily break and put you at risk of catching infections, and the woman can get pregnant)
  • Distraction techniques like mental exercises during sex and foreplay, to keep you from ejaculating. In this case, when the pleasure gets so intense, you need to picture something gross, or something that can completely kill the vibe to prevent you from ejaculating early.
  • Kegel exercises: strengthen pelvic muscles to improve ejaculatory control

WHAT TO DO IF YOU THINK YOU HAVE THE CONDITION

If you suspect that you have premature ejaculation, you need to visit a urologist or speak to a sexual health expert for the underlying cause to be accurately determined. A urologist will run some tests and give you the most appropriate treatment option to go for. So, don’t be too quick to use ‘delay’ products sold on the market, else you might wind up disappointed because the underlying cause of your condition tends to be left untreated. An example is a prostate infection that needs to be treated before ejaculation can be delayed effectively. 

DON’T LET ANYTHING STOP YOU FROM SEEKING MEDICAL HELP/TREATMENT!

Per my definition, if you have premature ejaculation and you’ve tried out so many products but none worked, go and see a urologist and get the right treatment. You can only get help when you seek it in the appropriate places. 

Sadly, so many men don’t seek help for premature ejaculation because of the stigma attached. They tend to feel embarrassed or shy about the condition; hence, they are unable to talk about it. Don’t be one of them! 

I honestly hope that you found this article helpful! I need you to remember that there are two types of premature ejaculation (lifelong and acquired). The lifelong condition is diagnosed when the man, from the time he started having sex, always ejaculated in less than 1 minute during sex. If a man, from the time he broke his virginity, always lasted less than 3 minutes before ejaculating, he can’t be diagnosed with acquired premature ejaculation (because 3 minutes is his normal ejaculating time).


Also, unless a man who previously used to last long starts to consistently ejaculate in less than 3 minutes during sex (and it keeps happening for months), he doesn’t have premature ejaculation. If it happens on rare occasions it doesn’t count, and it can be attributed to stress, illness, sexual excitement, overstimulation, sex drought, or first-time sex. Once the person feels better or betters his sexual skills, he will last longer during sex. 

Do you have any questions? Ask in the comments and I will answer as soon as possible. Subscribe to this blog if you haven’t to receive new post updates and announcements directly in your email. Just click the red, subscribe link on your screen! 

STAY SAFE!

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MENTAL HEALTH ADVOCATE, WRITER, SEX AND RELATIONSHIP EXPERT

Ami Shikah is a sex educator and mental health advocate. She is passionate about sex education and is working towards making her website/blog a place where people come to for knowledge and information that will help them make healthy decisions about sex and sexuality. Mental health isn't treated with much importance in her part of the world (Ghana, Africa) and as someone who has had to deal with depression and suicidal thoughts, she hopes to share her experiences with the world and help other people like her. She has in-depth knowledge about sex, sexual health, sexuality, vaginal health, pregnancy and abortion and is working to share it all with the world. She has also made it possible for people to ask questions and get answers to them anytime.

6 Comments

  1. Wow. This is very educative. There was a lot I didn't know about premature ejaculation. Thanks for the enlightenment

  2. Very Educative.
    But can I still use any of the drugs even though I dont suffer premature ejaculation? maybe just to enjoy sex more

    • It’s not advisable.. people have done that and wound up with delayed ejaculation. It’s not advisable

  3. I'm trying to find a paroxetine and I don't know if I need a prescription or can easily get one. Please help with any instructions or directions or pharmacy recommendation.

    • A number of pharmacies sell it without prescription. I know a friend who works in a pharmacy that sells it without prescription but she is at Sapeiman. You can ask a number of big pharmacies and see!

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