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Frequently Asked Questions on Premature Ejaculation

What is ejaculation?

Ejaculation is the release of sperm and seminal fluid from the penis during sexual intercourse.11  It is often known as ‘coming’ or ‘cumming’.

What is the normal time to ejaculation?

It is important to note that time to ejaculation varies widely. It varies so much between men and even varies for the same man with different partners or situations.12 Some men wish they could last longer in bed, even though they don’t have premature ejaculation.

Is there any difference between “normal” ejaculation and premature ejaculation?

In men with premature ejaculation, the mechanism of ejaculation is the same as in men without premature ejaculation, but it happens with a diminished sense of control. Otherwise, ejaculation for a man with premature ejaculation is the same for a man without premature ejaculation.11

Normal ejaculation is a reflex action controlled by the brain and the nervous system.11 Men with premature ejaculation have compared their inability to control ejaculation to a sneeze. Think about sneezing as another reflex and how hard it is to control. In some ways, premature ejaculation is the same – men can feel that it is about to happen but they cannot do anything to stop it.11

This is because, like a sneeze, ejaculation is a reflex action that is controlled by the brain and nervous system.11 Once triggered, it can’t be stopped. 

What is premature ejaculation?

Premature ejaculation is when a man ejaculates with little sexual stimulation and before the man wishes.10 This can lead to a decrease in sexual satisfaction and quality of life for men and their partners.10

Premature ejaculation can take two forms. Men can have premature ejaculation from the first time they have sex (lifelong), or develop premature ejaculation later in life, even after many years of normal ejaculatory experience  (acquired).10

Can premature ejaculation be treated?

Many men carry on with their lives hoping that their premature ejaculation will get better with time. The important thing to remember is that premature ejaculation is treatable, and that by speaking to your doctor, you can access a number of effective treatments.

What causes premature ejaculation?

In the past, premature ejaculation was thought to be purely psychological.8 Now doctors understand that premature ejaculation can have a biological explanation and is associated with serotonin signals in the brain that control ejaculation.14 Serotonin is a brain chemical that acts as a messenger.

Our understanding of premature ejaculation continues to increase. Scientists have discovered variations in a gene controlling serotonin signalling that could be linked to premature ejaculation.13 Among the currently available treatments for premature ejaculation, one works by influencing the serotonin signalling pathway.15

How many men suffer from premature ejaculation?

One-in-three men may experience some form of premature ejaculation in their lives, which negatively impacts their quality of life and sexual satisfaction with their partner..1–6

Based on a study in Asia-Pacific conducted in Australia, New Zealand, China, Hong Kong, Indonesia, Malaysia, Philippines, South Korea, Taiwan and Thailand, involving almost 5000 men 16% of respondents were diagnosed with premature ejaculation using the Premature Ejaculation Diagnostic Tool (PEDT) and 15% were diagnosed with probable premature ejaculation.1 This means that about 31% of the males interviewed in Asia Pacific have some form of premature ejaculation.1

Overall, the majority of respondents with premature ejaculation reported extreme difficulty delaying ejaculation and felt very or extremely frustrated because they ejaculated before they wished.1

Who has premature ejaculation?

Premature ejaculation is not linked to any particular age group. Studies have shown that as many men in their fifties have premature ejaculation as men in their teens and early twenties.4,16  It appears that premature ejaculation crosses borders and cultures too, with men from different backgrounds and cultures experiencing similar rates of premature ejaculation.4,17,18

What is the impact of premature ejaculation?

Coping with premature ejaculation is both emotional and physical.7,19 Premature ejaculation may cause low self-confidence, anxiety, feelings of shame and avoidance of sexual intimacy.19 Premature ejaculation can also affect partners, negatively impacting overall quality of life and sexual satisfaction for couples.7

How can premature ejaculation affect your relationship?

A survey of more than 12,000 men showed that those with premature ejaculation had experienced less sexual satisfaction.4 Men with premature ejaculation were also more likely to report having ‘little interest in sex’ and ‘lack of orgasm’.4

Men with premature ejaculation in this survey also had greater concerns about their overall relationship – sometimes even avoiding relationships altogether.2

Men with premature ejaculation and their partners may feel that there is something missing from their relationship and that this affects their sense of intimacy.5

How can premature ejaculation affect your partner?

Women with partners who have premature ejaculation are less likely to initiate sex due to anxiety over performance. Due to their partner’s response during sex, women may feel that they are not doing the right thing which causes their partner to be unable to control ejaculation. Many women also report feelings of anger and resentment, partly because premature ejaculation can make it seem as though a man is being selfish in bed.5

A survey of over 12,000 men and their partners showed that the partners of men with premature ejaculation had less sexual satisfaction and were more concerned about their relationships overall.4

What’s the difference between premature ejaculation and erectile dysfunction?

Premature ejaculation is sometimes confused with erectile dysfunction, but they are very different.19 Erectile dysfunction is a condition where a man cannot achieve or maintain an erection firm enough for sexual intercourse.3,15 Some men with erectile dysfunction rush orgasm in order to finish before their erection fails, but this is not premature ejaculation.8 It is important to note that the treatment is different for erectile dysfunction  and premature ejaculation.3,9

Studies in the Asia-Pacific region show that erectile dysfunction affects 5% of men. In contrast, 31% of men are affected some form of premature ejaculation1

Here’s a summary of the differences between premature ejaculation and erectile dysfunction.3

table


Is there a treatment for premature ejaculation?
 

A Menarini will be launching soon Dapoxetine, the first and only drug specifically designed and approved for premature ejaculation. This will be available in drugstores in June 2014 but you need to consult first with your doctor especially the urologists. There will be an early experience program soon for this product that will benefit these men diagnosed with this condition.

How is it taken?

Dapoxetine is taken 1 to 3 hours before sexual intercourse.

 

References:

  1. McMahon CG, Lee G, Park JK, Adaikan PG. Premature ejaculation and erectile dysfunction prevalence and attitudes in the Asia-Pacific region. The journal of sexual medicine. 2012 Feb;9(2):454–65.
  2. Rowland DL, Patrick DL, Rothman M, Gagnon DD. The psychological burden of premature ejaculation. J Urol. 2007 Mar;177(3):1065–70.
  3. Rosenberg MT, Sadovsky R. Identification and diagnosis of premature ejaculation. Int J Clin Pract. 2007 Jun;61(6):903–8.
  4. Porst H, Montorsi F, Rosen RC, Gaynor L, Grupe S, Alexander J. The Premature Ejaculation Prevalence and Attitudes (PEPA) survey: prevalence, comorbidities, and professional help-seeking. Eur Urol. 2007 Mar;51(3):816–23.
  5. Revicki D, Howard K, Hanlon J, Mannix S, Greene A, Rothman M. Characterizing the burden of premature ejaculation from a patient and partner perspective: a multi-country qualitative analysis. Health Qual Life Outcomes. 2008 Jan;6:33.
  6. Montague DK, Jarow J, Broderick GA, Dmochowski RR, Heaton JP, Lue TF, Nehra A SIAEDGUP. AUA guideline on the pharmacologic management of premature ejaculation. J Urol. 2004;172(1):290–4.
  7. Sharlip I. Diagnosis and treatment of premature ejaculation: the physician’s perspective. J Sex Med. 2005 May;2 Suppl 2(1):103–9.
  8. Althof SE. Prevalence, characteristics and implications of premature ejaculation/rapid ejaculation. J Urol. 2006 Mar;175(3 Pt 1):842–8.
  9. Jannini EA, Lombardo F, Lenzi A. Correlation between ejaculatory and erectile dysfunction. Int J Androl. 2005 Dec;28 Suppl 2:40–5.
  10. Wespes E, Amar E, Eardley I, Giuliano F, Hatzichristou D, Hatzimouratidis K, et al. Male sexual dysfunction : premature ejaculation [Internet]. 2012. Available from: http://www.uroweb.org/fileadmin/guidelines/2012_Guidelines_large_text_print_total_file.pdf
  11. Lording D. Factsheet: Premature ejaculation [Internet]. Andrology Australia. 2011 [cited 2013 Feb 20]. p. 2. Available from: https://www.andrologyaustralia.org/wp-content/uploads/Factsheet_PremEjac_2011.pdf
  12. Jannini EA, Lenzi A. Ejaculatory disorders: epidemiology and current approaches to definition, classification and subtyping. World J Urol. 2005 Jun;23(2):68–75.
  13. Donatucci CF. Etiology of ejaculation and pathophysiology of premature ejaculation. J Sex Med. 2006 Sep;3(Suppl 4):303–8.
  14. McMahon CG, Abdo C, Incrocci L, Perelman M, Rowland D, Waldinger M, et al. Disorders of orgasm and ejaculation in men. J Sex Med. 2004 Jul;1(1):58–65.
  15. Gurkan L, Oommen M, Hellstrom WJG. Premature ejaculation: current and future treatments. Asian J Androl. 2008 Jan;10(1):102–9.
  16. Janssen PKC, Bakker SC, Réthelyi J, Zwinderman AH, Touw DJ, Olivier B, et al. Serotonin transporter promoter region (5-HTTLPR) polymorphism is associated with the intravaginal ejaculation latency time in Dutch men with lifelong premature ejaculation. J Sex Med. 2009 Jan;6(1):276–84.
  17. Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA. 1999;281(6):537–44.
  18. Nicolosi A, Laumann EO, Glasser DB, Moreira ED, Paik A, Gingell C. Sexual behavior and sexual dysfunctions after age 40: the global study of sexual attitudes and behaviors. Urology. 2004 Nov;64(5):991–7.
  19. Sotomayor M. The burden of premature ejaculation : The patient’s perspective. J Sex Med. 2005;2(Suppl 2):110–4.

20.            Symonds T, Perelman MA, Althof S, Martin M, May K, Abraham L, et al. Development and validation of a premature ejaculation diagnostic tool. Eur Urol. 2007;52(2):565–73.

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