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Premature Ejaculation

 

Types and Causes Of Premature Ejaculation

The first step in the treatment of premature ejaculation is to establish the type of premature ejaculation
that the patient suffers from and the underlying causes as summarised below:

  1. Primary life long premature ejaculation

The criteria for a patient to be classified as having Primary premature ejaculation
are the following:

  • From the first sexual experience
  • Intravaginal latency time IELT ≤ 1-2min (90% of patients will have IELT < 1min, 10% between 1-2 min)
  • Inability to delay ejaculation on all or nearly all vaginal penetrations.
  • Negative impact e.g distress, bother, frustration, and/or the avoidance of sexual intimacy.

Ante-portal ejaculation is the severest form of primary PE when IELT= Zero, which means that the patient ejaculates even before penetration.

Causes

Lifelong premature ejaculation is usually neuro-biologically rather than psychologically determined meaning that the patients suffering from this have genetic predisposition with environmental influences. Unfortunately, the exact neuro-biological mechanisms have not been established (hence multi-optional treatment rather than targeted treatment is recommended) although there are a number of theories in development.

  1. Acquired or secondary premature ejaculation

The criteria for a patient to be classified as having Acquired or Secondary premature ejaculation
are the following:

  • PE symptoms beginning after a period of normal ejaculatory function causing a clinically significant reduction in the IELT
  • IELT≤ 3min
  • Inability to delay ejaculation on all or nearly all vaginal penetrations;
  • Negative impact e.g distress, bother, frustration, and/or the avoidance of sexual intimacy.

Causes

Potential causes of secondary premature ejaculation
are the following:

  • Neurological factors causing hypersensitivity of genital skin and hyper excitability of the ejaculatory reflex e.g increased sympathetic tone (Hypertension), Diabetes, metabolic syndrome and alcoholism
  • Hormonal Causes such as Hyperthyroidism/ Hypothyroidism / reduced Prolactin/ increased Leptin
  • Erectile Dysfunction causing secondary premature ejaculation
  • Tight Frenulum
  • Phimosis / Balanoposthitis causing Dyspareunia
  • Chronic Prostatitis
  • Chronic Pelvic pain syndrome
  • Psychological factors; e.g Anxiety/depression, partner issues, paranoia habituation through early sexual experiences, habituation via masturbation, negative early sexual experiences
  • Recreational drugs
  • Certain medication such sympathomimetics

 

  1. Variable PE:

Variable premature ejaculation
will happen naturally in certain situations such as:

  • Abstaining from sex for a long time
  • Over sexually excited, e.g having sex for the first time
  • New sexual stimulants: sexually exciting situations e.g special occasions, fantasy enactments

This should not be considered a pathology but a small variation in normal sexual performance.

 

  1. Premature-like ejaculatory dysfunction (Subjective PE)

Subjective complaint of premature ejaculation
(SPE) in men with a normal IELT of more than 3min. SPE is characterized by one or more of the following:

  • Subjective perception of consistent or inconsistent short IELT;
  • Preoccupation with an imagined short ejaculatory latency or lack of control over the timing of ejaculation;
  • IELT in the normal range or even of longer duration (i.e., an ejaculation that occurs after 5 minutes);and
  • Ejaculation control that may be diminished or lacking.

I am suffering from Premature Ejaculation, what should I do next?

If you are suffering from premature ejaculation then we advise you to book a consultation with one of our highly experienced doctors. The first step to successful treatment is a correct diagnosis of the underlying causes of premature ejaculation by your doctor.
Beyond that, our doctors will seek to do two things:

  • Design the best therapy plan that will allow you to immediately improve your ejaculation time so as to continue normal sexual activities;
  • Design a treatment procedure that will address the underlying causes of your issue.

Our doctor’s experience, treating over 10,000 PE patients, allows us to create highly personalised plans to help you.

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LEARN MORE ABOUT PREMATURE EJACULATION

Premature Ejaculation, often referred to as PE, is the most common sexual dysfunction in men below 60 years old, estimated to affect around 30% of men irrespective of age. Continue Reading....
The first step in the treatment of premature ejaculation is to establish the type of premature ejaculation Continue Reading....
Our Premature Ejaculation treatment processes are based on the latest medical research, medical guidelines and our extensive clinical experience and we expect that a majority of our patients will improve their ejaculation time. Continue Reading....
Every patient treated in our clinic will undergo our extensive diagnostic treatment protocol consisting of the following steps: Continue Reading....
Unfortunately, most insurance companies do not cover sexual dysfunction or male fertility consultations and most of our patients are self-financing. If your insurance company covers the cost of treatment or diagnostic tests, then we would be glad to assist you with the refund claim or claim directly from your insurance company on your behalf. Continue Reading....

LEARN MORE ABOUT PREMATURE EJACULATION

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