Premature Ejaculation: Causes and Solutions for Men

Premature ejaculation issues?

Doctor, I have a few questions:
1.
In the past, during middle and high school, I would masturbate about three times a week.
Just watching adult films would quickly arouse me, but I would often stimulate myself four to five times before ejaculation.
If I didn't watch anything, it would take me much longer.
However, now when I have intercourse with my girlfriend, I feel the urge to ejaculate within about a minute (or even less).
After the first ejaculation, we take a break and continue with foreplay, kissing, and oral sex until I become erect again for a second round.
Sometimes the duration is similar to the first time, and sometimes it isn't.
Should I consider this premature ejaculation, or is it due to increased sensitivity of the glans (I have phimosis and have not undergone circumcision)?
2.
I've read online that masturbation can reduce sensitivity; is this true?

Hao Jun, 10~19 year old female. Ask Date: 2017/08/27

Dr. Fu Shizhang reply Urology

1.
According to medical definitions, lasting less than one minute is indeed considered premature ejaculation, and it is recommended to seek consultation at a clinic.
2.
Not relevant.

Reply Date: 2017/08/27

More Info

Premature ejaculation (PE) is a common concern among men, and understanding its causes and potential solutions can help address the issue effectively. Based on your description, it seems you are experiencing difficulty in controlling ejaculation during sexual intercourse, which can indeed be classified as premature ejaculation if it consistently occurs within one minute of penetration.

Causes of Premature Ejaculation
1. Psychological Factors: Anxiety, stress, and performance pressure can significantly affect sexual performance. If you feel anxious about your sexual encounters, it may lead to quicker ejaculation. This is particularly common in new relationships or when there is a fear of not meeting a partner's expectations.

2. Physical Sensitivity: You mentioned that you may have a sensitive glans (the head of the penis). Increased sensitivity can lead to quicker ejaculation. Conditions like phimosis (where the foreskin cannot be fully retracted) can also contribute to heightened sensitivity.

3. Hormonal Factors: Hormonal imbalances, particularly involving testosterone, can play a role in sexual function.
4. Neurological Factors: Conditions affecting the nervous system can influence ejaculation control.
5. Relationship Dynamics: Sometimes, the dynamics of a relationship can affect sexual performance. Communication with your partner about preferences and comfort levels can alleviate some pressure.

Solutions for Premature Ejaculation
1. Behavioral Techniques:
- Start-Stop Technique: This involves stimulating the penis until you feel close to ejaculation, then stopping until the urge decreases. This can help you gain better control over your ejaculation.

- Squeeze Technique: Similar to the start-stop method, but involves squeezing the base of the penis to reduce the urge to ejaculate.

2. Desensitizing Products: Over-the-counter creams or sprays that contain numbing agents can reduce sensitivity and help prolong the duration of intercourse. However, it's essential to use these products cautiously and follow the instructions.

3. Pelvic Floor Exercises: Strengthening the pelvic floor muscles through exercises (often referred to as Kegel exercises) can improve control over ejaculation. These exercises involve repeatedly contracting and relaxing the muscles that control urination.

4. Counseling or Therapy: If anxiety or psychological factors are contributing to your premature ejaculation, speaking with a therapist or counselor can be beneficial. Cognitive-behavioral therapy (CBT) has been shown to help many men with PE.

5. Medical Treatments: In some cases, medications may be prescribed. Selective serotonin reuptake inhibitors (SSRIs) are sometimes used off-label to help delay ejaculation. Consult a healthcare provider for personalized advice.

6. Communication with Your Partner: Open dialogue with your partner about your concerns can help reduce anxiety and improve intimacy. Discussing preferences and comfort levels can create a more relaxed environment for both partners.

Regarding Masturbation and Sensitivity
There is a common belief that regular masturbation can help reduce sensitivity over time. This is somewhat true, as frequent ejaculation can help you learn to control your arousal levels better. However, the effectiveness varies from person to person. If you find that masturbation helps you last longer, it may be beneficial to incorporate it into your routine, but it should not be relied upon as the sole solution.

Conclusion
In summary, premature ejaculation can stem from various factors, including psychological, physical, and relational dynamics. Understanding these causes can help you explore effective solutions. If the issue persists or worsens, consider consulting a healthcare professional specializing in sexual health for further evaluation and tailored treatment options. Remember, you are not alone in this, and many men experience similar challenges. Open communication with your partner and seeking professional help can lead to improved sexual satisfaction for both of you.

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