Premature Ejaculation: Causes and Solutions for Young Men - Urology

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Premature ejaculation (PE) is a common concern among young men, and it can be influenced by a variety of factors, including psychological, physiological, and lifestyle elements. In your case, at the age of 23, experiencing significant early ejaculation during sexual activity can be distressing, especially when compounded by feelings of urgency to ejaculate regardless of erection status.
From what you've described, it seems that you have already sought medical advice and were diagnosed with low testosterone levels. Testosterone plays a crucial role in sexual function, and low levels can contribute to various sexual dysfunctions, including premature ejaculation. It's good to hear that you have started exercising, as physical activity can help improve overall health, boost testosterone levels, and enhance sexual performance.

However, it’s important to note that while exercise can be beneficial, it may not be a complete solution for premature ejaculation. Psychological factors such as anxiety, stress, and performance pressure can also significantly impact sexual function. You mentioned that your symptoms worsened after a period of stress and sleeplessness, which suggests that psychological factors may be playing a role in your experience. Stress and anxiety can lead to heightened sensitivity and a lower threshold for ejaculation, making it more challenging to control.

Additionally, your history of smoking for seven years could also be a contributing factor. Smoking has been linked to various sexual health issues, including erectile dysfunction and reduced libido, which can indirectly affect ejaculation control. The chemicals in cigarettes can impair blood flow and reduce overall sexual function, so quitting smoking may not only improve your sexual health but also enhance your general well-being.

To address premature ejaculation effectively, consider the following approaches:
1. Consult a Specialist: Since you have already seen a urologist, it may be beneficial to consult a sexual health specialist or a psychologist who specializes in sexual dysfunction. They can provide tailored advice and treatment options.

2. Behavioral Techniques: Techniques such as the "stop-start" method or the "squeeze" technique can help you gain better control over ejaculation. These methods involve practicing control during sexual activity and can be effective over time.

3. Pelvic Floor Exercises: Strengthening the pelvic floor muscles through exercises like Kegels can improve control over ejaculation. These exercises involve contracting and relaxing the muscles used to stop urination.

4. Medication: In some cases, medications such as selective serotonin reuptake inhibitors (SSRIs) or topical anesthetics may be prescribed to help delay ejaculation. Discuss these options with your healthcare provider.

5. Lifestyle Changes: Continue to focus on a healthy lifestyle, including regular exercise, a balanced diet, and adequate sleep. Reducing stress through relaxation techniques such as meditation or yoga can also be beneficial.

6. Quit Smoking: If you haven’t already, consider quitting smoking. This can improve your overall health and may positively impact your sexual function.

In conclusion, premature ejaculation can be a multifaceted issue, and addressing it often requires a comprehensive approach that includes medical, psychological, and lifestyle considerations. By continuing to seek professional guidance and making positive changes in your life, you can work towards improving your sexual health and overall well-being.