Premature Ejaculation: A Guide for Young Men

Distress

Hello, doctor.
I am 24 years old, and during my first sexual experience, I ejaculated before penetration even occurred.
At first, I thought it was just nerves since it was my first time, so I didn't pay much attention to it.
However, I later noticed that during each sexual encounter, my erection wasn't very firm and would quickly soften.
Even when I managed to penetrate, I would ejaculate very quickly.
This issue has been troubling me.
Could you please help me with this?

Xiao Zhao, 20~29 year old female. Ask Date: 2004/02/01

Dr. Cai Bingkun reply Urology

Based on your medical history, you have a condition known as "penile cavernous venous leak," which is caused by abnormal venous reflux in the penile cavernous bodies.
This leads to difficulty in maintaining an erection, as the arterial blood that fills the cavernous bodies can easily flow back through these abnormal veins.
Therefore, the complaint is not about the inability to achieve an erection, but rather the inability to sustain it; this is referred to as "rigid but short-lived." We can confirm this condition through "dynamic intracavernous pressure testing and cavernosography."
Treatment options vary; for patients with mild venous leakage, applying a rubber band at the base of the penis can compress the venous return, or using a "vacuum erection device" may be beneficial.
Regular practice of Qigong, yoga, and pelvic floor exercises can also help maintain erection duration.
For patients with severe cases, surgical intervention may be necessary.

Premature ejaculation is often attributed to psychological factors, and various behavioral therapies, desensitization training, and anxiolytic medications can help patients gain control over their climax timing.
Some physicians use nerve blockers as a treatment for premature ejaculation, while others have attempted surgical solutions, though results remain inconclusive.
Currently, a physician in South Korea has developed a topical treatment for premature ejaculation called "ss ointment," which contains various herbal and pharmaceutical ingredients that may reduce sensitivity, showing unusual effectiveness.

Reply Date: 2004/02/01

More Info

Premature ejaculation (PE) is a common concern among young men, and it can be particularly distressing for those experiencing it for the first time. At 24 years old, it's understandable that you might feel anxious about your sexual performance, especially if you have encountered difficulties during your initial sexual experiences. Let's break down the issue and explore potential causes and solutions.

Understanding Premature Ejaculation
Premature ejaculation is defined as ejaculation that occurs with minimal sexual stimulation before, during, or shortly after penetration, and it can happen before the individual wishes it to. This condition can lead to feelings of frustration, embarrassment, and anxiety, which can further exacerbate the problem. It's important to note that PE is not uncommon; studies suggest that it affects a significant percentage of men at some point in their lives.

Possible Causes
1. Psychological Factors: Anxiety, stress, and nervousness are often significant contributors to PE. The pressure to perform well during sexual encounters can lead to heightened anxiety, which may result in premature ejaculation. This is especially true for younger men who may feel societal or personal pressure to meet certain expectations.

2. Physical Factors: While psychological factors are common, there can also be physical causes. Hormonal imbalances, neurological issues, or even certain medical conditions can contribute to PE. However, in many cases, the issue is primarily psychological.

3. Inexperience: As a young man, inexperience can also play a role. The first few sexual encounters can be overwhelming, and the excitement may lead to quicker ejaculation. Over time, as you become more comfortable and familiar with sexual activity, this may improve.

4. Relationship Dynamics: The emotional connection with your partner can also influence sexual performance. If you feel comfortable and relaxed with your partner, it may help alleviate some of the anxiety associated with sexual performance.

Strategies for Management
1. Communication: Openly discussing your concerns with your partner can help alleviate anxiety. Understanding that both of you are in this together can create a supportive environment that may reduce performance pressure.

2. Relaxation Techniques: Practicing relaxation techniques such as deep breathing, mindfulness, or meditation can help manage anxiety levels. The more relaxed you are, the less likely you are to experience premature ejaculation.

3. Desensitization Techniques: Some men find that using desensitizing creams or sprays can help reduce sensitivity and prolong the duration before ejaculation. However, it's essential to use these products as directed and consult with a healthcare provider if you have concerns.

4. 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.

5. Professional Help: If the problem persists and significantly impacts your quality of life, consider seeking help from a healthcare professional. A urologist or a sexual health specialist can provide guidance, evaluate for any underlying conditions, and suggest appropriate treatments, which may include therapy or medication.

6. Gradual Exposure: Gradually increasing sexual activity can help desensitize you to the experience. Start with non-penetrative activities and gradually work your way up to penetration as you become more comfortable.

Conclusion
Experiencing premature ejaculation can be distressing, but it's essential to remember that you are not alone, and there are effective strategies to manage the condition. By addressing both the psychological and physical aspects of the issue, you can work towards improving your sexual experiences. Communication with your partner, relaxation techniques, and potentially seeking professional help can all contribute to a more satisfying sexual life. Remember, sexual health is an integral part of overall well-being, and taking proactive steps can lead to positive outcomes.

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