Premature Ejaculation: When to Seek Medical Help - Urology

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Premature ejaculation (PE) is a common sexual dysfunction that can significantly impact a man's self-esteem and intimate relationships. It is characterized by ejaculation that occurs sooner than desired, either before or shortly after penetration, leading to distress for one or both partners. Your experience of noticing a decrease in the duration of intercourse from about 10 minutes to around 5 minutes in subsequent attempts may indeed suggest the presence of premature ejaculation, especially if this pattern is consistent and causes you anxiety or disappointment.

The first step in addressing this concern is to understand that PE can be influenced by various factors, including psychological aspects such as anxiety, stress, and performance pressure, as well as physiological factors. In your case, it seems that the pressure you feel regarding the duration of intercourse may be contributing to your anxiety, which can further exacerbate the issue. This cycle of anxiety and performance pressure can lead to a decrease in sexual satisfaction and may even result in erectile difficulties, as you mentioned feeling "cold" or losing erection during intercourse.

When considering whether to seek medical help, it is important to evaluate the impact of this issue on your quality of life and relationships. If you find that your sexual experiences are causing significant distress or affecting your relationship with your girlfriend, it would be advisable to consult a healthcare professional. In this case, a urologist or a sexual health specialist would be the most appropriate choice, as they can provide a thorough evaluation and discuss potential treatment options tailored to your specific situation.

Treatment for premature ejaculation can vary based on the underlying causes. Options may include behavioral techniques, such as the "start-stop" method or the "squeeze" technique, which can help you gain better control over ejaculation. Additionally, counseling or therapy may be beneficial, especially if anxiety or relationship issues are contributing to the problem. In some cases, medications such as selective serotonin reuptake inhibitors (SSRIs) or topical anesthetics may be prescribed to help delay ejaculation.

It is also worth noting that communication with your partner is crucial. Open discussions about sexual preferences, concerns, and feelings can help alleviate some of the pressure you may be feeling and foster a more supportive environment for both of you. This can also enhance intimacy and reduce anxiety during sexual encounters.

In summary, if you are experiencing distress related to premature ejaculation, it is advisable to seek help from a urologist or a sexual health specialist. They can provide you with the necessary support and treatment options to address your concerns effectively. Remember, you are not alone in this experience, and many men face similar challenges. Seeking help is a positive step towards improving your sexual health and overall well-being.