Premature Ejaculation: Causes, Treatments, and Finding a Specialist - Urology

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Premature ejaculation issues?


Hello doctor, I usually take about 2 minutes from penetration to ejaculation during intercourse.
Does this count as premature ejaculation? I would like to see a doctor to see if I can extend this time.
I heard that acupuncture therapy can help.
I live in Pingtung; could you recommend a reliable doctor? Thank you.

Xiao Yuan, 30~39 year old female. Ask Date: 2005/06/18

Dr. Pan Zhenqin reply Urology


Premature ejaculation can be considered a significant concern regarding male sexual performance, and the duration of intercourse is a matter of great importance for many men.
In reality, there is no absolute standard for premature ejaculation, and no definitive conclusions have been reached to date.
It is important not to compare oneself to male actors in adult films, as much of their performance is aided by medication or editing effects.

Alfred Kinsey, a pioneer in modern sexology, published a report in 1950 indicating that 75% of American men ejaculate within two minutes of vaginal penetration.
Consequently, the "two-minute" benchmark was previously used as a standard, but it is no longer widely accepted.
Another perspective suggests that the standard should be based on whether the sexual partner achieves satisfaction or orgasm at least half the time, but the definitions of satisfaction or orgasm for female partners are also difficult to quantify.
According to the old standard, a performance of two minutes is generally considered sufficient; however, it is essential to also consider the thrusting speed and the partner's reactions to determine if it qualifies as premature ejaculation.

As for improving premature ejaculation, a method proposed by Masters and Johnson in the 1970s involves the male-on-top position.
When the male feels he is about to ejaculate, he should pause, and the female partner should immediately lift her body away from the penis.
The male should then apply pressure to the glans for three to four seconds to reduce arousal, waiting 15 to 30 seconds before resuming.
Their report indicated a 90% effectiveness rate.
Additionally, ancient Chinese methods suggest not using a specific position but rather, when the urge to ejaculate is felt, the male should immediately pull back and refrain from movement, take deep breaths, and contract the lower abdomen until calm, before slowly resuming.
This approach is also expected to yield good results.

For further consultation on this issue, you may seek advice from a urologist in Pingtung.

Reply Date: 2005/06/18

More Info


Premature ejaculation (PE) is a common sexual dysfunction characterized by the inability to delay ejaculation during sexual intercourse, often resulting in distress for both partners. The condition is generally defined as ejaculation that occurs within one to two minutes of penetration, which aligns with your experience of lasting about two minutes. This duration is typically considered to be within the range of PE, particularly if it causes you or your partner distress.


Causes of Premature Ejaculation
The causes of PE can be multifactorial, including:
1. Psychological Factors: Anxiety, stress, or feelings of guilt can contribute to premature ejaculation. Performance anxiety, in particular, is a common psychological trigger.


2. Biological Factors: Hormonal imbalances, neurotransmitter levels, and certain medical conditions (like prostatitis or thyroid issues) can also play a role.

3. Genetic Factors: Some studies suggest that PE may run in families, indicating a potential genetic predisposition.

4. Relationship Issues: Problems with communication or intimacy in a relationship can exacerbate the condition.


Treatments for Premature Ejaculation
There are several treatment options available for PE, which can be tailored to your specific needs:
1. Behavioral Techniques: Techniques such as the "stop-start" method or the "squeeze" technique can help you gain better control over ejaculation.

2. Topical Anesthetics: Creams or sprays containing numbing agents can reduce sensitivity and help delay ejaculation.

3. Medications: Selective serotonin reuptake inhibitors (SSRIs), which are typically used to treat depression, have been found to help delay ejaculation as a side effect. Other medications may also be prescribed based on individual needs.

4. Counseling or Therapy: If psychological factors are contributing to your PE, speaking with a therapist or counselor can be beneficial.

5. Acupuncture: Some individuals have reported improvements with acupuncture, which is believed to help balance the body's energy and reduce anxiety.


Finding a Specialist
Since you mentioned living in Pingtung and seeking a reliable physician, I recommend looking for a urologist or a sexual health specialist. These professionals are trained to address sexual dysfunctions, including PE. You can start by checking local hospitals or clinics that specialize in men's health. Additionally, consider seeking recommendations from friends or family, or checking online reviews to find a reputable doctor.


Conclusion
It’s important to remember that PE is a common issue and seeking help is a positive step. Many men experience this condition at some point in their lives, and effective treatments are available. If you’re considering acupuncture or any other specific treatment, it’s advisable to discuss this with your healthcare provider to ensure it’s appropriate for your situation. They can help you explore all available options and find the best approach for you. Don’t hesitate to reach out to a specialist to discuss your concerns and explore treatment options that can enhance your sexual experience and overall relationship satisfaction.

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