Premature Ejaculation
Welcome, Bestie! I’m happy to have you back for another chat. Today, we’re talking Premature Ejaculation (PE). Since males often take pride in their sexual performance, you don’t tend to hear folks talking openly about PE. In some ways, it’s a bit of a taboo subject (okay, most pelvic health topics are taboo). PE can be the source of shame and embarrassment for men around the world, but in reality, it is the most common sexual dysfunction (1). Let’s talk about it!
What is Premature Ejaculation?
According to the Mayo Clinic, PE occurs when ejaculation happens sooner than desired during intercourse (2). Usually this impacts the male as well as his partner. As mentioned above, it is very common, with up to 1 in 3 males reporting that they have experienced early ejaculation at some point (2). However, you will likely only be diagnosed with PE if it happens regularly. For example, if you almost always ejaculate within 1 to 3 minutes of penetration and/or cannot delay ejaculation during penetrative intercourse, you might get diagnosed with PE (2).
PE can be a categorized as “lifelong” or “acquired.” In folks that have experienced PE since their first sexual encounter, the condition would be considered “lifelong.” In those that have had prior sexual experiences with the absence of PE, it would be considered “acquired” (2). The good news is that PE is a treatable condition! While it can be difficult to talk about with your healthcare provider, sharing your symptoms and frustration can be the first step toward improvement.
What causes PE?
More research needs to be done in order to fully understand the causes of PE. I wish we could point to one thing and say “That’s it, that’s why you have PE,” but that’s just not the case. Some of the contributors to PE include hormonal changes and psychological issues. These could include stress, depression, low amounts of serotonin, issues in your relationship, and more (2). It’s likely that PE is a result of multiple factors working together.
How is PE treated?
Since PE can have social/emotional (relationship), biological (hormones), and psychological causes, it is important for treatments to address all of the above, as necessary. Let’s talk a bit about each of the possible treatments for PE:
- Psychological therapy: This type of treatment can be used to improve symptoms of depression or work through issues that have arisen in your relationship(s). It can be especially beneficial for developing confidence and combatting the feelings of shame or embarrassment that often come with PE (3).
- Medications: Medications are available that can help with the symptoms of PE. As mentioned, decreased levels of serotonin often contribute toward PE. Drugs that are typically used for depression and/or mood disorders can work to boost levels of serotonin and therefore help decrease PE (2). Talk with your medical provider regarding whether you would benefit from antidepressants for your PE.
- Physical Therapy (PT): Pelvic health physical therapy can play a role in improving your PE symptoms (4). PE can sometimes be improved by strengthening the pelvic floor muscles (PFMs). One study looked pelvic health treatment of men with lifelong PE and found that 82.5% of the participants gained control of their ejaculatory reflex after the pelvic floor rehabilitation (1). The treatment for these men consisted of PFM training, electrical stimulation of the pelvic floor and pudendal nerve, and biofeedback training (1). Treatment went on for 12 weeks and clearly yielded very promising results. Further research should be done in order to get a better idea of the specific training protocol that will work best in patients with PE, but initial studies are positive.
- Behavioral Treatment: There are two common behavioral treatment methods that folks use to help their PE symptoms. The first is called the “squeeze method” in which the person with PE gets close to ejaculation before squeezing the penis until the erection decreases slightly (3). The second is called the “stop-start method” in which the person with PE gets close to ejaculation before stopping penis stimulation until the urge to ejaculate decreases. Once it decreases, you can start stimulation again. This is repeated three times (3).
PE is a complex issue that affects a large number of men. If you’re feeling embarrassed about your sexual performance in regard to PE, know that you are not alone. Your medical providers would be happy to chat with you about how to manage and improve your symptoms. Though medications are an option, remember that pelvic floor physical therapy is a great, non-invasive treatment option that doesn’t require you to take any medications. Let’s chat soon.
XOXO,
Your Pelvic Bestie
References:
1. Pastore AL, Palleschi G, Fuschi A, Maggioni C, Rago R, Zucchi A, Costantini E, Carbone A. Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: a novel therapeutic approach. Ther Adv Urol. 2014 Jun;6(3):83-8. doi: 10.1177/1756287214523329. PMID: 24883105; PMCID: PMC4003840.
2. Mayo Foundation for Medical Education and Research. (2022, July 14). Premature ejaculation. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/premature-ejaculation/symptoms-causes/syc-20354900
3. Premature ejaculation. Premature Ejaculation: Causes & Treatment - Urology Care Foundation. (n.d.). https://www.urologyhealth.org/urology-a-z/p/premature-ejaculation
4. Myers C, Smith M. Pelvic floor muscle training improves erectile dysfunction and premature ejaculation: a systematic review. Physiotherapy. 2019 Jun;105(2):235-243. doi: 10.1016/j.physio.2019.01.002. Epub 2019 Jan 14. PMID: 30979506.
*The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a qualified health provider regarding any questions you may have about a medical condition or health objectives
