Understanding Premature Ejaculation

NOTE: Be sure to check out my latest post on premature ejaculation, which includes information on a number of new studies and potential treatments. 

Crossing the Finish Line Too Soon

premature-ejaculation-milkMy husband was pouring milk into glasses for our children at the dinner table recently, and the jug slipped from his hand and milk gushed over the table and spilled onto the floor in puddles. After our kids rolled their eyes at his sarcastic quip “now there is no reason to cry over spilled milk kids!” and we mopped up the mess, dinner moved along as usual.

Unintentional spilling of milk so to speak during sex is a common sexual concern for many men called premature ejaculation (PE). Premature ejaculation is when a man ejaculates sooner during sexual intercourse than he or his partner would like, which is often prior to or within one minute of vaginal penetration, and is coupled with a notable lack of control over the ability to regulate ejaculation.

PE is associated with negative personal consequences such as upset or frustration which can lead to the avoidance of sexual intimacy. Some men have had premature ejaculation since their initial intercourse experience, and this is called lifelong premature ejaculation, versus acquired premature ejaculation which develops later on in life after previous ability to exert comfortable control over ejaculation timing.

Premature ejaculation has been recognized as a syndrome for well over 100 years, but accurate assessment of prevalence can be difficult to identify accurately due to variance in definitions of PE and the sensitive nature of the concern which leads to under reporting. While estimates vary, as many as 1 out of 3 men say they experience this problem, and almost every man will cross the finish line too soon at some point in their sexual lives.

In some sports an early finish is applauded, but this is not usually the case when it comes to sex. Men often seek help when an early completion persists upon every sexual act and causes conflict in a relationship.

Both psychological and biological factors can play a role in premature ejaculation. Although many men feel embarrassed to talk about it, PE is a common and treatable condition. There are many things that can cause premature ejaculation and warrant a conversation with a healthcare provider, including thyroid or prostate disease, urinary track symptoms, mood disorders, alcohol or drug use, as well as other sexual dysfunctions including erectile dysfunction.

Often there are behavioral correlates that are noted in men with PE such as history of rapid masturbation or use of vibratory devices that cause excessive stimulation. There are numerous medical treatments available to improve ejaculation latency, or time from the start of intercourse to ejaculation, including oral medications taken daily, medications taken prior to sexual acts, and sprays applied directly to the penis prior to intercourse.

Cognitive behavioral therapy with a sex therapist is often warranted in addition to medical care to provide techniques proven to resolve premature ejaculation that focus on mindfulness, education on the sexual response cycle, and how to modify ejaculation timing.

We all expect to clean up spilled milk from the floor every now again, and if a rapid ejaculation event occurs periodically most men make a joke or an easy apology and know that next time will be different. But if we find ourselves wringing out the towel at every act of intimacy in our relationship, frustration commonly develops, and if efforts to improve the experience have not been successful on our own, support from a healthcare provider becomes warranted and often leads to resolution of the concern — and keeps the applause for an early finish at the horse races.