Premature ejaculation

Premature ejaculation or early ejaculation is the most common sexual problem experienced by men and 1 out of 3 people say that they have experienced early ejaculation at sometime in their life.

What is the average time of premature ejaculation?

There are broadly two types of Premature ejaculation:

• Lifelong premature ejaculation happens since the time of puberty and usually men ejaculate within 1 minute.
• Acquired premature ejaculation happens after few months/years of normal sexual experience with normal ejaculation. Men usually ejaculate within 3 minutes.

It is more commonly related to the problems in normal sexual response cycle. Some of the possible causes include stress, familial discord, erectile dysfunction, irregular levels of brain chemicals like serotonin and so on. This can lead to severe family stress and infertility issues.

How can I stop premature ejaculation?

• Behavioral therapies like stop-start technique, Kegels exercises
• Couple counseling
• Oral tablets (antidepressants, erection inducing medications)
• Penile sprays or creams
• Botox injection to penile ejaculatory muscle and glans
• Microscopic penile dorsal neurectomy as the last option

Does Viagra help in Premature ejaculation?

Paper published by Dr Pramod Krishnappa in International Journal of Impotence Research (PMID 30837718) clearly explains Viagra (Sildenafil) does help in premature ejaculation along with some behavioral therapies.

Is it normal for a guy to release semen early?

Releasing the semen early may sometimes affect the sexual relationship. The partner might not get fully aroused or reach climax if you release early which can lead to unsatisfactory sex life. But premature ejaculation per se does not cause any serious medical issue to the person or for conception. If the couple are not in distress due to the early ejaculation, then premature ejaculation may be neglected. But if the person has issues simultaneously with his erections, then one should seek consultation with an andrologist.

Some men face other ejaculatory disorders such as delayed or anejaculation.

Anejaculation is the inability of a man to ejaculate (put the semen out). It could be due to psychological or organic cause. Common causes of inability to ejaculate (anejaculation) include anxiety, uncontrolled Diabetes, infections, current medications, nerve damage during a complex surgery, nervous system problems such as Parkinson’s disease or multiple sclerosis.

Sometimes men may not ejaculate on certain occasions such as while giving a semen sample for IVF / IUI (situational or psychological), but they ejaculate normally at home when their comfort levels are good. In such situations, we counsel the men to reduce their anxiety levels, start on oral medications and we use a penile vibrator.

Rarely, some men can have blockage of the male reproductive tract which carries the semen. In such situations’, a detailed evaluation is required including ultrasound or MRI scan of the pelvic organs and vasography.

If one is still unable to ejaculate in spite of all the measures, then sperms may have to be retrieved for IVF-ICSI from testis or epididymis (PESA, TESA, TESE, MicroTESE) for infertility.

How long is delayed ejaculation?

Delayed ejaculation is when a man who in trying to ejaculate but takes an unwanted extended time of more than 30 min to reach orgasm and ejaculate.

Which doctor is best for premature ejaculation?

Dr Pramod Krishnappa is the best andrologist dealing with Men’s Sexual Health and Male Fertility. He has been trained extensively in high volume Andrology centres in Madrid (Spain), Belgrade, Budapest, Chicago, and New York. It is preferable to consult a urologist who is further exclusively trained or specialized in Andrology to seek treatment for premature ejaculation.