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PREMATURE EJACULATIONPremature ejaculation is when a man ejaculates more quickly than he wants to on a fairly regular basis and is bothered by it. * The typical man complaining of premature ejaculation relates that he ejaculates within 1-2 minutes of vaginal penetration. * Premature ejaculation is the most common sexual dysfunction in men, effecting as many as 1 out of 3 men. * While there are men who can last substantially longer, most men ejaculate between 3-7 minutes after sustained vaginal penetration. Many men want to last longer. Men are designed to ejaculate quickly - that is what makes babies. * If every man took 30 minutes to ejaculate, the human race might not survive. Evolution requires fairly rapid ejaculation. Many men are embarrassed and reluctant to talk about premature ejaculation. They think that they are the only one to have it. * They think their buddies are all lasting 20-30 minutes. Think again! It is a common and treatable condition. Premature ejaculation is more common among younger men, but effects men of all ages. Premature ejaculation is usually a behavioral issue and not a physical one. While some men are found to be abnormally sensitive, most men complaining solely of premature ejaculation have a normal physical exam. Premature ejaculation is either: A. Primary - meaning that a man has had it since he began to be sexually active; or B. Secondary or acquired, and developed only after a period of normal or better ejaculatory control. There are several causes of premature ejaculation. Early sexual experiences often play a role, in which patterns are established that are difficult to change later in life. Guilt over having sex or masturbating creates enough stress and anxiety to cause premature ejaculation in some men. Relationship problems with a man's partner often increase a man's anxiety level and make premature ejaculation more likely. Some men have very infrequent sexual intercourse, making ejaculatory control more difficult. This is especially true in men who do not masturbate in between sexual encounters. Men with erectile dysfunction are more likely to have premature ejaculation. Performance anxiety is a common cause of premature ejaculation. If a man is concerned about how his sexual encounter is going to go, such as, will he get a good erection or have good control of his ejaculation, he might have a higher level of anxiety. The more anxious a man is, the less control he might have over his ejaculation. While premature ejaculation is rarely caused by a physical problem, it can cause physical problems. Many men with premature ejaculation have difficulty beginning and maintaining relationships. It may cause fertility issues, especially if a man is ejaculating before vaginal penetration. The stress that premature ejaculation causes a man is in general not healthy and may contribute to many other medical problems. TREATMENTS FOR PREMATURE EJACULATIONThere are many ways to treat premature ejaculation. They include sex therapy, behavioral modification, desensitizing creams, sprays and condoms, oral medications, penile injections, acupuncture and the use of sexual surrogates. For most men a combination of treatments works best. It is worth noting that not one single medication is FDA approved specifically for premature ejaculation. The medications commonly used by physicians to treat premature ejaculation or their components, are FDA approved for another purpose. As such they may be legally used to treat premature ejaculation, but constitute an off label use for these drugs. Most men can be helped to get better ejaculatory control. The goal of some methods of treatment is to delay ejaculation and for others it is to maintain the erection after ejaculation. * While we will certainly try to help all of our patients, as with any medical treatment, there is no guarantee of specific results, as results can and usually do vary from patient to patient. All numbers and time frames mentioned are approximate and may vary from patient to patient. |
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