Premature Ejaculation Tubes

Premature Ejaculation Tubes
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Ferri FF. Ejaculation and orgasm disorders. In: Ferri's Clinical Advisor 2022. Elsevier; 2022. https://www.clinicalkey.com. Accessed May 3, 2022.
Melmed S, et al. Sexual dysfunction in men and women. In: Williams Textbook of Endocrinology. 14th ed. Elsevier; 2020. https://www.clinicalkey.com. Accessed May 3, 2022.
Veettil Raveendran A, et al. Premature ejaculation — Current concepts in the management: A narrative review. International Journal of Reproductive Biomedicine. 2021; doi:10.18502/ijrm.v19i1.8176.
Partin AW, et al., eds. Disorders of male orgasm and ejaculation. In: Campbell-Walsh-Wein Urology. 12th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed May 3, 2022.
Shindel AW, et al. Disorders of ejaculation: An AUA/SMSNA guide. Journal of Urology. 2022; doi:10.1097/JU.0000000000002392.
Gillman N, et al. Premature ejaculation: Aetiology and treatment strategies. Medical Sciences. 2019; doi:10.3390/medsci7110102.
Myers C, et al. Pelvic floor muscle training improves erectile dysfunction and premature ejaculation: A systematic review. Physiotherapy. 2019: doi:10.1016/j.physio.2019.01.002.
Sexual dysfunctions. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5-TR. 5th ed. American Psychiatric Association; 2022. https://dsm.psychiatryonline.org. Accessed May 11, 2022.
Kegel exercises. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/urologic-diseases/kegel-exercises. Accessed May 3, 2022.
Chen T, et al. Medical treatment of disorders of ejaculation. The Urologic Clinics of North America. 2022; doi:10.1016/j.ucl.2021.12.001.
Tramadol oral. Facts & Comparisons eAnswers. https://fco.factsandcomparisons.com. Accessed May 11, 2022.
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Your health care provider asks about your sex life and your health history. Your provider might also do a physical exam. If you have both early ejaculation and trouble getting or keeping an erection, your provider might order blood tests. The tests may check your hormone levels.
In some cases, your care provider might suggest that you go to a urologist or a mental health provider who specializes in sexual problems.
Common treatment options for premature ejaculation include behavioral techniques, medications and counseling. It might take time to find the treatment or combination of treatments that work for you. Behavioral treatment plus drug therapy might be the most effective.
In some cases, therapy for premature ejaculation involves simple steps. They may include masturbating an hour or two before intercourse. This may allow you to delay ejaculation when you have sex with your partner.
Your care provider might recommend avoiding intercourse for a period of time. Focusing on other types of sexual play may remove the pressure you might feel during sexual intercourse.
The pelvic floor muscles support the bladder and bowel and affect sexual function. Kegel exercises can help strengthen these muscles.
Weak pelvic floor muscles might make it harder to delay ejaculation. Pelvic floor exercises (Kegel exercises) can help strengthen these muscles.
Your health care provider might instruct you and your partner to use the pause-squeeze technique. This method works as follows:
By repeating as many times as needed, you can reach the point of entering your partner without ejaculating. After some practice, delaying ejaculation might become a habit that no longer requires the pause-squeeze technique.
If the pause-squeeze technique causes pain or discomfort, you can try the stop-start technique. It involves stopping sexual stimulation just before ejaculation. Then waiting until the level of arousal has diminished and starting again.
Condoms might make the penis less sensitive, which can help delay ejaculation. Specially designed "climax control" condoms are available without a prescription. These condoms contain numbing agents such as benzocaine or lidocaine to delay ejaculation. They might also be made of thicker latex. Examples include Trojan Extended Pleasure and Durex Prolong.
Creams, gels and sprays that contain a numbing agent — such as benzocaine, lidocaine or prilocaine — are sometimes used to treat premature ejaculation. They're applied to the penis 10 to 15 minutes before sex to reduce sensation and help delay ejaculation. They're available without a prescription. However, a cream containing both lidocaine and prilocaine (EMLA) is available by prescription.
Although topical numbing agents are effective and well tolerated, they have potential side effects. They may cause decreased feeling and sexual pleasure in both partners.
Many medications might delay orgasm. These drugs aren't approved by the Food and Drug Administration to treat premature ejaculation, but some are used for this purpose. They include antidepressants, pain relievers and drugs for erectile dysfunction.
These medications might be prescribed for either on-demand or daily use. Also, they may be prescribed alone or with other treatments.
Antidepressants. A side effect of certain antidepressants is delayed orgasm. For this reason, selective serotonin reuptake inhibitors (SSRIs) are used to treat premature ejaculation. SSRI s include paroxetine (Paxil, Pexeva, Brisdelle), escitalopram (Lexapro), citalopram (Celexa), sertraline (Zoloft) or fluoxetine (Prozac).
The SSRI dapoxetine is often used as the first treatment for premature ejaculation in some countries. It's not currently available in the United States.
Of the drugs approved for use in the United States, paroxetine seems to be the most effective. These medications usually take 5 to 10 days to begin working. But it might take 2 to 3 weeks of treatment to see the full effect.
If SSRI s don't improve the timing of your ejaculation, your health care provider might prescribe the tricyclic antidepressant clomipramine (Anafranil). Side effects of antidepressants might include nausea, perspiration, drowsiness and decreased sex drive.
Pain relievers. Tramadol (Ultram, Conzip, Qdolo) is a medication used to treat pain. It also has side effects that delay ejaculation. Tramadol might be prescribed when SSRI s haven't been effective. Tramadol can't be used in combination with an SSRI .
Side effects might include nausea, headache, sleepiness and dizziness. Tramadol can become habit-forming when taken long-term.
Research suggests that several drugs might be helpful in treating premature ejaculation. But more study is needed. These drugs include:
This approach involves talking with a mental health provider about your relationships and experiences. Sessions can help you reduce performance anxiety and find better ways of coping with stress. Counseling is most likely to help when it's used in combination with drug therapy.
With premature ejaculation, you might feel that you lose some of the closeness shared with a sexual partner. You might feel angry, ashamed and upset, and turn away from your partner.
Your partner also might be upset with the change in sexual intimacy. Premature ejaculation can cause partners to feel less connected or hurt. Talking about the problem is an important step. Relationship counseling or sex therapy also might be helpful.
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Several alternative medicine treatments have been studied, including yoga, meditation and acupuncture. However, more research is needed to determine their effectiveness.
It's typical to feel embarrassed when talking about sexual problems. But you can trust that your health care provider has had similar conversations with many others. Premature ejaculation is a very common condition. And it's one that can be treated.
Being ready to talk about premature ejaculation will help you get the treatment you need to put your sex life back on track. The information below should help you prepare to make the most of your appointment.
The list below suggests questions to ask your health care provider about premature ejaculation. Don't hesitate to ask more questions during your appointment.
Your health care provider might ask very personal questions and might also want to talk to your partner. To help your provider determine the cause of your problem and the best course of treatment, be ready to answer questions, such as:
Deciding to talk with your health care provider is an important step. In the meantime, consider exploring other ways in which you and your partner can connect. Although premature ejaculation can cause strain and anxiety in a relationship, it is a treatable condition.
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Premature ejaculation occurs when a man has an orgasm and ejaculates earlier during intercourse than he or his partner would like. It’s a common problem, affecting 30% to 40% of men. Causes include physical problems, chemical imbalances and emotional/psychological factors. Treatments include learning techniques to delay ejaculation, counseling and medications.

American Urological Association. Urology Care Foundation. Premature Ejaculation. (https://www.urologyhealth.org/educational-materials/premature-ejaculation-x2949) Accessed 8/4/2020.
American Academy of Family Physicians. Familydoctor.org. Premature Ejaculation. (https://familydoctor.org/condition/premature-ejaculation/) Accessed 8/4/2020.
American Urological Association. Premature ejaculation. (https://www.auanet.org/education/guidelines/premature-ejaculation.cfm) Accessed 8/4/2020.
Merck Manual Consumer Version. Premature Ejaculation. (https://www.merckmanuals.com/home/men-s-health-issues/sexual-dysfunction-in-men/premature-ejaculation?query=premature%20ejaculation) Accessed 8/4/2020.
Sexual Medicine Society of North America. Conditions: Premature Ejaculation. (https://www.sexhealthmatters.org/premature-ejaculation) Accessed 8/4/2020.
Crowdis M, Nazir S. Premature Ejaculation. (https://www.statpearls.com/as/genitourinary/27656/) StatPearls. Accessed 8/4/2020.
American Psychiatric Association. DSM-5. Premature (Early) Ejaculation. Accessed 8/4/2020.

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Premature ejaculation is a type of sexual dysfunction that occurs when a man has an orgasm and releases (ejaculates) semen sooner than he or his partner would like. It often happens before or shortly after penetration during intercourse. Premature ejaculation can be a frustrating experience for both you and your sexual partner and makes your sex lives less enjoyable. However, the good news is that it’s usually fixable!

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Between 30% and 40% of men experience premature ejaculation at some point in their life. According to the American Urological Association, premature ejaculation is the most common type of sexual dysfunction in men. About one in five men between the ages of 18 and 59 report incidences of premature ejaculation.
Although the definition of premature ejaculation varies, the American Urological Association defines ejaculation as “premature” if it occurs sooner than desired, either before or shortly after penetration, causing distress to either one or both partners. The American Psychiatric Association defines three levels of severity (mild, moderate, severe), based on time to ejaculation, with mild being under one minute. If pressed for a time frame, many doctors would define prematurity as ejaculation within a minute of beginning intercourse. Despite professional opinions, your feelings as to what is premature are also considered.
Physical, chemical and emotional/psychological factors cause premature ejaculation.
Physical and chemical problems include:
Emotional or psychological causes include:
No. The only symptom of premature ejaculation is the condition itself.
If you have frequent premature ejaculations, or if premature ejaculation is causing you anxiety or depression and affecting your relationship, make an appointment to see a urologist.
Your urologist will begin an exam by asking about your sexual experiences. You will likely be asked:
While the questions are personal, it is important that you answer your urologist honestly so they can best diagnose the source of your problem.
Your urologist will also ask about any other medical conditions you may have and any medications including over-the-counter medications, supplements and herbal products you are taking. You will also be asked about any alcohol and illegal drug use.
Lab tests are usually not needed unless your healthcare provider suspects that an underlying health problem is contributing to the problem.
There are many different treatments options for premature ejaculation depending on the cause. These include behavioral therapy, counseling and medications. Most causes of premature ejaculation are usually treated first with behavior therapy and/or counseling to help with emotional concerns, performance anxiety or stressors that may be contributing. Often more than one treatment approach may be tried at the same time.
Behavioral therapy involves trying different methods to delay your orgasm. Its goal is to teach you how to control your body and your feelings. Methods include:
If the cause of your premature ejaculation is psychological, emotional, or due to relationship issues – due to performance anxiety, depression, stress, guilt, or a troubled relationship – seek the help of a psychologist, psychiatrist, couples therapist or sex therapist. Your urologist can help direct you to these health professionals.
Several types of medications may be tried.
Antidepressants, especially selective serotonin reuptake inhibitors like citalopram (Celexa®), escitalopram (Lexapro®), fluoxetine (Prozac®), paroxetine (Paxil®) and sertraline (Zoloft®) or the tricyclic antidepressant clomipramine (Anafranil®), can help delay premature ejaculation. This is an “off-label” use (not approved by the Food and Drug Administration for this use). Be sure to discuss the side effects of this medication with your urologist to be sure it’s appropriate for you.
Anesthetic (numbing) creams and sprays applied to the head and shaft of the penis is another medication option to delay ejaculation. The anesthetic cream or spray is applied to the penis, absorbed for 10 to 30 minutes or until you feel less sensitivity in your penis. It’s important to wash your penis before sex to prevent numbness to your partner’s vagina or loss of your erection.
Erectile dysfunction medications, which include sildenafil (Viagra®), tadalafil (Cialis®), vardenafil (Levitra®) and Avanafil (Stendra®), have also been used to treat premature ejaculation, particularly in men with underlying erectile dysfunction.
Lab tests are usually not needed unless your healthcare provider suspects that an underlying health problem is contributing to the problem.
Yes, you likely can! By following the techniques described in this article to delay ejaculation, taking any prescribed medications, and seeking counseling if needed, premature ejaculation can become a problem of your past.
There are several treatment methods that can help prevent premature ejaculation. By involving your partner and seeing the appropriate healthcare professionals – a urologist for initial assessment plus other health care professionals (psychologists, psychiatrists, counselors) as needed for underlying contributing problems, you will likely be able to control your ejaculation and enjoy your sex life once again.
Yes. Wearing a condom can decrease sensitivity to your penis and help delay ejaculation.
Premature ejaculation itself is not harmful but other health problems may contribute to the development of premature ejaculation. These health problems include:
If you have erectile dysfunction, you can’t attain or maintain your erection. If you have premature ejaculation, you have an erection but you reach orgasm and ejaculate earlier than you or your partner would have liked.
However, erectile dysfunction can actually lead to the development of premature ejaculation. This happens when a man knows his ability to sustain an erection is poor, so he develops the habit of ejaculating soon after erection before he loses his erection.
Because of this connection between these two conditions, your urology will want to figure out if you have erectile dysfunction and, if so, treat that first.
While it’s true that drinking alcohol can delay orgasm, it’s not a treatment for premature ejaculation.
Your urologist and team of healthcare providers will come up with a plan to treat your premature ejaculation. Premature ejaculation i
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