Understanding Premature Ejaculation

Uncontrollable ejaculation / premature ejaculation (PE) is also known as rapid ejaculation, premature climax or early ejaculation. PE is a very common male sexual disorder. On average, it affects about one in three men aged 18 to 59 years. It is characterized by a lack of voluntary control over ejaculation. Many men occasionally ejaculate sooner than they or their partners would like during sexual activities. They may ejaculate with minimal sexual stimulation before, on or shortly after penetration.  

Uncontrollable ejaculation / PE can be a very disturbing problem in sexual life; it affects not only the patient, but also his partner and their sexual relationship.

Uncontrollable ejaculation / PE is classified into two types. They are:

  • Primary PE – A man has been suffering from uncontrollable ejaculation / PE ever since he has been sexually active.
  • Secondary PE – A man has begun to suffer from uncontrollable ejaculation / PE later in his sexually active life.
Causes of Premature Ejaculation

The causes of uncontrollable ejaculation / PE can be physical or psychological. A combination of both may act in patients already developed a tendency to ejaculate early.

Possible Physical Causes:

  • Oversensitivity on glans
  • Insufficient rigidity / ED
  • Diabetes
  • Redundant prepuce
  • Nervous system disorders
  • Inflammation involved the genital organs, e.g., prostate infection
  • Abdominal trauma

Possible Psychological Causes:

  • Marital and relationship problems with partner
  • Performance anxiety, especially to new partner
  • Fear (associated with concerns regarding getting caught or discovered, sexually transmitted diseases or potential pregnancy)
  • Guilt (believing the activity is sinful e.g., premarital or extramarital sex)
  • Wrong perception of sex

Other Possible Causes

  • Bad masturbation techniques
  • Drugs
  • Infrequent sexual activity

 

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Consequences

Uncontrollable / premature ejaculation has profound impact on a person’s quality of life. It does not only mean a loss of sexual satisfaction, but also creates adverse effects on intimate relationships. An unsatisfying sex life could cause feelings of inferiority and lead to questioning of one’s manliness. This may also lead to social inhibition and poor self-image. Instead of finding cure to the problem, most people try to cover up their conditions. They may avoid sexual contact with their partners and this leads to marriage breakdown eventually.

It is always wise to consult a doctor immediately once the problem is discovered. Discussing the problem with and gaining support from partner are crucial, as partner’s involvement would definitely help the progress of the treatment.

Treatment

The ultimate goal of the uncontrollable ejaculation / PE treatment is to help both patients and their partners to regain sexual satisfaction. We focus on a curative approach rather than just treating patients’ symptoms. This way, patients do not have to rely on life-long medications when dealing with such problem. Effective treatments allow patients to gain a better control over the time of ejaculation. Patients will overcome both sensitivity issues and performance anxiety gradually. After treatments, most patients are able to control ejaculation on their own and no further treatment is needed.

There are numerous ways to treat PE, some common and effective methods include Trimix Therapy, Oral Medication and Counseling (Sex Therapy)

 

1) Trimix Therapy

Trimix Therapy, a mixture of 3 registered and recognized vasoactive agents, was first introduced in early 1980s and has been widely used by doctors around the USA, Europe, Latin America, Australia for decades. In Hong Kong, the therapy has been practiced by doctors since 2004. The efficacy and tolerability of Trimix Therapy is clinically proven by hospitals and universities worldwide. 

Unlike the over-the-counter-drugs, “3P” medications are required to be prescribed by a registered doctor. To determine the most suitable dosage, the doctor will conduct relevant tests to evaluate patients’ blood flows and the nerve systems.

Trimix, a medical therapy traditionally used for erectile dysfunction, along with desensitizing techniques, can also be effective in the treatment of uncontrollable / premature ejaculation. Trimix is a mixture of 3 registered and recognized vasoactive agents that will help a man achieve an erection within 8-10 minutes. The duration of erection varies from approximately a half hour up to two hours (depends on the dosage prescribed by doctor and the patient’s reaction to the medication). This allows the man to continue the intercourse process without losing his erection even after ejaculation, lengthening the intercourse process. By continuing to have intercourse the patient is actually desensitizing the head of his penis, building patients’ confidence and reducing psychological burden, while meeting the sexual needs of himself and his partner. Trimix Therapy has dramatically improved the sexual performance of men with PE and their relationship with partner.

Details on Trimix Therapy:Trimix Therapy

 

2) Oral Medication

Our Center provides oral medication for the treatment of uncontrollable / premature ejaculation in men between 18 to 64 years old[1]. Oral medication delays ejaculation by inhibiting the serotonin transporter and increasing serotonin’s action at the post synaptic cleft[2]. 

Details on Oral Medication for Premature Ejaculation: Oral Medication

 

Other Methods include: 

Method

Concept

Stop and Start Method /
Squeeze Method
Pausing in the middle of sexual stimulation, allows men to identify the point of climax and control ejaculation. Thus improve the interaction between partners
Biofeedback Therapy Contracting the pelvic floor muscles for variable time intervals (e.g. 10 seconds) during urination, enables men to become aware of the muscles that control ejaculation with the use of “Kegel exercises”
Sex Positions Different sex positions can affect men’s ability to control their ejaculation

“man-on-top” position” : more difficult for men to control the timing of ejaculation since they have to hold themselves up

“woman-on-top” position” : more relaxing for men and enables them to control ejaculation

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