Premature Ejaculation Treatment

Premature ejaculation is a pathological condition in which a man cannot control the level of sexual arousal, causing ejaculation to occur before the start of intercourse or immediately after.

It is considered that the normal duration of sexual intercourse is about 8 minutes. If ejaculation occurs within the first 2 minutes or before engaging in intimacy, this is classified as premature ejaculation. According to statistics, around 60% of men face this issue from time to time or live with it their entire lives, yet only a few seek medical help.

The main causes of premature ejaculation include:

• Prolonged absence of sexual activity;

• Anxiety or emotional discomfort during intimacy;

• Psychological blockages or fears (for example, fear of infection or of not meeting expectations);

• Increased sensitivity of the glans penis;

• Spinal cord or head injuries;

• Infectious diseases;

• Inflammation in the genitourinary system;

• Endocrine disorders;

• Malignant tumors;

• Bad habits;

• Constant stress.

There are two types of premature ejaculation:

• Primary – a congenital condition that manifests from the first sexual experience. It may be caused by dysfunction of the nerve centers responsible for ejaculation control, as well as abnormalities in the development of sexual organs or birth injuries.

• Secondary – occurs due to or after trauma to the groin area, infectious and inflammatory diseases of the genitourinary system, or the use of certain medications. If a man already has sexual experience and a developed normal ejaculatory reflex, it can be restored after therapy.

Although the problem may seem obvious when a patient consults a urologist, a precise diagnosis requires examination. During the consultation, the doctor will ask about symptoms, lifestyle factors, and the presence of chronic illnesses, and if necessary, will perform a physical exam and recommend diagnostic procedures.

To make a diagnosis, the following tests may be conducted:

• Laboratory analyses;

• Biotensiometry;

• Vasoactive test;

• Doppler ultrasound;

• Ultrasound of the prostate gland.

These examinations help determine the cause of premature ejaculation and select the appropriate treatment method.

The treatment method depends primarily on the causes of premature ejaculation. In some cases, these lie in psychological factors and require working with a therapist. In others, anatomical features are the cause, which can only be corrected surgically. An examination is necessary to establish an accurate diagnosis.

Treatment of premature ejaculation includes:

• Thorough assessment of physical health and psychological state;

• Identification of the underlying cause;

• Development of a personalized treatment plan;

• Psychotherapy and training in techniques to control sexual arousal;

• Lifestyle modification (nutrition, physical activity, etc.);

• Medication if inflammation, infections, or endocrine disorders are detected;

• Denervation of the glans penis.

In most cases, the issue can be resolved with medication and/or psychotherapy and training in ejaculation control techniques.

Surgical treatment is used only when there are congenital anatomical features. For example, a short frenulum or increased sensitivity of the glans penis. In the first case, plastic correction is performed; in the second – denervation (nerve severing), which reduces sensitivity. These procedures are carried out using minimally invasive methods, which minimize trauma to healthy tissues and ensure a short recovery period.

Premature ejaculation is a condition in which a man cannot sufficiently control ejaculation, causing it to occur before the start of sexual intercourse or immediately after it begins.

According to International Society for Sexual Medicine (ISSM), the average time to ejaculation during sexual intercourse is about 5–6 minutes. If it consistently occurs within approximately 1 minute or significantly earlier than the man or couple expect, this may indicate premature ejaculation. According to the results of various studies, about 30% of men face this problem, but only some of them seek medical help.

At the “Oxford Medical” medical center, you can receive a consultation with an experienced urologist who will help determine the cause of the disorder and select individual treatment to improve control over ejaculation. Depending on the cause, medication therapy, topical agents, behavioral methods, and surgical treatment of premature ejaculation may be used. To make an appointment for a consultation, use the online appointment form on the website or contact the contact center administrators.

There are two types of premature ejaculation:

1. Primary — is a congenital condition and manifests from the beginning of sexual life. It is associated with the characteristics of the nervous system that controls the ejaculation process.
2. Secondary (acquired) — occurs after a period of normal sexual function. If a man has already developed normal control over ejaculation, then after eliminating the cause and undergoing treatment, it can often be restored.

Determining the type of disorder is an important stage of diagnosis, since the choice of treatment tactics and the prognosis of its effectiveness depend on it.

The main causes of rapid ejaculation:

• a prolonged break in sexual activity;
• anxiety or emotional discomfort during intimacy;
• psychological blocks or fears (for example, fear of failure or of not meeting the partner's expectations);
• increased sensitivity of the glans penis;
• short frenulum of the penis;
• injuries to the brain or spinal cord;
• infectious and inflammatory diseases of the genitourinary system;
• endocrine disorders;
• constant stress and harmful habits.

According to International Society for Sexual Medicine (ISSM), rapid ejaculation can have both psychological and physiological causes. That is why during the examination it is important not only to confirm the presence of the disorder, but also to determine the factors that caused it.

Doctors at “Oxford Medical” emphasize that the effectiveness of treatment largely depends on correctly determining the cause of the disorder. Eliminating the underlying disease or provoking factor often makes it possible to significantly improve control over ejaculation.

Diagnosis begins with a consultation, during which the urologist asks in detail about the symptoms, the time when the problem appeared, the characteristics of sexual life, previous diseases, and the use of medications. After this, the doctor performs an examination and, if necessary, prescribes additional tests.

Depending on the clinical situation, the following may be recommended:

• laboratory tests to assess the level of sex hormones, thyroid function, or detect inflammatory processes;
• ultrasound of the prostate gland;
• other examinations — as indicated.

A comprehensive examination helps determine the cause of the disorder, rule out concomitant diseases, and select the most effective treatment method.

The treatment method depends mainly on the causes that provoke early ejaculation. In some cases, they are associated with psychological factors and require work with a psychologist or psychotherapist. In others, the cause may be anatomical features, for the correction of which surgical treatment may be recommended.

Modern methods of treating premature ejaculation:

• psychotherapy and training in techniques for controlling ejaculation;
• treatment of the underlying disease, if it was the cause of the disorder;
• medications and topical agents to improve control over ejaculation;
• surgical treatment.

In most cases, rapid ejaculation can be treated without surgery — with the help of medication therapy, psychotherapy, and training in techniques for controlling ejaculation.

Surgical treatment is used when the cause of the disorder is anatomical features. This may be, for example, a short frenulum or increased sensitivity of the glans penis. In the first case, frenuloplasty is performed, and in the second — denervation of the glans, which makes it possible to reduce its sensitivity. The operations are performed using minimally invasive methods, which ensures minimal tissue trauma and a short rehabilitation period.

For the prevention of early ejaculation, it is recommended to:

• maintain a healthy lifestyle;
• quit smoking and limit alcohol consumption;
• treat urological, endocrine, and other diseases in a timely manner;
• eat a balanced diet;
• maintain regular physical activity;
• control stress levels;
• have a regular sex life;
• undergo a preventive examination by a urologist every year.

Doctors at “Oxford Medical” recommend consulting a urologist if episodes of premature ejaculation recur regularly or begin to negatively affect intimate life. Rapid ejaculation in men is often a consequence of diseases or other disorders that require treatment, so timely diagnosis helps resolve the problem more quickly.