Premature Ejaculation

What is Premature Ejaculation?

Premature ejaculation (PE) occurs when a man has an orgasm and ejaculates soon after sexual activity begins. In essence, it’s the inability to delay an orgasm. Not to be confused with retrograde ejaculation, when semen enters your bladder instead of exiting through your penis, for most men, PE generally occurs after little physical stimulation. Most often, in instances of PE, ejaculation occurs before a man wants it to. PE is sometimes called rapid ejaculation, early ejaculation, or premature climaxing. It’s not uncommon, and it affects almost all men at some point in their lives.

Premature Ejaculation
Early ejaculation is the most common sexual dysfunction complaint for men, affecting 20-30 percent of all men, regardless of age or where they live (Journal of Sexual Medicine, 2014). The definition of premature ejaculation has evolved over the years.

  • In the 1950s – PE was defined as the inability to control ejaculation and the inability to satisfy the partner at least 50 percent of the time.
  • In 2000 – the definition changed to ejaculation with minimal stimulation before or shortly after penetration.
  • In 2001 – the definition was again altered, this time to simply ejaculation before penetration.
  • In 2004 – it was decided that PE should be defined as ejaculation soon after intercourse, about 15 seconds or so.
  • In 2008 – PE was yet again redefined, this time to ejaculation within about a minute of penetration.
  • In 2014 – The International Society of Sexual Medicine released new comprehensive definitions of Premature Ejaculation, outlining the requirements for diagnosis which are below.

Beyond the actual definition, The International Society for Sexual Medicine panel also concluded that there should be 3 components present for a PE diagnosis to be accurately made.

  1. Time from vaginal penetration to ejaculation
  2. The inability to delay ejaculation on all or nearly all vaginal penetrations
  3. A result of negative personal consequences such as distress, bother, frustration, and avoidance of sexual encounters

Currently, the most accepted definition of Premature Ejaculation is ejaculation prior to when a man wishes and which is out of his control. No longer is a man identified as a premature ejaculator only if he ejaculates within a specific time (e.g. 1 minute) of vaginal penetration. Some men may last much longer than 1 or 2 minutes, but still wish they could control their orgasm better and have their ultimate finish time be closer to their partner's.

If you are experiencing premature ejaculation, there is hope. The great news is that Promescent is effective for anyone who wants to take control of their ejaculatory dysfunction and, ultimately, last longer in bed.

No matter how long you currently last before ejaculation, Promescent users can experiment with the perfect dose to overcome premature ejaculation and last longer, creating an exciting new dynamic in the bedroom.

Symptoms

Before we can address the symptoms of PE, we should first define a commonly-used term related to premature ejaculation - the "intravaginal ejaculatory latency time" or IELT. IELT is the time from initial penetration to ejaculation, or, in more general terms, the length of time that sexual intercourse lasts.

Although IELT is important for most men, the primary symptoms of premature ejaculation are the inability to control orgasm and disappointment in sexual performance.

Note that both premature ejaculation and erectile dysfunction result in the loss of an erection. Erectile dysfunction (ED) is sometimes confused with premature ejaculation, but in cases of premature ejaculation, the loss of erection always occurs after ejaculation. In contrast, ED involves a loss of erection that may occur at any time during sexual activity. Some men attempt to treat PE with very aggressive ED treatments which can help a man maintain an erection after ejaculation.

Types

Premature ejaculation can be divided into four sub-types:

  • Lifelong Premature Ejaculation (primary)
    • characterized by having symptoms during your entire sexual life
    • occurs during all or nearly all sexual encounters
    • typically begins the first time sex is experienced
    • consistent IELT of approximately one minute or less
  • Acquired Premature Ejaculation (secondary)
    • characterized by acquiring symptoms later in your sexual life
    • generally develops after a previous sexual experience or experiences that have not included a problem with ejaculatory function
    • consistent IELT approximately three minutes or less
  • Variable Premature Ejaculation
    • Sometimes referred to as natural variable premature ejaculation - periods of rapid ejaculation in addition to periods of normal ejaculatory control.
  • Subjective Premature Ejaculation
    • characterized by symptoms of normal IELT accompanied by sexual dissatisfaction with the length of time of sexual intercourse

Causes of Premature Ejaculation

Understanding what causes premature ejaculation is a primary concern for most men suffering from PE.

Ejaculation is a function of the nervous system. It involves the brain, spinal cord, and genital nerves. Although the euphoria of orgasm occurs in the brain, ejaculation is actually a spinal reflex, and can occur even without the brain's involvement. Despite this, the connection between the brain and penis is still important for successful ejaculation.

Most men can sense their bodies starting to prepare for orgasm, and if wanted, they can slow or stop sexual stimulation prior to having an orgasm (this is one way to deal with PE, known as the start-stop technique – we’ll go into further detail about the method below). While it may delay ejaculation, it can be a frustrating tactic for both partners.

The male reproductive system is quite complex, which is one of the reasons the exact cause of PE is not known. Although Premature Ejaculation often decreases a man's sexual confidence, and psychological therapy is often recommended, most physicians now think that psychological issues are rarely an actual cause of PE.

Rather, experts now believe what causes premature ejaculation in males can be linked to neuro-biological issues. The most common premature ejaculation causes cited by medical professionals and literature are:

  • High penile sensitivity
  • A serotonin deficiency in the brain
  • Elevated oxytocin levels in the blood

Additionally, there are several less common biological causes of PE, including hyperthyroidism and prostatitis.

Treating Premature Ejaculation

Men suffering from Premature Ejaculation are often desperate to find help or a cure. They will try almost anything. Most treatment methods focus on either the brain or the penis. There are also oral medications that alter brain chemistry to delay premature ejaculation, as well as topical desensitizers that can increase time to ejaculation.

Early Ejaculation
Unfortunately, there are also a plethora of home remedies out there claiming to treat premature ejaculation that, for most men, simply don’t work.

While the medical community is still debating the role of penis sensitivity in premature ejaculation, the American Urological Association now includes topical anesthetics, such as Promescent, as an accepted course of treatment for an oversensitive penis – in essence, they’ve recognized these topicals as a valid treatment of premature ejaculation.

These medications typically come in the form of a spray or cream, and they’re simply applied to the penis prior to sexual activity. They work by desensitizing the penis, which in turn enables men to delay ejaculation.

The most common anesthetic for PE topical medications is lidocaine, although benzocaine and prilocaine are also used as well. Topical anesthetics have the possible side effect of diminished sexual pleasure for both the man and his partner. However, a new class of topical anesthetics with absorption technology is proving to greatly decrease these side effects.

Promescent, with TargetZone™ technology, is a topical delay spray that provides ejaculation control with minimal loss of sensitivity.

Another common type of medication often used for premature ejaculation treatment is antidepressants in the form of Selective Serotonin Reuptake Inhibitors (SSRIs). SSRIs are oral drugs that have a side effect of delaying ejaculation. It’s important to understand that SSRIs often have numerous additional negative side effects as well, including:

  • Nausea
  • Headaches
  • Loss of libido

There are several ways to treat PE. We’ve compiled a list of treatment options below.

Start-Stop Method and Squeeze Technique

Treatment of premature ejaculation sometimes starts with behavioral therapy, including the stop-start technique or the squeeze method. Although men report that these methods can delay ejaculation, their overall sexual satisfaction reportedly does not improve significantly.

Kegel and Pelvic Floor Exercises

Kegel exercises, also commonly known as floor exercises, are a method use to strengthen pelvic floor muscles by squeezing the pubococcygeus muscle. Created by Dr. Arnold Kegel in the 1940s, they’re primarily used by women for improved urinary control. Some doctors think Kegel exercises can also be used by men to obtain improved bladder control, which may help with PE. In spite of the numerous premature ejaculation videos and blogs touting Kegel training for PE, there is no clinical evidence to back up claims of improvement.

Topical Anesthetics

Topical anesthetics like sprays and creams have proven both effective and popular with men suffering from PE. They have no major side effects and are easy-to-use.

Premature Ejaculation Pills

Herbal pills and pharmaceutical pills are both potential treatments for PE. However, herbal pills have not been proven to help PE. And while pharmaceutical pills may be effective at delaying climax, men should be aware of the potential side effects, which in some cases may be worse than the actual issue.

Promescent Delay Spray

Delay sprays, creams, gels, and wipes, also called male desensitizers and penis desensitizers, are widely available. There are more than 100 of them readily available on the market, and while affordable and effective, some forms are less desirable than others, as side effects can include loss of sensation and transference to your partner. You can read more and compare the options here.

Common Myths About Premature Ejaculation

There are many common myths about premature ejaculation. Largely due to its complex nature, PE - and ejaculation in general - is not totally understood, even in the medical community. As a result, there are numerous misconceptions and myths about PE that are either not true, or that have not been backed by scientific evidence. If you’re researching PE, be sure to look for studies that have been ethically conducted – a general rule of thumb is to look for studies that are published in medical journals, particularly the Journal of Sexual Medicine and the Journal of Impotence Research, which are considered the “gold standard” of studies.

Myth #1 – PE is for Young Men Only

Premature Ejaculation Statistics

Data from the Journal of Sexual Medicine shows roughly equal prevalence by age among sexually active men. Additionally, based on a random survey, our own data (see pie chart) shows that the age of our customers actually doesn’t skew towards young men.

Myth #2 – The Cause of PE is Primarily Psychological

The myth that PE is caused by a psychological factor, or results from performance anxiety, has been around as long as anyone can remember. Despite the belief, there has never been a legitimate medical study that proves any psychological origins of premature ejaculation. What the medical studies have suggested is that PE is caused by one of two common neuro-biological conditions:

  1. Higher than normal penis sensitivity, or
  2. Reduced serotonin levels in the brain, which is why selective serotonin reuptake inhibitors like Priligy (Dapoxetine) work for some men suffering from premature ejaculation.

Myth #3 – Uncircumcised Men Have Higher Rates of PE

It’s long been thought that men who are circumcised at birth have their penis exposed to constant rubbing against undergarments, slowly decreasing penile sensitivity and decreasing the likelihood of having PE. However, this theory is largely discounted when you look at the data. Countries like the United States, where circumcision is common, don’t actually have different rates of PE than countries with low rates of circumcision, such as parts of Holland and Belgium, even when the cultures and religions are similar.

Additional Resources

Independent Medical Information about Premature Ejaculation

Websites with Medical Information about Men's Sexual Health Including PE

Medical Journals, Articles, Blogs

  • Journal of Men's Health
  • Journal of Sexual Medicine
  • Paddy K.C. Janssen, et al, Serotonin transporter promoter region (5-HTTLPR) polymorphism is associated with the intravaginal ejaculation latency time in Dutch men with lifelong premature ejaculation. J Sex Med 2009; 6:276-284.
  • Science Daily Article: Premature ejaculation? Not your fault. Gene determines rapidity of ejaculation in men, Read more
  • National Institute of Health, Dapoxetine. Premature Ejaculation: Not worth the Risk, Read more

FAQs

FAQ

How common is premature ejaculation? Who is affected by it?

Approximately 30% of men have PE – that’s almost ⅓ of the male population! Some have it for the duration of their lives and others only temporarily. PE occurs across people of all ages and ethnic backgrounds, and it's nothing to be embarrassed about.

I deal with early ejaculation – is it all in my head? Should I think about baseball, or math, or anything other than sex, during sex?

Men naturally climax faster than women, so in the past, you had to think about anything but sex just to last longer – but that is not how great sex happens. With Promescent, you can leave your math exercises behind and focus on making great sex last longer while avoiding ejaculating too quickly. This video explains the "Orgasm-Gap".

I’ve heard of doing Kegel exercises to control ejaculation. Should I do them while using Promescent?

The theory is that Kegel exercises help give you control over ejaculation, so it wouldn’t hurt to use Kegels as an additional practice to help you last longer. Of course, with the right dosage, Promescent allows you to focus on lovemaking, so you can forget about that Kegel workout, and have better sex!

What about the Start-Stop Method? The Squeeze Technique? The Valsalva Maneuver?

All these are methods to aid in the prevention of PE, and many claim they are effective, but they all have one thing in common. They are all designed to interrupt the natural flow of great sex. The beauty of Promescent is that it’s designed to allow you to put these techniques to the side, and focus on making your lovemaking more intense and pleasurable without worrying about using one of the above techniques. With Promescent, you can leave the start-stop for rush-hour traffic.

Does circumcision have an effect on PE?

In short, there is no data which shows circumcision has an effect on PE. A few studies claim circumcision lowers the incidence of PE, simply because the head of the penis is less sensitive. But, to date, no substantial proof has been cited. Promescent is effective whether you are circumcised or not. In fact, you can adjust dosage depending on your sensitivity level.

Do low testosterone levels effect PE?

There is no correlation between low testosterone and PE. There is strong data which supports this. Unfortunately, as men get older, testosterone levels drop naturally, and with that, a lower sex drive is usually not far behind, but there’s always a dirty old man in all of us.