Premature ejaculation (PE) is considered the most common sexual dysfunction in men, affecting approximately 30% of all males. However, in the past, the definition of PE has not been consistent, and it has changed over time. This has caused confusion, even within the medical community and urologists. Recent definitions of lifelong and acquired PE have somewhat helped to clarify diagnoses for physicians, but it remains difficult for men with PE concerns to address their needs. Our intention here is to help stop PE and to simplify the new definitions so that men can better determine if they should visit their physician or possibly seek over-the-counter medication for treatment.
Professor and Dr. Marcel D. Waldinger (MD, PhD), a neuropsychiatrist and Professor in Sexual Psychopharmacology in the Department of Pharmaceutical Sciences at the University of Utrecht, in the Netherlands, has published extensively about PE. He’s often credited for the transition of PE being thought of as a psychosomatic disorder to a neurobiological one.
Professor Waldinger published the following table in Premature Ejaculation - From Etiology to Diagnosis and Treatment (2013) which illuminates the shift in thinking towards neurobiological origins. As the definition and our understanding of PE has changed over time, so too has the approach on how to treat premature ejaculation.
|Authors||Postulated Etiology and Pathogenesis of PE||Advocated Treatment of PE|
|1917||Karl Abraham||PE is a neurosis, linked to unconscious conflicts||Psycho-analysis and psycho-analytic therapy.|
|1943||Bernhard Schapiro||PE is a psychosomatic disorder, linked to a weak genital system. There are two PE subtypes.||Topical anesthetic creams.|
|1970||William Masters and Virginia Johnson||PE is a behavioral disorder, linked to self-learned behavior.||Behavioral treatment (squeeze technique).|
|1998||Marcel Waldinger||Lifelong PE is a neurobiological-genetic disorder, linked to central serotonin neurotransmission dysfunctions. There are four PE subtypes (2006)||Selective serotonin reuptake inhibitors (SSRIs)|
The following table provides more recent definitions of PE used by urologists and psychiatrists worldwide, although you’ll note it’s still largely from a psychiatric orientation.
|1980||DSM-III||Ejaculation occurs before the individual wishes it, because of recurrent and persistent absence of reasonable voluntary control of ejaculation and orgasm during sexual activity.|
|1987||DSM-III-R||Persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it.|
|1994||DSM-IV||Persistent or recurrent onset of orgasm and ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it and must also cause marked distress or interpersonal difficulty.|
|2000||DSM-IV-TR||Persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it. The clinician must take into account factors that affect duration of the excitement phase, such as age, novelty of the sexual partner or situation, and recent frequency of sexual activity.|
|2013||DSM-V||Similar to IV-TR with the added contraint: "ejaculation must occur within approximately one minute following vaginal penetration"|
A major concern among experts with the DSM definitions of PE is that they’re all authority-based rather than evidence-based. As a result, in 2007, the International Society for Sexual Medicine (ISSM) appointed several international experts in PE to an Ad Hoc Committee for the Definition of PE. In 2014, the committee released a new evidence-based definition of PE.
While the definition and treatment recommendations have changed over time, one thing that has remained consistent over the last several years is how effective Promescent is. Our proprietary, patented formula is a top-selling premature ejaculation treatment, endorsed by both urologists and sex therapists. With backing like that, you can trust you’re in good hands.
We live in a day and age of information that’s available 24/7, so it can be tempting to do your own online research, particularly when you’re experiencing something as personal and sensitive as premature ejaculation. But it’s always best to see your doctor for any sudden or persistent changes that occur when it comes to your sexual function. There may be medical conditions responsible for these changes, and sometimes these conditions can be efficiently and effectively treated.
You may want to see your primary care physician or a urologist if you’ve recently experienced any of the following:
The following four definitions of the types of premature ejaculation can be useful when trying to determine when you should see a doctor.
It’s important for men and their partners to understand that normal male ejaculation times during intercourse is actually about 5-7 minutes.
Given how common the condition is, it’s no surprise that premature ejaculation treatments have been around for years. There are a handful of methods and approaches used to treat PE. Treatment can stem from everything from herbal pills to prescription pills to techniques like the start-stop method. But generally, the most common forms of treatment typically fall into one of two categories: Pills or Topical Delay Sprays.
There are currently two oral pharmaceutical options available to treat PE. Tramadol, which generally is prescribed to treat pain, and SSRIs (Selective Seretonin Reuptake Inhibitors such as. Zoloft, Prozac, Paxil), which are typically prescribed to treat depression. In the U.S., both Tramadol and a daily dose of an SSRI are available by off-label prescription. In many countries outside the U.S., a drug by the name of Priligy (and its generic form, dapoxetine), is an on-demand SSRI specifically designed for PE.
But despite some clinical success, these prescription solutions are becoming less popular in the U.S as new topical treatments with lower side effects become more available. While it may be tempting to pop a pill and gain more ejaculation control, it’s important to keep in mind that there can be significant drawbacks to going this route. There are some major side effects linked to these oral drug treatments, including loss of libido!
If the side effects of taking a pill are concerning, you may want to consider something like a topical delay spray to treat your PE. Last-longer gels and sprays like Promescent have been available over-the-counter for years, and with clinically-proven results and a very low side effect profile, why wouldn’t you consider trying one?
Keep in mind that not all delay sprays are equal…you want one that actually works. Promescent is the only last-longer spray available in the U.S. with patented TargetZone™ technology that’s proven in clinical studies to give you more pleasure, and more time. Isn’t it time you tried Promescent?