How Common is Premature Ejaculation?
Kamau* has a problem; it is every man’s nightmare.
On the surface, things have been great for him. He is lucky to work as a consultant and is also successful in his personal life as he constantly meets amazing women.
You know how it is; a drink after work and some small talk. Everything is going unbelievably well. Conversation is flowing great; he eventually brings her home. After a while, they are in their bedroom. Then after some sexy foreplay, she is visibly aroused and very turned on. Kamau wants her and she wants him.
But then, it happens; exactly what he had been dreading. BAM! He came too quickly.
Shit! he exclaims, realising he ejaculated 15 seconds into sex. Done, Over. Total mood killer.
Kamau sees the admiration the girl had for him is gone. The fire is out; not even a small flame left burning. In spite of everything, she tries not to openly show her disappointment. She just looks at him with pity and says: “It’s fine; it can happen to anyone”.
Kamau wishes that he could satisfy her in bed and give her everything that she deserves; be the man of her dreams. At the same time, he prays that a hole opens up in the floor so he could jump in it and hide there forever.
What Kamau experienced is called premature ejaculation. It is when you ejaculate too quickly to enjoy sex and before your partner has orgasmed.
Sometimes men describe premature ejaculation as a quickie; and it can cause psychosocial distress.
How Common is it?
Premature ejaculation is a common condition; one in three men report to have had ejaculated prematurely.
Numerous studies have been done on ejaculation time since the 1960s and there is a variation of as less as 4% and as big as 40% in ‘stopwatch’ studies versus patient reports.
According to these studies, most men last between 200-400 seconds during sex. Most participants lasted for 5.4 minutes and the variation from this figure ranged from 30 seconds to 44 minutes.
Hence, contrary to what many people think or like to brag about, the average duration of sex is about five and a half minutes.
With this in mind, lasting under two minutes and being distressed about it is the technical definition of premature ejaculation.
It is important to mention here that there’s no standard timeframe for ejaculation; it differs from person to person and varies from one reason to another, and that’s okay.
Many men find it difficult to openly talk about it, even to a doctor; and this may lead to negative personal consequences such as distress, bother, frustration and/or avoidance of sexual intimacy.
How Ejaculation Happens?
To understand premature ejaculation, it is important to first understand how ejaculation happens.
There are four stages of sexual response: desire, arousal, orgasm and resolution. Desire (or attraction) leads to sexual arousal, which after a certain level triggers orgasm (ejaculatory response in males). After orgasm, the sexual episode terminates.
Ejaculation is a reflex that occurs after sexual stimulation. It starts with the muscles deep in the pelvis, pushing out the semen from the seminal vesicles.
However, the brain controls ejaculation and releases a hormone called serotonin. It helps delay ejaculation and as a result, extend the sexual episode and pleasure.
What Causes Premature Ejaculation?
Lifelong premature ejaculation can be explained as a variation in the sensitivity of serotonin receptors or low levels of serotonin in the brain. Serotonin help delay ejaculation.
Emotional factors such as stress, guilt, performance anxiety, sexual abuse and relationship problems have a role to play in premature ejaculation.
Erectile dysfunction (inability to get or keep a firm erection) is also closely associated with premature ejaculation. Because conditions such as hypertension, diabetes, hyperthyroid disease and obesity have been associated with both erectile dysfunction and premature ejaculation.
Further, urogenital infections such as prostatitis can lead to premature ejaculation. Prostatitis is when one experiences pain in the groin, painful urination, difficulty urinating and other symptoms.
Premature ejaculation is common and curable; you should not hesitate to seek help.
Diagnosis is largely based on a patient’s self report on climax period and ‘bother’. If you are climaxing at the slightest stimulation in most sexual encounters, it is time to see a doctor.
Treatment options are both medical and non-medical. Noteworthy here is the non- oral medications licensed by FDA to treat the condition.
Some topical drugs such as Lidocaine can improve the condition by prolonging climax when applied. However, you should be careful about not rubbing the cream on to your partner’s genitals. This may inhibit their senses.
There are also some behavioural changes that are important in treating the problem:
- Using condoms that have a local anaesthetic like benzocaine, as they can help reduce penile sensitivity.
- Squeezing the glans (tip of the penis) until the urge to ejaculate subsides. A study quotes 97.8% success rate but this has not been replicated in subsequent studies.
- Trying ‘start-stop’ technique or ‘edging’. Stimulate the penis to the point of ejaculation but stop right before it. Wait for the urge to go away. And then repeat this for at least 3-4 times.
In terms of physical activities, exercises to reduce weight and improve cardiovascular health can help with premature ejaculation. Some experimental techniques like Kegel muscle exercises and acupuncture have also been suggested. But there is inadequate data to show their effectiveness.
Further, psycho-sexual therapy including individual and/or couple counselling helps expand sexual repertoire and open discussion.
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About the author: Martin Mūthare is a licensed clinical officer and a public health practitioner.