Can premature ejaculation be controlled?

Some health professionals prefer to use the term 'rapid ejaculation'.

What is premature?

A study involving 500 couples found the average time for ejaculation was about five-and-a-half minutes after starting sex. This time could be longer in the case of men who have sex with men.

International guidelines define premature ejaculation as regularly ejaculating within one minute of entering your partner.

However, it is up to you and your partner to decide if you are happy with the time it takes you to ejaculate.

If ejaculation times are causing you persistent distress then it is a problem that can be helped with treatment.

Types of premature ejaculation

There are two types of premature ejaculation:

• primary premature ejaculation – where you have always had the problem
• secondary premature ejaculation (or "acquired premature ejaculation") – where you recently developed the problem

The causes of primary premature ejaculation are often psychological, such as having a traumatic sexual experience at an early age. Secondary premature ejaculation can be caused by both psychological and physical factors. Physical causes can include drinking too much alcohol and inflammation of the prostate gland

Treatment

If your premature ejaculation is caused by a physical condition, treating the underlying condition should help. Your doctor can suggest possible treatment options.

Treating premature ejaculation caused by psychological factors can be more challenging. However, most men who persevere with treatment find the problem resolves.

Self-help

There are a number of self-help techniques you can try before seeking medical help.

These include:

• masturbating an hour or two before having sex
• using a thick condom to help decrease sensation
• taking a deep breath to briefly shut down the ejaculatory reflex (an automatic reflex of the body, during which ejaculation occurs)
• having sex with your partner on top (to allow them to pull away when you are close to ejaculating)
• taking breaks during sex and distracting yourself by thinking about something completely different
• If you are in a long-term relationship, you may benefit from having couples therapy.

You will be encouraged to explore issues that may be affecting your relationship and be given advice on how to resolve them. You may also be shown techniques that can help you 'unlearn' the habit of premature ejaculation.

Medication

Selective serotonin reuptake inhibitors (SSRIs) are available if the above self-help techniques don't improve the problem. SSRIs are mainly used to treat depression, but one of their side effects is delaying ejaculation.

Some SSRIs are specifically designed to treat premature ejaculation. But a doctor may recommend you try another kind of SSRI on an "off-label" basis. This is when a medication is used for a different purpose than it was licensed for. Doctors can prescribe medication on an off-label basis if they decide it is in the best interest of the patient on the basis of available evidence.

The use of anaesthetic creams and sprays can also help, as they make your penis less sensitive. Combining an anaesthetic cream with a condom can be particularly effective. A doctor should be able to recommend a suitable cream.