Premature Ejaculation

Premature ejaculation
Classification and external resources
10 F52.4
9 302.75
MedlinePlus 001524
eMedicine med/643

Premature ejaculation (PE) is a condition in which a man ejaculates earlier than he or his partner would like him to. Premature ejaculation is also known as rapid ejaculation, rapid climax, premature climax, or early ejaculation. [3]

Most men experience premature ejaculation at least once in their lives. Because there is great variability in both how long it takes men to ejaculate and how long both partners want sex to last, if at all, an accurate prevalence rate is hard to determine, estimates range from as low as 5% to as high as 30%[6] Nevertheless, it is possible that men with abnormally low IELTs could be “happy” with their performance and do not report a lack of control. Likewise men with higher IELTs may consider themselves premature ejaculators, suffer from detrimental side effects normally associated with premature ejaculation, and even benefit from treatment.


[edit] Possible physical factors

[edit] Mechanism of ejaculation

The physical process of ejaculation requires two actions: emission and expulsion.

Mechanism of Ejaculation

The emission is the first phase. It involves deposition fluid from the [8]

It is believed that the selective serotonin reuptake inhibitors (SSRIs), which increase serotonin level in the synapse, in treating Premature Ejaculation.

Sympathetic motor neurons control the emission phase of [10]

Several areas in the brain, and especially the nucleus paragigantocellularis, have been identified to be involved in ejaculatory control.[12] Some men prefer using anaesthetic creams; however, these creams may also deaden sensations in the man’s partner, and are not generally recommended by sex therapists.

[edit] Differential diagnosis

Premature ejaculation should be distinguished from erectile dysfunction related to the development of a general medical condition, and a diagnosis should be made using the patient’s sexual history looking for a history of; decreased sexual arousal may be so high that ejaculation occurs immediately. Occasional problems with premature ejaculation that are not persistent or recurrent or are not accompanied by marked distress or interpersonal difficulty do not qualify for the diagnosis of premature ejaculation. The clinician should also take into account the individual’s age, overall sexual experience, recent sexual activity, and the novelty of the partner. When problems with premature ejaculation are due exclusively to substance use (e.g., opioid withdrawal), a substance-induced sexual dysfunction can be diagnosed.

[edit] Other ejaculation disorder types

[edit] Treatment

When deciding the appropriate treatment, it is important for physician to distinguish PE as a “complaint” versus PE as a “syndrome”.[19]



Clomipramine (Anafranil) is sometimes prescribed to treat PE. One side effect of the drug can help delay ejaculatory response. The side effect is described by the Mayo Clinic as “Increased [sic] sexual ability, desire, drive, or performance.”[26]

Desensitizing creams that are applied to the tip and shaft of the penis can also be used prevent premature ejaculation. Such creams are applied on an “as needed” basis and have fewer systemic side effects. However, use of these creams may lead to insensitivity in the penis, and reduction of sensation for the partner due to contamination.[27]

One more method is entitled intracavernous pharmacotherapy. This is a method of injecting a drug known as a vasodilator directly into the penis to help men control premature ejaculation and maintain their erection. It has been proven to be effective in over seventy percent of test patients.[citation needed] This method is used by companies such as Florida Men’s Medical Clinic, Boston Medical Group and others.[28]

[edit] References

  1. ^ b Waldinger M.D., Berendsen H.H., Blok B.F., et al. Premature Ejaculation and Serotonergic Anti-Depressants – Induced Delayed Ejaculation: The Involvement of the Serotenergic System Behavioural Brains Res. 1998 92(2):111-118
  2. ^ Kinsey, Alfred (1948), Sexual Behavior in the Human Male, W. B. Saunders Co
  3. ^ Godpodinoff M.L. Premature Ejaculation: Clinical Subgroups and Etiology Journal of Sex and Marital Therapy 1989; 15(2):130-134
  4. ^ “Ejaculation delay: what’s normal? [July 2005; 137-4"]. Retrieved 2007-10-21.
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  10. 12202834.
  11. 9284512.
  12. ^
  13. ^ Diaz, V.A., Close, J.D. Male Sexual Dysfunction. Primary Care. 2010; 37(3):473-489.
  14. ^ Lauman E.O., Nicolosi A., Glasser D.B., et al. Sexual Problems among Women and Men Aged 40 – 80 Years; Prevalence and Correlates Identified in a Global Study of Sexual Attitudes and Behaviours. International Journal of Impotence Research 2005; 7(1):39 – 57.
  15. ^ “Premature Ejaculation”. Premature Ejaculation and Male Orgasmic Disorder. Armenian Medical Network. 2006. Retrieved 2007-09-19.
  16. ^ b Waldinger, MD. “Changing paradigms from a historical DSM-III and DSM-IV view toward an evidence based definition of premature ejaculation. Part II: Proposals for DSM-V and ICD-11″. Proposals for DSM-V and ICD-11. J Sex Med.
  17. ^ Godpodinoff, ML. “Premature ejaculation: clinical subgroups and etiology”. J Sex Marital Ther. Vol15:130.
  18. ^ Waldinger, Marcel D.. “New Insights in Premature Ejaculation”. Psychiatric Times Vol. 24 No. 9. Psychiatric Times. Retrieved 1 August 2007.
  19. ^ Serefoglu, EC; Yaman O, Cayan S, et al. (2011). “Prevalence of the complaint of ejaculating prematurely and the four premature ejaculation syndromes”. J Sex Med (8): 540–8.
  20. 18360636. //
  21. ^ PRILIGY (Dapoxetin) erhält die Zulassung für die Behandlung der Ejaculatio praecox in Deutschland
  22. ^ Janssen-Cilag EMEA announces receipt of first regulatory approvals for Priligy for PE in Finland and Sweden, February 11, 2009
  23. 21059176.
  24. ^ Herrera (2011-10-28). “Scientific Studies/Articles: Premature Ejaculation and Successful Tramadol Treatment”. Retrieved 2011-11-15.
  25. ^ Kaynar, M. & Abdel-Hamid, I.A. On-Demand Tramadol Hypochloride Use in Premature Ejaculation Treatment. Journal of Urology 2012; 71(31):145-149
  26. ^ “Clomipramine Side Effects”. Mayo Clinic. Retrieved 28 October 2011.
  27. ^ MacCarty E.J. & Dinsmore W.W. Premature Ejaculation: Treatment Update International Journal of STD AIDS 2010; 21:77-81
  28. ^ Vasoactive intracavernous pharmacotherapy for the treatment of erectile impotence in men with spinal cord injury. BioMedSearch, 14. A A Sidi; J S Cameron; D D Dykstra; Y Reinberg; P H Lange, (2007)

[edit] External links

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