Premature ejaculation

What is premature ejaculation?

In short: ‘coming’ earlier than you’d like during sex. This can vary from person to person, and is really down to you and your partner to decide what you’re happy with. But the general feeling is that premature ejaculation can be defined by a short latency (time between starting and finishing sex), which you struggle to control and that causes distress.

There are two types:

• Primary (lifelong) premature ejaculation: where you have always had the problem, and
• Secondary (acquired) premature ejaculation: where the problem is a recent development.

No widely accepted ‘normal’ latency (normal time that it takes to ejaculate) exists, but an estimate suggests around 7 minutes for men without premature ejaculation, and just under 2 for men with it.

But, as we said earlier, this is more a question of whether you feel like premature ejaculation is causing distress and is getting in the way of you and your partners’ sex life.

How common is premature ejaculation?

Pretty common. It’s pretty difficult to get accurate data on just how common, as the definition can often be loose or subjective, and many men ‘suffer in silence’ - so estimates can range from 4%-66% of men worldwide - though most studies indicate that the number is between 25%-40%

Whatever the exact number, most men will have at least one premature ejaculation at some point in their lives. Most of the time it’s not a concern, and often it will only happen once or twice.

It’s really only a problem if it happens with enough frequency to cause further distress, disrupt your relationship, or has happened consistently since you’ve been sexually active.

How do you stop premature ejaculations?

There are things you can try before seeking medical help. Some men find it useful to masturbate around one to two hours before sex, or to use condoms (or thicker ones if you already do) to lessen sensitivity. You can also take breaks, change position, or try to think about something a little less exciting.

Also, if you’re in a relationship, there are things you can do with your partner to help to extend your orgasms. The two main recommendations are the ‘squeeze’ technique, and the ‘stop and start’ technique. Both of which involve stopping intercourse when you are close to climaxing, and starting again when you feel comfortable. But these take a lot of practice, and might not always work.

Failing this, there are treatments you can take which have been shown to help you to delay ejaculations.

How do premature ejaculation treatments work?

One of the most common treatments for premature ejaculation are drugs called SSRIs (selective serotonin reuptake inhibitors). These were originally designed as antidepressants, but an unintended side effect of these was that they delayed ejaculation.

This happens because serotonin manages the transportation of pleasure signals around the body, and SSRIs increase the activity of serotonin within a certain point of the nervous system, which leads to the user having greater control over their orgasms during sex.

Because of this, SSRIs started to be recommended to people who were struggling with premature ejaculations, but they have to be taken daily and there is often a delay of 1 to 2 weeks before you feel the effects. More recently, an “on demand” SSRI has been licensed with the sole intention to help people with premature ejaculation: Dapoxetine (or Duralast). This is the only drug marketed at helping to prevent premature ejaculations.

Lidocaine cream is another possible treatment. This is a topical anaesthetic cream which will reduce sensation when applied to the penis. You may need to use a condom when using EMLA, though, as the cream can transfer to your partner when engaging in sex or foreplay, which can cause numbing and a loss of sensation for them.