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Premature Ejaculation- The long and short of it!

Premature Ejaculation (PE)! 40% of patients presenting to the Metromale Clinic present with this complaint. World over with prevalence rates ranging between 15 to 25%, PE remains the most common sexual complaint in men under 60 years.

What is it? Is there a definition? Simply speaking, it refers to ejaculation occurring before the man and his partner wishes it to occur. However, the definition itself may be too premature as the time to ejaculation and thereby satisfaction is very subjective. Men with ejaculations within a minute may not complain where as some men with ejaculation times lasting more than 10 minutes complain.

The International Society of Sexual Medicine (ISSM) defined PE as ejaculation occurring within one minute and the inability to delay ejaculation on nearly all vaginal penetrations. Also there should be a significant degree of bother associated with the event. PE could be lifelong or acquired. Natural variable type of PE could involve activity with a new partner, a wrong partner, abstaining from sex a long time, being very excited and so on.

Should you be worried? Whatever may be the type, PE causes considerable distress to both the affected individual and their partner. Partner sexual dysfunction is very common in men with PE. Hence it may be very important to involve the partner during psychosexual treatment in men with PE. PE can be treated by pharmacological agents as well as psychosexual therapy.

The SSRI (Selective Serotonin Reuptake inhibitor) drugs are very effective in the management of PE. As these drugs interfere with neurotransmitter reuptake, it is important that these drugs are taken under the supervision of a physician. Psychosexual therapy also helps considerably and some physicians do advocate combination therapy.

Therefore, the questions to ask is not whether it is 3 minutes or 30 but rather the quality of sex, partner satisfaction and individual distress.

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