Summary about Disease
Premature ejaculation (PE) is a common sexual dysfunction in which a man ejaculates sooner than he or his partner would like during sexual activity. It is characterized by ejaculation that occurs persistently or recurrently with minimal sexual stimulation before, upon, or shortly after penetration and before the person wishes it. It can lead to distress, frustration, and relationship problems.
Symptoms
The primary symptom of PE is ejaculating sooner than desired. Diagnostic criteria typically include ejaculation occurring:
Within about one minute of vaginal penetration (lifelong PE).
Significantly sooner than desired, causing distress (acquired PE).
Inability to delay ejaculation during all or nearly all vaginal penetrations. Distress, frustration, and avoidance of sexual intimacy are also common symptoms.
Causes
The exact cause of PE is often multifactorial and can involve a combination of psychological and biological factors.
Psychological factors: Anxiety (performance anxiety, general anxiety), stress, depression, relationship problems, unrealistic expectations about sexual performance, learned patterns early in sexual experiences.
Biological factors: Abnormal hormone levels, abnormal levels of neurotransmitters (serotonin, dopamine), inflammation or infection of the prostate or urethra, inherited traits.
Other factors: Erectile dysfunction (ED) can sometimes contribute, as men may rush to ejaculate before losing their erection.
Medicine Used
Several medications can be used to treat PE, often in combination with behavioral therapies.
Selective Serotonin Reuptake Inhibitors (SSRIs): These antidepressants, such as paroxetine, sertraline, fluoxetine, and citalopram, can delay ejaculation. Dapoxetine is specifically designed and approved for PE in some countries.
Tricyclic Antidepressants: Clomipramine is sometimes used off-label.
Topical Anesthetics: Creams or sprays containing lidocaine or prilocaine can be applied to the penis to reduce sensation and delay ejaculation.
Tramadol: An analgesic with off-label use for PE, but it has potential side effects and addiction risks.
Phosphodiesterase-5 (PDE5) inhibitors: if premature ejaculation is caused by or related to erectile dysfunction (sildenafil, tadalafil, vardenafil)
Is Communicable
No, premature ejaculation is not a communicable disease. It is not caused by an infectious agent and cannot be transmitted to another person through sexual contact or any other means.
Precautions
While PE itself isn't something you "catch," there are precautions to consider regarding related factors and treatment.
Open communication with your partner: Discussing your concerns and working together can reduce anxiety and improve intimacy.
Seeking professional help: Consulting a doctor, therapist, or sex therapist is crucial for diagnosis and treatment.
Following medication instructions: If prescribed medication, adhere to the dosage and instructions provided by your doctor.
Being aware of potential side effects: Understand the potential side effects of any medications and discuss them with your doctor.
Practicing relaxation techniques: Mindfulness, meditation, and other relaxation techniques can help manage anxiety and improve control.
Using condoms: While condoms won't directly treat PE, they can slightly reduce sensation.
Avoiding excessive alcohol or drug use: These substances can worsen sexual dysfunction.
How long does an outbreak last?
PE is not an "outbreak". PE is not an infectious disease. It can be a lifelong condition, acquired over time, or situational. The duration varies greatly depending on the individual, the underlying causes, and the effectiveness of treatment. Some men may experience it only occasionally, while others may have it consistently. With appropriate treatment, many men can significantly improve their control and satisfaction.
How is it diagnosed?
PE is typically diagnosed based on the patient's self-reported history and symptoms. There is no specific medical test to diagnose PE. The diagnostic process usually involves:
Medical history: The doctor will ask about your sexual history, relationship status, and any underlying medical conditions.
Physical examination: A physical exam is usually performed to rule out any underlying medical problems.
Diagnostic criteria: The doctor will assess if you meet the diagnostic criteria for PE, which usually involve ejaculation occurring sooner than desired, inability to delay ejaculation, and negative personal consequences.
Validated questionnaires: Questionnaires like the Premature Ejaculation Diagnostic Tool (PEDT) may be used to assess the severity of the condition.
Timeline of Symptoms
The key symptom, early ejaculation, can present differently:
Lifelong PE: Ejaculation occurs prematurely from the very first sexual encounters.
Acquired PE: Develops after a period of normal sexual function. The onset can be sudden or gradual.
Variable PE: Occurs sporadically, with periods of normal function interspersed with PE episodes.
Subjective PE: The man perceives his ejaculation as premature, even though the timing may be within the normal range. The impact on mood, self-esteem, and relationships can develop over time as the problem persists.
Important Considerations
Psychological impact: PE can significantly affect self-esteem, confidence, and relationship satisfaction. Addressing these psychological aspects is essential for successful treatment.
Partner involvement: Involving the partner in treatment can improve communication and support, leading to better outcomes.
Realistic expectations: Treatment may not result in perfect control, but it can significantly improve ejaculatory latency and overall sexual satisfaction.
Comorbidity: PE often co-occurs with other sexual dysfunctions, such as erectile dysfunction. Addressing all underlying issues is crucial.
Treatment options: A combination of medication, behavioral therapy, and lifestyle changes is often the most effective approach.
Persistence: Sometimes finding the right treatment takes time and patience. Consistent effort is important.