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Premature Ejaculation

Premature ejaculation is a condition in which a man ejaculates before he wishes to or after little sexual stimulation. Premature ejaculation is a common physiological condition, estimated to occur in 25% to 40% of adult men, and is thought to be the most frequent male sexual dysfunction. Premature ejaculation can cause marked distress and difficulties between a man and his partner, and can make it more difficult for a man and his partner to conceive, but men with premature ejaculation typically do not seek treatment.

In most patients the cause of premature ejaculation is not known and the condition is usually life-long, suggesting that it is a born behavioral variation rather than a disease. The specific mechanisms that contribute to premature ejaculation are not fully known. In rare cases, though, premature ejaculation can result from abdominal surgery, pelvic fractures, prostatic enlargement, urethritis; and from diseases and conditions such as polycythemia, diabetes, cardiovascular disease, polyneuritis, and withdrawal from alcoholism.

Treatment for Premature Ejaculation

Doctors at Columbia University Department of Urology at NewYork-Presbyterian Hospital typically combine the following treatment approaches to ensure the best chance of success.

Behavioral Modification for Premature Ejaculation

Sexual behavior modification known as the pause method and the pause-squeeze technique can result in considerable improvement early on. When used alone they show little long-lasting improvement.

Oral Medications for Premature Ejaculation

While the FDA has not yet approved any medications for the treatment of premature ejaculation, anti-depressants are, in some cases, helpful for this condition. New oral medications are currently under investigation.

Topical Medications for Premature Ejaculation

Topical anesthetics reduce sensation in the penis and help men sustain their erection, but some men report that this approach lessens their enjoyment of sex.

Other Treatments

In cases that do not respond to other treatments, men sometimes use penile self injection therapy to sustain the erection beyond ejaculation and achieve longer-lasting intercourse.