A common sexual disorder in men is premature ejaculation or early ejaculation. It is defined as an involuntary ejaculation occurring without control or immediately after penetration or before the individual wishes it. This involuntary ejaculation can cause marked distress in the individual as well the partner.1
The American Urological Association (AUA) has defined that the ejaculation which occurs faster than desired, before or soon after penetration, leading distress to either one or both partners in known as premature ejaculation.2
In other words, premature ejaculation is defined as ejaculation which occurs when a man reaches orgasm and ejaculates immediately without any control or ejaculation happens before the man desires it. It can happen before or at the beginning of the intercourse or sex. Many men can experience lot of personal distress due to this condition.
An exact cause for premature ejaculation is still unknown but certain several risk factors are possible.
Few known risk factors are as follows:
• Abnormal levels of the brain neurotransmitter serotonin
• Abnormal hormonal levels of luteinizing hormone, prolactin, and thyroid hormone disorders
• Inflammation or infection of the prostate or urethra such as chronic prostatitis
• Penises have a greater sensitivity to stimulation
• PE can be secondary to neurological diseases such as multiple sclerosis and peripheral neuropathies.
• Caused by drugs such as amphetamine, cocaine, and dopaminergic drugs.
• Kidney disorders
Certain psychological factors can also contribute to PE as follows:
• Tension or stress
• Unlikely expectations of sex
• History of sexual suppression
• Lack of confidence
• Sexual abuse
• Relationship problems
The important symptoms of premature ejaculation are:
• Ejaculation occurs with less sexual stimulation and with little or no control
• Reduced sexual satisfaction because of poor control on ejaculation
• Guilty feeling with embarrassment or frustration
If premature ejaculation is due to a physical condition, then see your doctor for treating the underlying cause.
If premature ejaculation is caused by psychological factors then following methods can be applied:
Pause and squeeze method
The pause-squeeze method can help in PE by allowing the excitement to decrease before climax. When you feel you are about to ejaculate, stop and let your partner squeeze the end of your penis where the head joins the shaft. Squeeze for several seconds till you no longer want to climax. Repeat this process as necessary. In due course, you would be able to delay ejaculation without any help.
Stop and start method
The stop-start method can help to delay climax by removing the desire. It is also known as orgasm control. Once you feel the impulse to ejaculate, stop the sexual activity totally. Then when you feel less stimulated, start slowly to have sex again. Repeat this process as necessary to gain control over ejaculation.
Pelvic floor exercises
Pelvic floor exercises can help men with premature ejaculation to control their ejaculatory reflex by increasing the time to climax. Few pelvic floor exercises are as follows:
• Locate the right muscles by stopping mid-stream during passing urine
• Lie down and contract your pelvic floor muscles for 3 seconds, and then relax for 3 seconds. Do this at least 10 times subsequently. Repeat this exercise least thrice a day.
• Slowly increase the number of seconds to make your muscles stronger. Try new positions, for example standing, walking, or while sitting down.
• Breathe and focus on your pelvic floor muscles. Do not tighten your thighs or buttocks.
Condoms can also decrease sensitivity and delay ejaculation. There are climax control condoms available over-the-counter that are made of a thicker latex material meant to delay climax.
Avoid sex for some time
Focusing on other types of sexual activity instead of intercourse can help take off the pressure from your sexual encounters. Intercourse is not the only way to reach sexual satisfaction, thus consider about other techniques to satisfy yourself and your partner so that it won’t cause frustration.
A number of drugs are at present used by doctors for the treatment of PE which includes antidepressants, local anaesthetic agents and phosphodiesterase type 5 inhibitors.
Selective serotonin reuptake inhibitors (SSRIs) are given to treat depression, but they can also delay ejaculation. Paroxetine, sertraline and fluoxetine are few SSRIs used for PE.
Analgesic creams and sprays containing a numbing agent, such as benzocaine, lidocaine or prilocaine, are0020 used to treat premature ejaculation. These products are applied on the penis 10 to 15 minutes before sex to lessen sensation and delay ejaculation.
Phosphodiesterase-5 inhibitors, such as sildenafil, also known as Viagra, are used to treat erectile dysfunction but has been found to treat premature ejaculation. Consult your doctor before taking Viagra.
A new meta-analysis of randomized controlled trials have demonstrate that tramadol is an effective treatment for PE. It results in a significant satisfaction with sexual intercourse and control over ejaculation.
Green onions – Seeds of green increase a person's stamina and strength prolonging his sexual ability. Crush the seeds and mix them with water. Drink this water thrice a day before meal. White onions can also be used.
Ashwagandha – Ashwagandha is an Indian medicinal herb, effective in treating sexual problems in men. It helps men to have control over ejaculation and extend their sexual intercourse.
Ginger and Honey – Ginger is helpful in holding the erection by causing fast blood supply. Honey is an aphrodisiac and can enhance the potency of ginger. Consume this remedy by mixing half a teaspoon of ginger with honey and eat it before bedtime.
Garlic – Garlic has aphrodisiac properties and can extend the duration of intercourse. Chew the cloves or fry them in ghee and then eat them every morning on an empty stomach.
Asparagus – Boil the plant roots in milk and drink it twice every day to strengthen your penile muscles.
Balanced diet – Avoid foods like chocolate, chillies and caffeinated beverages. Consume diet rich in zinc, selenium, calcium and iron for better control and strength. High carbohydrate and low protein food can ease anxiety.
Lady finger – Lady finger is also an effective remedy for premature ejaculation. Include this vegetable in your everyday diet.
Carrots – Carrots have a libido-improving quality that can help to control premature ejaculation.
Does excessive masturbation cause premature ejaculation?
It’s a myth. In fact, masturbating an hour or two before having sex can help to delay ejaculation during penetration.
Premature or early ejaculation is a normal and common type of sexual complaint that affects men of different age groups due to various reasons. Home remedies and natural treatments can help you to manage your symptoms. But if premature ejaculation still persists, you should see your doctor to rule out any underlying causes and explore other treatment options.
1. McMahon CG. Premature ejaculation. Indian J Urol. 2007; 23(2):97–108. doi:10.4103/0970-1591.32056
2. Gajjala SR, Khalidi A. Premature ejaculation: A review. Indian J Sex Transm Dis AIDS. 2014; 35(2):92–95. doi:10.4103/0253-7184.142391
3. El-Hamd MA, Saleh R, Majzoub A. Premature ejaculation: an update on definition and pathophysiology. Asian J Androl. 2019;21(5):425–432. doi:10.4103/aja.aja_122_18
4. Adapted from the website: https://www.health.harvard.edu/a_to_z/premature-ejaculation-a-to-z
5. Adapted from the website: https://www.healthline.com/health/mens-health/pe-home-remedies#home-remedies
6. Mohee A, Eardley I. Medical therapy for premature ejaculation. Ther Adv Urol. 2011;3(5):211–222.
7. Adapted from the website: https://www.nhs.uk/conditions/ejaculation-problems/
8. Khan AH, Rasaily D. Tramadol use in premature ejaculation: daily versus sporadic treatment. Indian J Psychol Med. 2013;35(3):256–259
9. Adapted from the website: https://doctor.ndtv.com/sexual-health/food-based-remedies-to-stop-premature-ejaculation-1718234