Premature Ejaculation *part 2 : treatment*

How is premature ejaculation treated?

     Treatment for mild cases

For men who last between 4-5 minutes but would like to last longer can practice some techniques such as:

1. Relaxation/Distraction technique: This method helps to delay ejaculation.

This means turning your mind to something else when you sense that climax is near, like thinking about something totally unconcerned with sex.


   2.   Lifestyle changes:

For some men, stopping or cutting down on the use of alcohol, tobacco, or illegal drugs may improve their ability to control ejaculation.

      

       3.  Use of condoms: Other options include using a condom to reduce sensation.

Another kind of condom contains a local anaesthetic (benzocaine or lidocaine) inside it. This has been shown to be effective in a couple of men with premature ejaculation, though some men may react to the local anaesthetic.

  

       4.     Local anaesthetic gel: A local anaesthetic gel that's applied to the shaft of the penis shortly

before intercourse can help reduce sensitivity of the penis and help in PE. This method has some disadvantages of dulling the partners’ sexual sensation as well as producing side effects such as intense itching, redness and soreness.

      

       5.     Local anaesthetic spray: This is a spray that contains a local anaesthetic, which is sprayed on

the penis within 15-20 minutes of initiation of sexual intercourse. This has been shown to be effective in many men presenting with ED.

Treatment for more severe cases

If PE is causing you significant problems, it is best to consult an expert for treatment. For more severe cases, the following may be used.

·                 The “penis grip” method

This technique is based on a special 'penis grip' and has been shown to cure the majority of men with premature ejaculation. It involves adequate co-operation from their partners and works like this:

1.        Your partner places her hand so that her thumb is on one side of the man's erect penis

2.       Her index and middle fingers are on the other side

3.       The index finger is just above the ridge of the glans (the 'head'), while the middle finger is just below the ridge

4.      When the man feels that he's near to a climax, he tells his partner

5.       She then squeezes his shaft firmly between her thumb and the other two fingers

This is continued until the man is then able to control his own ejaculation.

Use of medications

·        Antidepressants:

A group of antidepressant medicines called selective serotonin reuptake inhibitors (SSRIs) are sometimes used to treat premature ejaculation. These medicines are used because a side effect of SSRIs is inhibited orgasm, which helps delay ejaculation.

Antidepressants that are commonly used for this purpose include

·        Clomipramine

·        Fluoxetine

·        Sertraline

·        Paroxetine

        Tramadol

This belongs to the group of drugs called analgesics, and used for the treatment of pains. Tramadol, to a reasonable extent exhibit some characteristics of an anti-depressant in that it increases levels of serotonin and norepinephrine. Tramadol also has few side effects, and safe to use.

In management of premature ejaculation, it is shown to be very effective, having the potential to cause an increase in intravaginal ejaculation latency time (IELT) of 4-20 folds in greater than 90% of men.

        The stop-start technique

1.        The man is encouraged to masturbate alone.

2.       He is asked to set time aside to be private and to masturbate with dry hands.

3.       The man is encouraged to masturbate almost to the point of ejaculation and then stop.

4.      He should do this three times.

5.       On the fourth time, he is permitted to ejaculate

After he has achieved this measure of control, he can try masturbating with a wet hand, which will feel more like the inside of a vagina. He is encouraged to do the stop-start technique as before.

This method can be practiced at home, or preferably with the help of a sex therapist.

         Herbal medicines

Some of herbal products have been shown to help in premature ejaculation.

A product that has been shown to be very useful is panax ginseng, especially the red ginseng. These are actually useful in treating secondary PE.

References:

·         The Turek Clinic, male ejaculatory disorders http://www.theturekclinic.com/ejaculatory-disorder.html accessed 15 October 2012

·         Netdoctor.com, premature ejaculation, http://www.netdoctor.co.uk/sex_relationships/facts/prematureejaculation.htm

·         Waldinger MD, Quinn P, Dilleen M, Mundayat R, Schweitzer DH, Boolell M (2005). "A multinational population survey of intravaginal ejaculation latency time". The journal of sexual medicine 2 (4): 492–7.

·         PubMed Health, Premature ejaculation http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002492/

·         NHS Choices, Ejaculatory problems http://www.nhs.uk/conditions/ejaculation-problems/Pages/Introduction.aspx