Premature Ejaculation

Premature ejaculation (PME) is a condition when the man or woman “comes too quickly” and leaves the other partner dissatisfied. In other words, speedy Gonzales shoots and misses, leaving the other partner high and dry or as the colloquial term “slam, bam, thank you mam”.{{more}}

This distressing problem affects more men than one would care to mention, with the estimates being between 30 – 70% of all men. Even though it is predominantly a male problem, some women experience this and some of us men have had female partners who “come fast” only to fall asleep after, just like the men do! A man is considered to have PME if he comes before 1.5 to 2 minutes after insertion. This however is subjective, as she may be satisfied after one minute, while other women may not be satisfied after 10 minutes. So even though he comes in 8 minutes, the first man may not have PME and the second may be considered. We doctors and sex therapists only diagnose this problem when it is persistent and one or both partners are dissatisfied. In other words, the man who comes too quickly can also be dissatisfied, either because he himself is not enjoying the sex, or because his partner is dissatisfied.

There are many causes of “coming too quickly”, but the main causes are psychological. It is amazing how long some men have suffered from PME, before they ask for help. Indeed most men have “given up” with respect to getting help, and now look at this as the norm, and the woman has resigned to accepting substandard sex, sometimes sublimating such desires into housework, shopping, nagging, going to church and getting involved in extracurricular activities. Other women would complain of chronic lower back pain from pelvic congestion due to lack of an orgasm, while others suffer from mild depression. The younger women who want to preserve their relationship would use sex aids like dildos, or ask the spouse to “do the job” before he comes, using other aids like his tongue. Some women who just couldn’t be bothered, just dump the man to find a new man who could “do the job”.

The most common cause of PME is psychological and includes such factors as a new relationship, when the novelty has not worn off and the man worries about performance as he has to impress her. Men who have not had sex for a long time can also suffer from PME, as he has to “let off” that which has been “backed up” for a long time. Stressful situations like loss of a loved one, worries about money, fidelity, communications in the relationship and performance related issues could cause PME. Indeed, if the woman complains about his performance without trying to help, this can cause the PME to persist. As one author puts it, “While men sometimes underestimate the relationship between sexual performance and emotional well-being, premature ejaculation can be caused by temporary depression, stress over financial matters, unrealistic expectations about performance, a history of sexual repression, or an overall lack of confidence.

Interpersonal dynamics strongly contribute to sexual function, and premature ejaculation can be caused by a lack of communication between partners, hurt feelings, or unresolved conflicts that interfere with the ability to achieve emotional intimacy.” Therefore, I have always tried to look at the relationship issues between the man and the woman before treating PME, however most men just want a pill while the women are usually worried about the relationship. Like most problems related to sex and health, giving a pill just deals with the immediate issue temporarily, leaving the underlying problem unresolved. Indeed the relationship can be worse off later on if the initial problem is not resolved.

Other non-psychological causes include the abuse of recreational drugs such as alcohol and cocaine. Medical issues such as urinary tract infections, prostatitis, neurological diseases, depression and diabetes mellitus can contribute to PME, as can genetic factors. Ninety per cent of men who have PME have first-degree relatives (brothers or fathers) who suffer from it. PME is also more prevalent in relationships between older women and younger men, and tends to occur more commonly during the fertile phase of the menstrual cycle.

For comments or question contact:
Dr. Rohan Deshong
Tel: (784) 456-2785
email: deshong@vincysurf.com