Premature Ejaculation (PME) Part 2

Last week we looked at the problem of premature ejaculation (PME) and its causes. I said that most cases of PME were caused by psychological/relationship problems. I also mentioned that most men at some time in their sexual history will suffer from PME and that only if it was persistent and affected the relationship, should it be taken seriously.{{more}} That being said, a vast majority of men suffering from this problem do not seek help. That is because most of the men, having suffered from this problem for so long, assume that there is no help for them. For those who know there is help, they prefer over the counter preparations or a “pill” to treat what is largely a psycho-emotional problem.

Treatment of PME involves either the penis or psyche (the mind) or both. Incidentally, most patients come to us doctors expecting a pill to treat what they think is a “penis” problem, not realizing that the pill actually treats a mental problem. Unfortunately, we men are not very good in acknowledging psychological problems. Of the few men who seek help for this vexing problem, few would admit that they need emotional and psychological help and most behave as though the problem affects them only, especially the younger ones who are concerned only with performance. Besides, most men come to the office alone as though the problem was theirs only. Most cases of PME that respond successfully to treatment require long-term therapy. Since PME affects the relationship and is usually a reflection of a dysfunctional or immature relationship, the treatment of this problem involves relationship counseling to elucidate issues such as communication problems, infidelity, trust issues, performance anxieties, and emotional and substance abuse problems, among other issues. Unfortunately, in our environment, with a lack of psychotherapists, much less a sex therapist, we are already fighting a losing battle.

So how do we treat PME at a penile level? We desensitize the penis using local anaesthetic jellies or sprays. The jelly or spray is applied directly to the erect penis. These “numb” the penis and the reduced sensation prevents or reduces PME. The problem is that this is cumbersome and inhibits spontaneity. Besides, the women sometimes complain that their genitalia is also numbed. The spray is better in that once the spray is applied and dries, it is less likely to numb the female genitalia.

For couples in a less stable relationship when performance anxiety becomes a problem, then the use of condoms with local anaesthetic are ideal. These numb only the penis and do not affect the female genitalia. Indeed, just the use of condoms alone is enough to reduce the incidence of PME, as the men would say, “Doc, condoms reduce the sensation”.

Another method of reducing sensation is via the use of circumcisions. Circumcision exposes the penile head and the sensitive remnants of the foreskin to the environment, thus desensitizing it and reducing the incidence of PME. Once the skin of the penis is removed, a layer of keratin covers the remaining head and foreskin remnants. This makes them more resistance to infections; hence, you get the added benefit of reducing infections as helping to treat PME. This is theoretical as only about 20% (1 in 5) patients are helped with their PME using circumcisions. This is no better than using a sugar pill or placebo, further confirming the theory that PME is more a psychological / relationship problem than a penile sensitivity problem. Even for the men using sprays and jelly or condoms, when they stop using these aids, the problems recurs, because the underlying problem has not been treated. Next week we will look at the medical treatment of premature ejaculation or PME.

For comments or question contact:

Dr. Rohan Deshong

Tel: (784) 456-2785

email: deshong@vincysurf.com