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By Lila Havens, HealthAtoZ Writer
You're with your partner and things are heating up fast. You want to make it last, but just as you're getting started, it's over.
It's perfectly normal to ejaculate too soon once in a while. In some men, it happens during foreplay or as soon as the penis touches or enters their partner. When this happens regularly, it's called premature ejaculation.
Premature ejaculation can make you feel bad about yourself. It can also put stress on your relationship. You don't have to live with it. Treatment can often help.
What causes premature ejaculation?
There's no simple answer to what causes premature ejaculation. It has many possible causes, including:
- Psychological factors, such as depression, stress, guilt, lack of self-confidence or anxiety about sex
- Physical factors, such as a thyroid problem, a prostate infection or an abnormal level of certain hormones or brain chemicals
Young men sometimes have it because they don't yet know their bodies well enough. In some men, it's related to erectile dysfunction (trouble getting or keeping an erection).
How is it diagnosed?
Your doctor will need to ask a lot of questions to diagnose premature ejaculation. He or she will ask about your past and current health and any medicines you take. Your doctor may also question you in detail about your sexual history.
It may be hard to talk about such personal issues, but it's important to give honest answers. Your doctor may ask things like:
- How long have you had premature ejaculation?
- Did this problem start recently or have you had it ever since you became sexually active?
- Do you have it every time you have sex or only sometimes?
- Have you had it with all partners or only certain ones?
- How often do you have sex?
- Do you drink or use drugs?
Your doctor may also do a physical exam to see if there's a physical cause for your problem.
How is it treated?
The main treatments for premature ejaculation are psychological, sexual and medical therapy. For some men, one type of treatment fixes the problem. Others do better with a combination of treatments.
Psychological therapy
Talking to a mental health professional is often very useful. If you have a partner, couples counseling may help you discuss issues in your relationship. You may also get advice about ways to reduce stress and improve your sexual performance.
Sexual therapy
Exercises can help you learn to delay ejaculation. You can practice these with your partner or on your own.
- Squeeze method. The partner stimulates the man's penis with her hand. When he feels close to ejaculation, she squeezes the head of the penis for several seconds. This will make him partly lose his erection. After 30 seconds, she starts stimulating him again. The couple repeats these steps a few times. The last time the man ejaculates.
- Stop-and-start method. The partner stimulates the man's penis until he feels close to ejaculation. Then she stops and waits until the feeling passes. Once he's in control, she starts again. The couple repeats this a few times. The last time the man ejaculates.
Medical therapy
- Some antidepressants have a side effect of delaying orgasm. This can make them a good treatment for premature ejaculation. Your doctor may prescribe an SSRI antidepressant, such as paroxetine (Paxil) or fluoxetine (Prozac). If these don't help, another type of antidepressant, clomipramine (Anafranil) might help.
- Anesthetic creams, such as lidocaine, have been used for premature ejaculation for many years. Putting the cream on the head of the penis helps dull feeling and delay ejaculation. Wash it off before sex to keep the cream from getting on your partner.
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