What is premature ejaculation?
Premature ejaculation (PE) is when a man ejaculates (releases semen) sooner than he or his partner would like during sex/ within 1 minute of inserting the penis into the vagina. It is a common problem that affects up to 30%-40% of men.
Note: PE is not erectile dysfunction (ED), but ED may lead to PE.
How does ejaculation work?
Ejaculation is controlled by the central nervous system (brain & spinal cord). When a man is sexually stimulated, signals will be sent to the brain and spinal cord, which will then be sent to the reproductive organs when the man reaches a certain level of excitement. This releases semen through the penis - which is a process called ejaculation.
How do I know if I have PE?
The main symptom of PE is the inability to delay ejaculation for more than one minute/ unable to control ejaculation after penetration.
PE can be classified into two groups:
1. Lifelong (primary)
- Occurs (nearly) all the time
- Early ejaculation exists from the (nearly) first sexual intercourses
- Present in (nearly) every female partner in more than 80%-90% of sexual intercourse events
2. Acquired (secondary)
- Develops after you have had previous sexual experiences without ejaculatory problems
What are some factors that increase my risk of PE?
The factors that cause PE can be sorted into 2 categories: physical/ chemical and emotional/ psychological.
Physical/ Chemical Factors:
- Irregular hormone levels
- Oxytocin, luteinizing hormone, prolactin: High levels of these hormones leads to high levels of testosterone, which may result in PE
- Thyroid stimulating hormone (TSH): Low levels of TSH leads to hypothyroidism (a common condition where an insufficient amount of thyroid hormone is in the bloodstream, affecting a man's ability to keep an erection. Low levels of TSH therefore leads to PE
- Irregular serotonin/ dopamine levels
- Serotonin and dopamine are neurotransmitters that send signals which cause the body to become aroused and/or ejaculate
- Research has proven that a rat can ejaculate without being touched if the neurotransmitter receptors are stimulated
- Serotonin delays ejaculation; low levels of serotonin result in faster ejaculation, therefore leading to PE
- Dopamine causes an ejaculation to take place; a high level of dopamine results in PE
- Serotonin and dopamine are neurotransmitters that send signals which cause the body to become aroused and/or ejaculate
- A penis that is extra sensitive to stimulation
- The ejaculatory spinal cord pathway, which contains semen, is located at the frenulum
- Increased sensitivity at the frenulum will open up the pathway, resulting in early ejaculation
Emotional/ Psychological Factors:
- Performance anxiety
- Could occur when having sexual intercourse with a new partner, having sexual intercourse again after a long period of abstinence, lack of confidence, guilt, being overly excited or stimulated
- Anxiety may result in overly high dopamine levels
- Stress and depression
How can I confirm if I have PE?
If you suspect that you have PE, you should see your healthcare provider. You will be diagnosed after going through a physical examination and talking with your healthcare provider.
Some questions that the healthcare provider may ask include:
- How long have you been sexually active?
- When did PE become a concern?
- How long have you had this problem?
- How often does PE occur?
- Does PE occur with just one partner, or all partners?
- How long do you usually take before ejaculating during intercourse and when you masturbate?
- How has PE changed your sexual activity?
If your healthcare provider thinks that your PE is caused by emotional issues, you may be referred to a mental health professional who specializes in sexual dysfunction.
If you have both PE and trouble getting/ maintaining an erection, your healthcare provider might order blood tests to check your testosterone (male hormone) levels or other tests.
For more information or if you require a medical consultation, please contact My Healthcare Collective here.
