Premature Ejaculation

Premature ejaculation is considered by most urologists to be the leading form of male sexual dysfunction, affecting about 30 percent of men of all ages. Premature ejaculation has various definitions ranging from ejaculating within one minute of vaginal penetration to ejaculating prior to a man’s partner achieving orgasm or general sexual satisfaction.

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Causes of Premature Ejaculation

The exact cause of premature ejaculation is not well known. Studies have shown a variety of factors alone or in combination may contribute to premature ejaculation including:

Psychological

Premature ejaculation can be caused by temporary depression, stress or anxiety about a relationship, unrealistic expectations about performance or a history of sexual problems.

Biological

A number of biological factors could be the cause of premature ejaculation including abnormal hormone levels, abnormal reflex activity of the ejaculatory system, hyperthyroidism or inflammation or infection of the prostate or urethra.

Neurobiological

It is believed that the neurotransmitter serotonin (5HT) plays a central role in controlling ejaculation. Low levels of serotonin in specific areas of the brain may cause premature ejaculation. Studies have shown that increases in serotonin levels can help delay ejaculation in some men.

Penile Sensitivity

Many physicians believe that penile hypersensitivity plays a predominant role in the ejaculatory response while others believe that premature ejaculation is the result of a combination of multiple contributing factors. The success of topical (applied to skin) medications provides strong reason to believe that penile sensitivity does contribute to premature ejaculation.

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Diagnosing Premature Ejaculation

A premature ejaculation diagnosis begins with:

  • Education – description of the potential psychological, biological, neurobiological and penile sensitivity causes of premature ejaculation.
  • Health issues – premature ejaculation is rarely caused by a biological health condition, but this can be determined following a basic health history.
  • Relationship issues – past or current relationship issues may be a cause of premature ejaculation.
  • Physical Examination – examination of the genital area is typically not required.
premature ejaculation

Treatments

Behavioral therapy – Some patients respond to techniques such as starting and stopping. Although effective at times, most patients report limited sexual satisfaction with these methods. There are several other options available for treating the condition.

  • Topical medications – Topical anesthetic medications are typically the first treatment option for premature ejaculation. They are effective, easy-to-use, low-cost and have a negligible risk of systemic side effects.
  • One option for patients is a new product, Promescent®, from Absorption Pharmaceuticals, which provides improved ejaculatory latency (the time from penetration to ejaculation) with minimal loss of sexual sensation.
  • Oral medications – Some men respond well to low doses of the antidepressants known as selective serotonin reuptake inhibitors (SSRIs). These are prescribed off-label, with some side effects.

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Resources & Events

Dr. Mark Moyad, 11/13/19

The Urology Center of Colorado is proud to host Dr. Mark Moyad, MD, MPH, for the 23rd year. Dr. Moyad is world-renowned expert on nutrition and supplements, and he will be here again to share his knowledge and delight us with his amazing stories. When: Wednesday, November 13, 2019 @ 6:30pm Where: PPA Events Center

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Fall Medicare Education Session 10/8/19

Register today for the free Medicare Annual Enrollment Period Education Session. This educational event is for people already on Medicare. This year, we will be inundated with advertising due to numerous changes including: • 2 new Medicare Advantage plans • Custodial Care benefits being added to some plans • Plan F supplement closing to new

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ADT Nutrition and Exercise Class 11/5/2019

The ADT (Androgen/Hormone) Deprivation Therapy) class is a two-hour interactive class presentation on nutrition and exercise for men undergoing hormone deprivation therapy for prostate cancer. It is restricted to men diagnosed with prostate cancer and their spouses. The class takes place on the first Tuesday of every month in the TUCC third floor conference room.

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