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Home , Delayed ejaculation, Ejaculation, Erectile dysfunction, Premature ejaculation

1 6 Fact Sheet 7 12 2 8

11 Premature Ejaculation3 9

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What is ? 1 Bladder 2

Ejaculation is the release of from the 3 1 at (sexual climax). When a man is sexually 6 4 Penis stimulated, the brain sends signals to the genital 5 area through nerves in the to make the 7 2 12 pelvic muscles contract. 8 6 Seminal vesicle

11 7 At orgasm, waves of muscle contractions transport 3 8 gland the , with a small amount of fluid, from the testes through to the vas deferens. The seminal 9 9 vesicles and prostate contribute extra fluid to 4 10 10 protect the sperm. 11 Cowper’s gland 5 This mixture of sperm and fluid (semen) travels 12 along the urethra to the tip of the penis where it is ejaculated (released).

What is ? How common is premature 1 Bladder ejaculation? Premature ejaculation happens when a man is 2 Vas deferens unable to control the timing of ejaculation, and Premature ejaculation3 Urethra is the most common male ejaculates before he and/or his partner feels ready sexual problem and4 affectsPenis men of all ages. for this to happen. This may cause distress in both 5 Scrotum Premature ejaculation is more common in younger the man and his partner. 6 Seminal vesicle men. This is because ejaculation generally takes 7 Rectum How soon is too soon when a man longer as men get older and younger men may be 8 Prostate gland prematurely ejaculates? less sexually experienced or feel less secure with the situation in which9 Epididymis they are having . For a heterosexual man, a commonly used 10 Testicle definition of premature ejaculation is ejaculating What are the other11 Cowper’s types gland of within about one minute of his penis entering his ejaculatory problems?12 Ejaculatory duct partner. However, there is no fixed time for ‘too soon.’ Premature ejaculation is a loss of control Other types of ejaculatory problems can affect over ejaculation, and the distress it can cause to men such as no ejaculation, , one or both partners, not just the time it takes a and painful ejaculation. man to ejaculate. Men with any of these problems should talk to their doctor.

1 / 3 Are there different types of The doctor will ask questions about sexual history, premature ejaculation? including how long the premature ejaculation has been happening and when it first happened and, There are two types of premature ejaculation: based on this, will talk about the possible causes. • lifelong, sometimes referred to as primary. How is premature ejaculation treated? Lifelong premature ejaculation is when a man has not had control of ejaculation from the time Treatment for premature ejaculation is usually of his first sexual experience. If left untreated, based on the man’s relationship status and the the premature ejaculation will continue for the cause of the condition (whether it is lifelong or rest of his life. acquired).

• Acquired premature ejaculation, sometimes to There are several treatments available for referred to as secondary. premature ejaculation including sex , behavioural techniques, sprays to reduce penile Acquired premature ejaculation is usually when sensation, oral medicines and there has been a period of normal functioning treatments (if erectile dysfunction is also a before the premature ejaculation begun. It problem). is often linked to psychological (especially relationship) issues or either erectile problems Your doctor may refer you to a specialist, such as a such as erectile dysfunction. sex therapist, a urologist or an endocrinologist. What causes premature ejaculation? What is ?

The cause of premature ejaculation depends on Counselling with an experienced sex therapist may whether the premature ejaculation is lifelong or be very helpful in treating in men with acquired. either lifelong or acquired premature ejaculation. Counselling can help to identify any underlying Lifelong premature ejaculation can be caused by sexual or relationship issues with the opportunity a chemical imbalance in important brain centres for open discussion. that lowers the threshold for ejaculation. As these men need less stimulation, ejaculation can happen What are behavioural techniques? sooner than desired. Psychological problems, including performance anxiety, may be secondary Semans’ “stop-start” technique involves the man to lifelong premature ejaculation rather than being telling his partner to stop stimulation when he the primary cause. feels he is close to ejaculation. When the feeling has passed, stimulation can be started again. Acquired premature ejaculation is often caused These steps of stopping and starting can be by performance anxiety. The anxiety can be repeated as needed. about sexual performance, fear of being caught in a sexual act or anxiety related to a specific ’s “squeeze” technique situation, such as a new relationship. Some involves squeezing the end of the penis for several religious beliefs may also make a man feel anxious seconds just before ejaculation, to lessen the urge about having sex. to ejaculate. This is repeated until the man and his partner are ready for ejaculation to happen. Acquired premature ejaculation can also be caused This technique can help teach a man to control by problems such as erectile dysfunction. This may ejaculation. be because of the need for intense stimulation to get and maintain an or from anxiety How can a man reduce penile about the erection problem. sensation?

How is premature ejaculation Local anaesthetic sprays and creams can reduce diagnosed? penile sensation and should be applied up to 30 minutes before ; using a There are no tests for premature ejaculation as will prevent absorption of the gel or cream by the it is a self-reported diagnosis. Your local doctor partner. (GP) can help in the diagnosis and treatment of premature ejaculation. Using two may also reduce sensation and help a man take longer to ejaculate.

2 / 3 What are the oral medicines? What role do partners in the treatment of premature ejaculation? Some — tricyclic antidepressants and selective reuptake inhibitors (SSRIs) If a man is in a relationship, both the man and — have the side-effect of delayed ejaculation his can be affected by premature and are now commonly prescribed by doctors for ejaculation. Partners can give valuable support premature ejaculation. and help decide the best treatment option, and it is helpful to involve your partner when talking with (Priligy®) is the only SSRI that has your doctor. been approved as a specific treatment for premature ejaculation (in men 18-64 years old) Can premature ejaculation cause in Australia. It is taken “on-demand” rather than daily; 30 mg doses are taken one to three hours infertility? before intercourse. Premature ejaculation does not usually cause infertility (in a couple), although sometimes it The tricyclic () has can cause problems for couples trying to become been shown to work better than SSRIs (, pregnant. , ) in some men. These drugs work only for as long as the man continues to take Many men who have premature ejaculation feel the daily. embarrassed when ejaculation happens before vaginal penetration. If this is the case, a doctor Taking SSRIs can have some side-effects such may use a treatment to delay ejaculation or refer as decreased (sex drive), nausea, sweating, the couple to a specialist. bowel disturbance and fatigue.

What are the erectile dysfunction How can premature ejaculation treatments? affect men emotionally? Premature ejaculation can cause embarrassment If a man has erectile dysfunction and premature and anxiety, and men often feel more anxious ejaculation, treating the erectile problems first when they try to find ways to manage the problem. can help bring back normal control of ejaculation. Partners of men with premature ejaculation may Treatments for erectile dysfunction are commonly find it difficult to deal with their partner’s anxiety. oral , including Viagra®, Cialis® and Levitra®. Other treatments include vacuum Having an emotional response to premature devices, penile injections and penile prostheses. ejaculation is quite normal and discussing these feelings with your partner and/or doctor can help.

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EXPERT REVIEWER Dr Michael Lowy MBBS MPM FACHSHM FECSM The Male Clinic, Sydney

DATE REVIEWED: MAY 2018

The information in this fact sheet has been provided for educational purposes only. It is not intended to take the place of a clinical diagnosis or proper medical advice from a fully qualified health professional. Healthy Male urges readers to seek the services of a qualified medical practitioner for any personal health concerns.

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© Healthy Male (Andrology Australia) 2018