Premature Ejaculation

Premature ejaculation is the situation when the ejaculation occurs sooner than desired  especially when the penis just comes into the vagina or a little while after the penetration.  It occurs in about 40% of men under the age of 40 years. However, there is no definitive definition of this. Some men may also describe relationships lasting 5-10 minutes as premature ejaculation. The generally accepted time (IVLT) is that the ejaculation for less than 2 minutes after entering the vagina is premature ejaculation.

It is an important problem because  it can cause infertility since  semen cannot be thrown into the vagina and it negatively affects the sexual life of couples. In fact, the problem of intrauterine insemination (IUI) is that the male’s sperm can be transferred to the woman and the problem of not having a child can be solved to a great extent. But in order for the sexual intercourse to be more satisfactory, the natural delay of ejaculation should be treated with other methods.

First of all, the reason for not having sexual intercourse should be well understood whether if it is because of premature ejaculation or erection problem. Sometimes the ejaculation occurs before erection and sexual intercourse can not occur. Here, the presence of erection problem in the penis should be investigated well. For this, tests such as NPT test, penile Doppler and VSS can be requested.

Generally, premature ejaculation may occur in initial relationships. It depends on anxiety. If this stress situation lasts longer, premature ejaculation may continue for a while. In time, when the man can control himself, this problem disappears by itself. Insufficient sexual education and lack of knowledge also fears of masturbation are also important factors. Some cases are based on an organic cause. In other words, the sensitivity of the nerve stimulation increased. As a result, the semen ejaculates with a few movements. In inflammatory situations, such as urethritis.

First of all, it is recommended that the man to control himself during sexual intercourse (Masters and Johnson method). A man’s self-control means learning to interrupt the relationship just before the ejaculation. By pulling the penis out when he feels he is going to ejaculate or trying to distract for stopping ejaculation. Trying these exercises during masturbation will be better.  During masturbation, it is necessary to take a break immediately before discharge, wait for the decrease of the erection and then to resume. In fact, muscles contractions like urine retention is also useful in controlling ejaculation. This application is done 2-3 times. The exercise should be repeated 1-3 times a week. Later, during the sexual intercourse, the same exercises are made. Initially, the prevention of ejaculation before the relationship is made. Before the full discharge, the spouse is told to interrupt the relationship and wait until the erection disappears and then resumes. After being confident in this, the penis is started to be used to delay the discharge of the penis while in the vagina. The most appropriate position during this period, the man lies on the back, female-on-top position sexual intercourse. Only this way can best control male ejaculation. In the same way, it is felt right before discharge and the spouse is given a signal and the relationship is interrupted. After waiting for a while, it is continued again.

In the treatment of premature ejaculation, if they are caused by infection or irregular sexual life, they should be treated first. Some advice is given and retarding drugs are given. Psychiatric counseling may also be requested depending on the nature of the event.

If it is decided that there is no erection problem, a diagnosis of premature ejaculation is made and treatment is initiated.

All these applications can take time. It could take weeks. It is necessary to be patient and believe that the treatment can last a long time. If he / she cannot be successful, consult a doctor for sex therapy.

Another treatment method is the technique of squeezing the penis. Here, the handful of the penis in the handful of reflex to prevent ejaculation and blood to try to reduce the reaction is emptied. Care should be taken not to create excessive trauma.

Sometimes it is reported that masturbation before the relationship can be delayed during intercourse. It has been experienced that the use of a thick or double condom reduces the stimulation in the penis and delays the ejaculation.

During the period of treatment of premature ejaculation, the spouse help may be needed. Because in some cases, the woman’s orgasm may be delayed. For example, there are women who do not have orgasms despite sexual intercourse for minutes. For so long, it may not be possible for the man to continue sexual intercourse without ejaculation. The problem here is not the premature ejaculation of men, but the woman’s late onset of orgasm. Treatment should also be directed to this.

There are two types of retarding drugs.

1) pills taken orally

2) creams applied to the penis.

Oral pills are antidepressant drugs and are usually used in psychiatric disorders. But it is also widely used in the treatment of premature ejaculation because they delay the ejaculation by raising the stimulation threshold in the penis. It should be noted that the use of these antideprasan drugs in early ejaculation has not yet been approved by the Ministry of Health. They should be taken under the supervision of a doctor  because they may have side effects or adverse effects. Clomipramine, fluoxetine are some of these drugs. These drugs should be used for at least 15 days. If there is no response, there is no need to use too much, the drug can be changed or sex therapy can be started.

Retardant creams are actually locally effective anesthetics (drugs). They are sold very often in the market and are very good. But there are important drawbacks. First of all, they can prevent the woman from enjoying her pleasure by numbing vagina. In addition, they can distort the stimulation of the penis by making the erection difficult. Sometimes skin irritation can also occur.

In conclusion, it is very important for the man to control himself in the treatment of premature ejaculation. During each relationship to learn how to start the ejaculation even a few seconds later, will provide a satisfactory relationship after a while. His wife also needs to show understanding and contribute to the therapeutic direction. Drug use alone may not always be sufficient, so it is essential that one uses his / her will. Sex therapy may be required when necessary.