Fertility treatment and services

Premature Ejaculation

Premature ejaculation is a type of sexual dysfunction that occurs when a man has an orgasm and releases (ejaculates) semen sooner than he or his partner would like. It often happens before or shortly after penetration during intercourse. Premature ejaculation can be a frustrating experience for both you and your sexual partner and makes your sex lives less enjoyable. However, the good news is that it’s usually fixable!

How common is premature ejaculation?

Between 30% and 40% of men experience premature ejaculation at some point in their life. According to the American Urological Association, premature ejaculation is the most common type of sexual dysfunction in men. About one in five men between the ages of 18 and 59 report incidences of premature ejaculation.

Although the definition of premature ejaculation varies, the American Urological Association defines ejaculation as “premature” if it occurs sooner than desired, either before or shortly after penetration, causing distress to either one or both partners. The American Psychiatric Association defines three levels of severity (mild, moderate, and severe), based on time to ejaculation, with mild being under one minute. If pressed for a time frame, many doctors would define prematurity as ejaculation within a minute of beginning intercourse. Despite professional opinions, your feelings as to what is premature are also considered.

What causes premature ejaculation?

Physical, chemical and emotional/psychological factors cause premature ejaculation.

Physical and chemical problems include:

- An underlying erectile dysfunction diagnosis.

- A hormonal problem with oxytocin levels, which has a role in sexual function in men. Other hormone levels that play a role in sexual function include luteinizing hormone (LH), prolactin and thyroid-stimulating hormone (TSH)

- Low serotonin or dopamine levels, chemicals in the brain that are involved in sexual desire and excitement.

- A penis that is extra sensitive to stimulation.

Emotional or psychological causes include:

- Performance anxiety. This could be due to the nervousness of being with a new partner, the anxiousness of having sex again after a long period of abstinence, lack of confidence, guilt, being overly excited or stimulated or other reasons.

- Stress.

- Relationship problems.

- Depression.

How are the causes of premature ejaculation diagnosed?

If you have frequent premature ejaculations, or if premature ejaculation is causing you anxiety or depression and affecting your relationship, make an appointment to see a urologist.

Your urologist will begin an exam by asking about your sexual experiences. You will likely be asked:

- How long have you had this problem?

- Under what circumstances does it happen?

- How often does it happen?

- Does premature ejaculation happen at every sexual attempt?

- Does it happen with all partners?

- Does premature ejaculation occur when you masturbate?

- Do you have trouble maintaining an erection?

While the questions are personal, you must answer your urologist honestly so they can best diagnose the source of your problem.

Your urologist will also ask about any other medical conditions you may have and any medications including over-the-counter medications, supplements and herbal products you are taking. You will also be asked about any alcohol and illegal drug use.

RETROGRADE EJACULATION AND INFERTILITY

Unlike premature ejaculation, retrograde ejaculation does impact fertility. This is not a common condition and causes only about 0.3-2% of infertility problems. With retrograde ejaculation, the sperm are not making it to your partner even though they are viable.

Retrograde ejaculation is the result of the sphincter muscles of the bladder failing to respond correctly. Instead of semen travelling out through the head of the penis, it travels back into the bladder, where most of the sperm becomes trapped.

Certain health conditions such as diabetes or hypertension or mood-altering medications can cause retrograde ejaculation. Surgery to the prostate or urethra can also result in this condition. In some situations, it is reversible. Treatment for the condition depends on the cause. It may be as simple as stopping a certain medication.

Chawala Nursing Home can help you build your family, whether you are experiencing premature ejaculation or retrograde ejaculation. Contact our fertility office to schedule an appointment for an examination and consultation. We will help you explore your options.