Urology Specialty Group

Premature Ejaculation (PE)

Premature ejaculation is a condition in which a man regularly ejects semen very soon after the onset of sexual arousal, or sooner than he or his partner wishes.

Causes of Premature Ejaculation
The cause of premature ejaculation is unknown.  Studies have shown a variety of factors may contribute to PE:

 

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

 

Biological
Although rare, several biological factors could be the cause of premature ejaculation including abnormal hormone levels, abnormal reflex activity of the ejaculatory system, hyperthyroidism, and inflammation or infection of the prostate or urethra.

 

Neurobiological
The neurotransmitter serotonin (5HT) plays a role in controlling ejaculation and that low levels of serotonin in specific areas in the brain could cause premature ejaculation. It has been shown that increases in serotonin levels can help delay ejaculation in some men.

 

Penile Sensitivity
Many physicians believe that penile hypersensitivity plays a role in the ejaculatory response. The success of topical medications provides strong reason to believe that penile sensitivity does contribute to premature ejaculation.

Treatments for Premature Ejaculation
We recommend that you visit us for evaluation as this a problem which may be evaluated and treated with a single office visit.

 

Behavioral Techniques
Some patients may want to start with some behavioral techniques such as the start/stop or squeeze methods. Generally, patients report limited satisfaction with these methods and often request some type of medication.

 

Oral Medications
Some men respond well to low doses of the antidepressants known as selective serotonin reuptake inhibitors (SSRIs). SSRIs increase the levels of serotonin in certain areas of the brain. These medications prescribed off-label are often associated with a variety of side effects including fatigue, erectile dysfunction and dry mouth, among others.

 

Topical Medications
Topical anesthetic medications are often the first course of action for premature ejaculation.  They are effective, easy-to-use, cost effective, only need to be applied when you want to engage in sexual relations and have a negligible risk of significant side effects.

Our patients are having good success with a new product, Promescent®, from Absorption Pharmaceuticals, which provides improved ejaculatory latency (the time from penetration to ejaculation).

Our office has Promescent available for purchase.  You may walk in and purchase without a prescription. However, we recommend seeing one of our physicians to better understand your complete urology health.  You may also purchase Promescent on-line.

Additional Information
A comprehensive and well-organized resource is the "About PE" section of the Absorption Pharmaceuticals website.  Click here >> premature ejaculation resources to read the materials along with links to websites and articles from a variety of reputable institutions including the American Urological Association and the International Society for Sexual Medicine. 

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