Premature Ejaculation

This form of erectile dysfunction is the most common experienced in men.

It has been recognised as medical condition for more than 100 years.

Premature Ejaculation (PE) can cause substantial distress to a man and may cause significant problems in a relationship.

Definition of Premature Ejaculation:

For research purposes, the following definition of PE applies:

  • Ejaculation that always or nearly always occurs prior to or within about 1 minute of penetration and before the individual wishes
  • The symptom is causing significant distress

For some men the symptoms can be a life-long problem but for other they may be a new acquired problem. From a treatment perspective, it is important to differentiate the 2.

Causes of Premature Ejaculation:

There are several causes of PE which been hypothesized:

  • Hypersensitivity of the glans
  • The pudendal nerve (the nerve which supplies sensation to the penis) is “overrepresented” in the brain
  • Hormonal disturbances in some neurotransmitters such as Serotonin, Dopamine and Oxytocin.
  • Certain medications and drugs
  • Erectile dysfunction
  • Thyroid problems
  • Genetic predisposition
  • Prostatitis
  • Psychological factors

Assessment of a patient with Premature Ejaculation:

A comprehensive evaluation is essential to help determine if there are any underlying reversible causes of PE. This may allow the patient to avoid the need for lifelong treatments.

Treatment of Premature Ejaculation:

There are many treatments on the market but at Men’s Health Melbourne we prefer to take an evidence-based approach and recommend treatments that have been proven in scientific research.

  • Psychological/behavioural techniques:
    • In isolation, these techniques have a high failure. They are probably best used in conjunction with medication. For those patients seeking this type of therapy, we can recommend reputable sex counsellors and sex therapists for both heterosexual and gay couples. Undergoing this type of treatment can also have certain spin-off benefits such as improving a couple’s openness about discussing these problems and developing other sexual skills and self-confidence.
  • Pharmacological therapies:
    • There are several medications which have been proven to work well in premature ejaculation. The choice of which one is best for a certain patient will be determined after a comprehensive evaluation.
    • The options include:
      • Topical Lignocaine Therapy (Promescent®):
        • This is the first FDA approved medication for Premature ejaculation:
        • It is applied 5-10 minutes before sexual intercourse.
        • Studies have demonstrated a 6 x increase in the time taken to ejaculate compared to placebo.
        • To find out more about this medication visit: www.promescent.com
      • Dapoxetine (Priligy®):
        • This is the first oral therapy specifically designed and approved for premature ejaculation in Australia and is available in over 50 countries
        • These drugs should be taken 1-3 hours prior to sexual activity and on average can increase your ability to delay ejaculation by 3 times as long
        • Patients of Men’s Heath Melbourne may be eligible for a free starter pack of Dapoxetine.
      • Other drugs:
        • There are numerous other medications, which have been shown to have some benefit in premature ejaculation. Most of these drugs are designed for other conditions and therefore are only considered if other therapies are unsuccessful.

At Men’s Health Melbourne, we take a personalised, tailored approach to your problem and will recommend the best treatment based on a comprehensive assessment.

Our specialists will continue to monitor your progress with the various treatments that are prescribed and adjust or change the treatment to achieve the best response.

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