Premature ejaculation
Premature ejaculation or early ejaculation is the most common sexual problem experienced by men and 1 out of 3 people say that they have experienced early ejaculation at sometime in their life.
What is the average time of premature ejaculation?
There are broadly two types of Premature ejaculation:
- Lifelong premature ejaculation happens since the time of puberty and usually men ejaculate within 1 minute.
- Acquired premature ejaculation happens after few months/years of normal sexual experience with normal ejaculation. Men usually ejaculate within 3 minutes.
It is more commonly related to the problems in normal sexual response cycle. Some of the possible causes include stress, familial discord, erectile dysfunction, irregular levels of brain chemicals like serotonin and so on. This can lead to severe family stress and infertility issues.
How can I stop premature ejaculation?
- Behavioral therapies like stop-start technique, Kegels exercises
- Couple counseling
- Oral tablets (antidepressants, erection inducing medications)
- Penile sprays or creams
- Botox injection to penile ejaculatory muscle and glans
- Microscopic penile dorsal neurectomy as the last option
Does Viagra help in Premature ejaculation?
Paper published by Dr Pramod Krishnappa in International Journal of Impotence Research (PMID 30837718) clearly explains Viagra (Sildenafil) does help in premature ejaculation along with some behavioral therapies.
Is it normal for a guy to release semen early?
Releasing the semen early may sometimes affect the sexual relationship. The partner might not get fully aroused or reach climax if you release early which can lead to unsatisfactory sex life. But premature ejaculation per se does not cause any serious medical issue to the person or for conception. If the couple are not in distress due to the early ejaculation, then premature ejaculation may be neglected. But if the person has issues simultaneously with his erections, then one should seek consultation with an andrologist.
Some men face other ejaculatory disorders such as delayed or anejaculation.
Anejaculation is the inability of a man to ejaculate (put the semen out). It could be due to psychological or organic cause. Common causes of inability to ejaculate (anejaculation) include anxiety, uncontrolled Diabetes, infections, current medications, nerve damage during a complex surgery, nervous system problems such as Parkinson’s disease or multiple sclerosis.
Sometimes men may not ejaculate on certain occasions such as while giving a semen sample for IVF / IUI (situational or psychological), but they ejaculate normally at home when their comfort levels are good. In such situations, we counsel the men to reduce their anxiety levels, start on oral medications and we use a penile vibrator.
Rarely, some men can have blockage of the male reproductive tract which carries the semen. In such situations’, a detailed evaluation is required including ultrasound or MRI scan of the pelvic organs and vasography.
If one is still unable to ejaculate in spite of all the measures, then sperms may have to be retrieved for IVF-ICSI from testis or epididymis (PESA, TESA, TESE, MicroTESE) for infertility.
How long is delayed ejaculation?
Delayed ejaculation is when a man who in trying to ejaculate but takes an unwanted extended time of more than 30 min to reach orgasm and ejaculate.
Which doctor is best for premature ejaculation?
Dr Pramod Krishnappa is the best andrologist dealing with Men’s Sexual Health and Male Fertility. He has been trained extensively in high volume Andrology centres in Madrid (Spain), Belgrade, Budapest, Chicago, and New York. It is preferable to consult a urologist who is further exclusively trained or specialized in Andrology to seek treatment for premature ejaculation.
Frequently Asked Questions
Lifelong premature ejaculation generally begins from the early sexual years, while acquired premature ejaculation develops after a period of previously normal ejaculation. Understanding when the problem started can help an andrologist identify the appropriate premature ejaculation treatment.
Yes. The page specifically identifies erectile dysfunction as one possible factor associated with premature ejaculation. When both conditions occur together, treating only the ejaculation problem may not address the underlying issue, so a comprehensive male sexual health evaluation can be helpful.
Yes. Stress, anxiety, and relationship difficulties can influence the normal sexual response cycle and may contribute to early ejaculation. Addressing these factors through appropriate counselling or behavioural strategies can form part of premature ejaculation management.
Yes. The page mentions techniques such as the stop-start method and Kegel exercises as behavioural approaches that may help some men improve ejaculatory control. These approaches may be used alone or together with other premature ejaculation therapies.
Premature ejaculation itself does not directly cause a medical problem with conception. However, if ejaculation occurs before satisfactory intercourse or creates significant sexual difficulties, it may indirectly make conception more difficult for some couples. Premature ejaculation and fertility should therefore be assessed separately rather than assuming that early ejaculation means infertility.
The page notes that published research by Dr. Pramod Krishnappa found sildenafil (Viagra) can help premature ejaculation in some men, particularly alongside behavioural therapies. Whether it is appropriate depends on the individual's symptoms and medical history, so Viagra for premature ejaculation should be discussed with a qualified specialist rather than self-medicated.
These options may be considered when behavioural approaches alone do not provide adequate control or when a patient's symptoms require additional treatment. The appropriate choice depends on the individual's condition, other sexual symptoms, and medical history, making PE medication treatment an individualized decision.
Yes, but the page describes microscopic penile dorsal neurectomy as a last option, rather than a routine first-line treatment. Less invasive approaches such as behavioural therapy, counselling, medicines, sprays, or other treatments are generally considered before surgical intervention. Surgery for premature ejaculation therefore requires careful specialist assessment.
This can sometimes be situational or psychological, particularly when anxiety or lack of comfort affects ejaculation in a clinical setting. The page describes counselling, oral medication, and penile-vibrator assistance as possible approaches in such situations. Semen collection difficulty should be discussed with the fertility team rather than assumed to indicate permanent anejaculation.
They are opposite types of ejaculation difficulty. Premature ejaculation involves ejaculation occurring earlier than desired, whereas delayed ejaculation involves taking an unwanted extended period to reach orgasm and ejaculate; the page describes more than 30 minutes as a reference point for delayed ejaculation. Delayed ejaculation treatment requires identifying the underlying psychological, medication-related, neurological, or physical factors.
