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Premature Ejaculation

Many men needlessly worry about premature ejaculation without really understanding the condition. For most it represents a nuisance associated with novel situations, anxiety or embarrassment. When it only occasionally occurs it represents neither a physical nor a psychological condition. Primary premature ejaculation generally occurs within 1 minute of intravaginal penetration and occurs with every sexual encounter beginning in adolescence or early adulthood. It appears to represent a biochemical disorder in at least serotonin metabolism although a variety of other neurotransmitters may be involved as well. A variety of treatments exist including serotonin acting drugs: Paxil, Celexa, Lexapro, Prozac. A secondary premature ejaculation subtype occurs more frequently than the primary variety. It may result from prostate disorders, thyroid abnormalities, diabetes, alcohol misuse and drug abuse. It may also result from adverse relationship situations. Over time the role of sexual counseling, psychotherapy and attention to body sensations seems to have diminished as understanding of the biological basis of the condition increased. Unfortunately people’s concept of normal sexual function arose in the Victorian era and social media, misinformation and even pornography. Reality appears significantly different.