Learning About Rapid Ejaculation

***We are happy to present a series of articles on sexual and intimacy issues, written by our very own therapist Christina Campbell who has an extensive history working in the field of sexology. This series is the result of positive feedback from previous articles, and will cover topics that negatively affect couples. Please know that the content is intended for a mature audience and reader discretion is advised. Should you have any questions or concerns please feel free to contact us using the contact page on our website.

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99Defining Premature Ejaculation (PE) or Rapid Ejaculation (RE) has been difficult, as there is a lack of a clear and universally accepted definition of the condition. The idea of “normal” ejaculation varies by country and can differ based on the patient/client or their partner.

The guideline of the American Urological Association uses a definition of “ejaculation that occurs sooner than desired, either before or shortly after penetration, causing distress to either one or both partners”.  This definition, along with others, acknowledges three core components: short ejaculatory latency; lack of control over ejaculation; and lack of sexual satisfaction.

Rapid ejaculation affects most men at some point in their life. In addition, it is the most common sexual disorder in men younger than 40 years, with 30-70% males in the United States affected to some degree at one time or another.

Most researchers differentiate between two forms of RE: a primary (lifelong) and secondary (acquired) form, which may have distinct causes.

What are the causes of RE?

Physiological causes of RE: Like many areas of medicine, before doctors knew any better, the cause was thought to be psychological, but in reality there are many interacting factors. New research techniques have begun to shed light on some of the physiologic factors of RE, like hypersensitivity of the ejaculation reflex and of the sensory receptors on the penis. We know that the particular levels and combinations of neurotransmitters like adrenalin and serotonin in different people will play into the equation as well.

Historically, rapid ejaculation was not a subject most men felt comfortable talking about, but as medical reasons for RE became more public, this improved.

Medical conditions and the development of RE:

Rapid Ejaculation can be the result of a medical cause, like prostatitis, if it develops later in life. This should prompt men to see a doctor. Sometimes RE develops in conjunction with erectile dysfunction (ED). This too should prompt a visit to a physician so that any underlying medical conditions, like diabetes or vascular disease (to name just a few), can be uncovered or ruled out.

Research now shows us that the majority of RE cases are due to a combination of both psychosocial and physical factors. Psychological issues, such as increased anxiety, depression, and negative relationship dynamics, may greatly influence treatment outcomes. Furthermore, RE can worsen the psychosocial issues that may have originally caused the problem, creating a vicious cycle.

What are the consequences of RE? Often Rapid Ejaculation results in a great deal of frustration, depression, and marital discord, but not always. Younger men usually have a short “unmanageable period.” This is the time it takes to regain their erection after ejaculation; depending on the length of this period, sometimes it is easy to ignore the problem. After ejaculation they can just resume intercourse as soon as the erection recurs. It is only when the unmanageable period increases with age that RE starts to be a problem for the couple. His partner may be just getting started, and suddenly, he’s done.

If the man’s self-image suffers or if his partner’s disappointment is particularly evident, then the problem can become much worse. Blaming oneself or one’s partner can add a whole other dimension of “dis-ease” not typically seen with other medical conditions. In this case, if proper help is not sought, RE can lead to separation or break up.

RE significantly negatively impacts men and their partners and may prevent single men from forming new partner relationships. On the other hand, men are reluctant to seek treatment from their physicians, although they may be more encouraged to do so through their partner’s support and the availability of effective treatments (Rosen & Althof, 2008).

Treatment and drugs

Treatment options for premature ejaculation include sexual therapy, medications and psychotherapy. For many men, a combination of these treatments works best.

Sexual therapy
It is a good idea to see a sex therapist, a psychologist, or a family doctor who deals with sexual problems. If there are doubts, resistance, or communication barriers, seeing a therapist with your partner might be helpful. These problems are readily solvable, and in the end, increased communication between partners can result in more intimacy.

In some cases, sexual therapy may involve simple steps, such as applying techniques to prolong ejaculation without having intercourse. At first, it may be recommended to avoid intercourse for a period of time and re-focus on other types of sexual play so that pressure can be regulated. One of the techniques used in therapy is the squeeze technique. By repeating this technique as many times as necessary, you can reach the point of entering your partner without ejaculating. After a few practice sessions, the feeling of knowing how to delay ejaculation may become a habit that no longer requires the squeeze technique.

Taking the emphasis off intercourse can remove the worry about ejaculating too soon — and it can help lay the foundation for a more fulfilling sexual relationship

Medications
Certain antidepressants and topical anesthetic creams are used to treat premature ejaculation. Although none of these drugs are specifically approved by the Food and Drug Administration to treat premature ejaculation, some are used for this purpose.

Cognitive behavioral therapy
This approach, also known as counselling or talk therapy, can help you reduce performance anxiety or find effective ways of coping with stress and solving problems. Counselling is most likely to help when it’s used in combination with other therapies.

Many men who experience premature ejaculation feel frustrated and even ashamed. It may help you to know that this problem is common and often very treatable.

Open communication between sexual partners, as well as a willingness to try a variety of approaches to help both partners feel satisfied, can help reduce conflict and performance anxiety. If you’re not satisfied with your sexual relationship, talk with your partner about your concerns and discuss the options for getting help.

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Posted in Intimacy and Sexuality.