Early Climax, medically known as Premature ejaculation (PE), is a condition defined as ejaculation occurring within 1-2 minutes from penetration, where the man experiences little or no control over the event.
In recent years, the concept of IELT (intravaginal ejaculatory latency time) in order to grade PE has become more established. By this measure, an IELT of 1 minute or less is considered manifest PE, 1-2 minutes is considered as borderline PE and IELT exceeding 2 minutes falls within the broader range of normal variation.
PE is further categorized as either lifelong (primary) and acquired (secondary. Lifelong PE is present if the issue has always, or almost always, occurred since one’s first sexual encounter. Acquired PE, on the other hand, develops after prior sexual experiences without ejaculation issues.
If you frequently find yourself ejaculating within a minute or two following penetration, and this occurrs uncontrollably, causing frustration, distress and/or discomfort, you may be experiencing premature ejaculation that needs to be addressed. To better understand your situation and to receive assistance and guidance, we recommend that you contact your healthcare provider.
In Sweden, manifest PE (occurring most often, almost always or always) is estimated to affect approximately 5-8% of the adult males. Sporadic PE (happening rarely or occasionally) is by far more common, with a prevalence rate close to 40% among adult males aged 18-74. The older you get, the more common it gets. Additionally, PE is closely associated with low libido or a lack of sexual interest as well as erectile dysfunction.
Recent epidemiological studies indicate that the average time from arousal to ejaculation during intercourse (known as IELT or intravaginal ejaculatory latency time) ranges between 5 and 14 minutes. There have been discussions on whether circumcised men have longer IELT or not, but such findings have not been confirmed.
The causes of premature ejaculation (PE) are multifactorial, and the exact underlying factors are not yet fully understood. It is widely believed that PE is a combination of biological, psychological and interpersonal factors. There may be a genetic factor in men with lifelong, manifest PE, but recent research suggests that dysregulation in the central nervous system plays a significant role and might be of great importance for the development of PE.
Biological factors contributing to PE include disturbances in neurotransmitters, primarily serotonin, but also oxytocin, NO, GABA and estrogen, in addition to genetic factors. Psychological contributors encompass performance anxiety, hightened stress levels, and low self-esteem. Medical conditions such as erectile dysfunction, prostate issues and chronic substance misuse are also recognized potential risk factors that can contribute to the development of PE. Interpersonal factors known to influence the prevalence of PE incorporate relationship problems, traumatic sexual experiences and a perceived lack of intimacy.
There are numerous self-help strategies and techniques that can be explored prior to intercourse and before considering seeking medical help:
Masturbating 1-2 hours prior to sexual activity
Using a thick condom
Taking breaks during intercourse
Distracting yourself by trying to concentrate on something else
An investigation typically involves a doctor conducting a physical examination, which includes examination of the prostate gland. An investigation for PE aims at understanding a patient’s social history including both alcohol and other drug use, as well as the complexities of the ejaculatory problem.
Currently, the treatment for premature ejaculation (PE) typically involves one or several of the following:
The pharmacological approach to treating PE involves one of the following:
Topically applied anesthetic
Psychotherapy aims to reduce stress and anxiety related to performance. Various techniques can also be recommended, which can be practiced alone or with a partner.
The Start-and-Stop Technique
A proven method to extend the duration before ejaculation is the “start-and-stop technique”. This approach focuses on enhancing bodily awareness. The idea is to cease stimulation just before reaching the point of orgasm and repeating this process. It’s adviced to combine this technique with couples counseling.
Pelvic Floor Exercises
Some suggest that a weak pelvic floor may contribute to premature ejaculation. One potential strategy could be to strengthen the pelvic floor.
Occasional premature ejaculation doesn’t inherently necessitate concern. However, you should consider seeking medical assistance if you:
Always or nearly always feel like you ejaculate within 2 minutes of penetration
Always or nearly always feel that you cannot delay ejaculation during sex
Tend to avoid sexual intimacy due to premature ejaculation
Experience distress and frustration as a result of premature ejaculation