Premature Ejaculation: A Quick Guide

Although premature ejaculation does not represent any actual dangerous health risk for the men who suffer from it, it can be very embarrassing, resulting in dissatisfaction within relationships and is often a cause of poor self-esteem. The good news, however, is there are actually some easy treatments for the problem of premature ejaculation, including many that do not require any medication.

What is premature ejaculation?

Premature ejaculation is the term for a condition that around thirty percent of all men will suffer from at some time in their lives and often result in great distress. The condition causes men to produce semen at too early a point during sexual intercourse. This is generally felt to be between thirty seconds up to four minutes from the commencement of sexual intercourse, although more experts have come to believe that the condition is actually restricted to just the first two minutes. Men can often feel embarrassed by the condition and find it difficult to talk about, even with a medical professional.

Types of premature ejaculation

There are two different kinds of premature ejaculation, ‘acquired’ and ‘life-long.’

Life-long premature ejaculation is often the result of the condition occurring during first sexual contact during the teenage years and can result in psychological repercussions that make it very difficult to treat. Acquired premature ejaculation is generally a condition that occurs later in life and may be triggered by physical conditions such as diabetes and high blood pressure or psychological problems like stress.

There are very clear distinctions between the two forms of premature ejaculation but for most men, the most important question is how the condition in either form might be treated. There are some medical remedies for the condition but there are also some behavioural strategies and even home remedies that should probably be attempted before seeking medical help. These remedies include:

  • Thick condoms
  • The squeeze technique
  • The start-stop technique
  • Other alternatives

Thick condoms

It can be a good idea for men who have a very sensitive penis to make use of thicker than usual condoms. The thicker wall on the condoms helps to reduce the level of sensitivity, enabling sexual intercourse to last for a longer period of time prior to ejaculation.

The squeeze technique

If men feel they are about ready to commence ejaculation, repeatedly squeezing the penis between the glans and the shaft can prevent ejaculation and may even increase the strength of the erection until climax occurs. However, this technique requires a great deal of patience on the part of both sexual partners as it causes disruption to the sexual act.

The start-stop technique

The start-stop technique can be attempted with a sexual partner or even alone and involves the stimulation of the penis followed by withdrawal just prior to the feeling that ejaculation is about to begin. This should be followed by a thirty-second break and then repeated between four to five times, thus delaying orgasm. Although some people can find this technique inconvenient and frustrating, it may be an idea to use other methods of gaining pleasure at the same time while also preventing premature ejaculation.

Other alternatives

There are a number of other alternatives in regards to coping with premature ejaculation, including the likes of having sex more frequently, masturbating prior to sexual intercourse or engaging in sexual activity with the other partner on top during the act. Premature ejaculation can also sometimes be prevented by the sufferer distracting themselves by thinking about a boring, annoying or at least non-erotic subject.

There is no cause for embarrassment with premature ejaculation, but the problem should also not be ignored for a long period of time or relationship and self-esteem issues could arise. The best option is for sufferers and their partners to talk about the issue and cope with it as a couple.

Medication

If the above techniques prove to be inadequate to deal with the problem, then medical intervention may be necessary. There are a number of medications that can help with premature ejaculation including topical anaesthetics, which are generally applied to the penis around ten to fifteen minutes prior to intercourse in the form of sprays or creams, and some oral medications such as analgesics and antidepressants. However, there are often side-effects to medications, so it is important to attempt home remedies for the problem first.

What are the Alternative for Urinary Incontinence?

Thousands of women in the United Kingdom have had to have surgery to remove vaginal mesh implants over the course of the last ten years, National Health Service records have revealed. The Guardian obtained figures that suggest that nearly one in fifteen women who were fitted with the common mesh support eventually had to have surgery to extract it, because of later complications. The rate of removal has been called a “scandal” by University College Hospital’s consultant urogynaecological surgeon Sohier Elneil, who has been responsible for carrying out hundreds of such removal procedures, and notes that those who had to have it removed were likely to be those with the most serious complications.

The failure rate

The implants have been in use as a less invasive, and much simpler alternative to the more traditional approaches for the treatment of common post-childbirth conditions, such as urinary incontinence and prolapse, which generally requires surgery. The operation has been a success for most women, but concerns have been growing over the serious complications that have manifested in a wide array of patients, such as chronic pain and the mesh cutting through vaginal tissue, resulting in women being unable to have sex, or in some cases, even walk. The producer of one of the most commonly used meshes, Johnson & Johnson (via their Ethicon subsidiary), is already involved in a class action lawsuit within Australia and could face similar legal battles in the United Kingdom.

According to NHS digital records, around 75,000 trans-vaginal implants were fitted between 2006 and 2016, with over 4900 removal procedures also carried out in the same period, around 6.5 percent of those fitted. Over a thousand removals were also performed for another kind of mesh, known as transobturator tape, which was fitted in as many 44,000 women during this decade. 

The figures suggest a much higher complication rate than has been claimed, in both a 2014 government report that assessed the benefits and risks of vaginal mesh, and in short term clinical trials. The removal rate of TVT was estimated at just 0.9 percent with a complications rate of less than 1.5 percent in the former. The University of Oxford’s professor of evidence-based medicine, Carl Heneghan, who wants a public inquiry into mesh use, says that the figures are only likely to worsen, potentially resulting in as many as one in fifteen women requiring their mesh to be removed in the future.

The implications

TVT implants have been in favour in the United States and Europe since the beginning of the 2000s, coming to be used more commonly ahead of traditional open surgery procedures. These also came with complications, involved much longer patient recovery times, and took more time to carry out. TVT procedures usually take just half an hour with the use of keyhole surgery, and patients can usually be sent home on the same day. 

The trials also showed an impressive success rate for the resolution of incontinence problems. Elneil notes that many patients think the procedure fixes a distressing condition simply and easily, but removing the mesh can be a very different story. The plastic mesh is intended to be permanent once placed inside the body, with full removal often necessitating hours of surgery that carry the risk of damaging nerves, and organs such as the bowel and bladder. 1769 full removal procedures have been performed since 2006, NHS figures state. No device is without risk, according to the Medicines and Healthcare products Regulatory Agency, and Johnson & Johnson maintain that most women have had their lives improved via the mesh.

Alternatives

There are a number of possible alternatives to the use of vaginal mesh. Corrective surgery can help in serious cases of prolapsed organs, using tissue grafts or even the tissue of women’s own bodies. Although such surgeries are invasive and complex, they leave almost no foreign material within the human body following completion. 

Other options include bulking agents such as Botox, synthetic sugars, specialised gels, and collagen, which can be injected into tissues surrounding the bladder. This treatment only applies to SUI. Pessaries are devices inserted into the vagina which can give support to the vagina, uterus, rectum and bladder for weeks at a time, and can relieve the symptoms of prolapse, though they’re not a cure. Hormone replacement therapy may help some POP cases, and the pelvic floor may also be assisted by Kegel exercises in minor SUI or POP cases.