Premature Ejaculation: Assessment and Treatment in Birmingham
Premature ejaculation (PE), sometimes called rapid ejaculation, is the most common ejaculation problem in men. It is very treatable, and a confidential consultation is the first step to finding the right approach for you.
Book an appointment: The Priory Hospital, 0121 446 1668 · HCA Harborne Hospital, 0121 812 3051.
What is premature ejaculation?
PE means ejaculating sooner than you or your partner would like, with little stimulation and little sense of control. What counts as “too soon” varies a great deal between couples: for some men it happens before penetration, for others after several minutes that still feel too short.
On average, men ejaculate about five to six minutes after penetration, but there is no “correct” length of time. An occasional early ejaculation is normal. It is worth seeking advice if it happens in more than half of your sexual encounters, or if it is causing you or your partner distress.
Key facts
- Between one in five and one in three men are thought to be affected.
- Lifelong PE has been present since a man first became sexually active.
- Acquired PE develops later, after a period of normal control.
- It can be situational, happening only in certain circumstances or with a particular partner.
- It often occurs alongside erection problems.
- Fewer than one in four men with PE ever ask for help, even though effective treatment is available.
What causes it?
Often no single cause is found. It may run in families, and a number of factors can contribute:
Physical factors
- Inflammation of the prostate (prostatitis)
- Thyroid problems, either over- or under-active
- Erectile dysfunction
- Recreational drug use
Psychological factors
- Stress, anxiety or low mood
- Worry about sexual performance, especially early in a new relationship
- Relationship difficulties
- Past negative or traumatic sexual experiences
How is it assessed?
Mr Subramonian will talk with you in a relaxed, confidential setting about your symptoms, general health, lifestyle, alcohol and medicines. You may be asked to fill in a short questionnaire, and sometimes to time how long it takes to ejaculate after penetration. Ejaculation within about a minute on most occasions is considered clearly early.
A brief examination is usually carried out. Blood tests, such as sugar, thyroid and testosterone levels, are only needed if there are signs of another problem, for example erection difficulties.
Treatment options
Most men do best with a combination of techniques and, where needed, medication. The plan is tailored to how severe the problem is and whether it is lifelong or acquired.
Behavioural techniques and counselling
- Stop-start: pausing stimulation just before the point of no return, then starting again.
- Squeeze technique: gently squeezing the penis just before climax to reduce the urge to ejaculate.
- Pelvic floor (Kegel) exercises: strengthening the muscles that control ejaculation.
- Psychosexual counselling, cognitive behavioural therapy (CBT) or mindfulness, ideally involving your partner.
Numbing sprays and creams
Local anaesthetic sprays or creams are applied to the penis a short time before sex to reduce sensitivity. Wiping off excess or using a condom stops your partner being numbed too. Condoms containing a mild anaesthetic are also available.
Tablets
- Dapoxetine (Priligy): taken about an hour before sex, this is the only tablet licensed specifically for PE.
- Some other medicines in the same family (SSRIs) can be taken daily to delay ejaculation. Side effects such as tiredness, nausea or sweating are usually mild and often settle within a few weeks.
- If erections are also a problem, erection tablets such as sildenafil or tadalafil may be used, sometimes together with dapoxetine, to improve confidence and control.
Medicines are prescribed only after a discussion of their benefits and possible side effects.
When to seek help
If early ejaculation happens most of the time, is affecting your confidence or relationship, or has appeared alongside erection problems, it is worth seeking advice. Many men are reassured to learn how common and treatable PE is.
Why choose Birmingham Urology Clinic?
Mr Subramonian is a consultant urological surgeon with over 21 years of experience. He offers private, unhurried consultations at The Priory Hospital and HCA Harborne Hospital in Birmingham, where erection and ejaculation problems can be assessed and treated together in one place.
Further reading
Patient information from the British Association of Urological Surgeons: Premature ejaculation (BAUS)
