Premature Ejaculation: Causes, Myths and Treatments That Work
Premature ejaculation (PE), often called "early discharge", is one of the most common sexual problems men face. Yet many men suffer in silence for years because they feel embarrassed, or they spend money on advertisements and roadside "sex clinics" that promise quick cures.
The truth is simple: premature ejaculation is a medical condition, it is common, and it can be treated well with the right approach.
What exactly is premature ejaculation?
Doctors describe PE using three features together:
• Ejaculation happens very quickly after penetration, often within about one minute (lifelong PE), or there is a clear drop in the usual time (acquired PE)
• The man is unable to delay ejaculation on all or nearly all occasions
• It causes distress, frustration or avoidance of intimacy, for him or for the couple
An occasional quick ejaculation, for example after a long gap or on a new night together, is normal and is not PE.
What causes it?
Usually more than one factor is involved:
• Performance anxiety and stress, which create a cycle: worry leads to quicker ejaculation, which leads to more worry
• Relationship problems, poor communication or fear of disappointing the partner
• Erectile difficulties: some men rush to finish before the erection is lost
• Differences in brain serotonin signalling, which is thought to play a role in lifelong PE
• Medical conditions such as thyroid problems or prostate infection, in acquired PE
• Lack of sleep, heavy alcohol use and general stress
Myths that keep men from getting help
"Masturbation in youth has caused permanent weakness." It has not. Masturbation is a normal part of sexual development and does not damage the body.
"Night emissions or loss of semen make you weak." This fear, sometimes called "dhat", is very common in our part of the world, but semen loss does not cause weakness or illness. The anxiety itself is what causes the symptoms, and it responds well to counselling.
"Herbal capsules from advertisements are safe." Many such products are unregulated and some have been found to contain hidden prescription drugs. Always take treatment from a qualified doctor.
Treatments that actually work
Treatment is chosen after a proper assessment and is always confidential:
• Counselling and sex therapy to reduce performance anxiety and improve communication between partners
• Behavioural techniques such as the stop-start and squeeze methods, which train better control over time
• Pelvic floor exercises, which strengthen the muscles involved in ejaculation
• Numbing sprays or creams applied before intimacy, used as advised by the doctor
• Prescription medicines that delay ejaculation, taken either on demand or daily depending on the case
• Treating an underlying problem first, such as erectile dysfunction, thyroid disease or anxiety
The best results usually come from combining medical treatment with counselling, and involving the partner when possible. Please do not start any medicine without a prescription, as some interact with other drugs and are not suitable for everyone.
When to see a doctor
Book a consultation if PE is causing you distress, if you have started avoiding intimacy, if it is straining your marriage, or if the problem started recently after years of normal function. A new change can be a sign of an underlying medical issue that needs attention.
It also helps to see a doctor before marriage if you are anxious about sexual performance. Many worries can be settled with a single honest conversation.
Confidential care in Hyderabad
Dr. Abdullah Kamlur, MBBS, MD (Psychiatry), is a Psychiatrist and Sexologist who treats premature ejaculation, erectile dysfunction, low desire, performance anxiety and couple intimacy problems. He consults at Caspian Healthcare, Vijay Nagar Colony, and at Karla Mind & Neuromodulation, Jubilee Hills, in English, Hindi, Urdu and Telugu.
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