How long should I really last – do I have premature ejaculation?
This is a question that I recently received from one of my patients. Most men are concerned about how long they last and looking for ways to avoid early ejaculation. The simple answer is as long as necessary to derive pleasure from sexual activity. The medical definition of premature ejaculation is divided into whether symptoms have been present since the beginning of sexual activity (let’s say after puberty) or acquired (related new issue that you didn’t have before). In patients with lifelong premature ejaculation, men may report poor ejaculatory control that they are bothered by and ejaculation that occurs within 2 minutes of penetrative intercourse. Acquired premature ejaculation occurs in men who report poor ejaculatory control that they are bothered by and ejaculation time is reduced compared to before.
A detailed history and focused physical exam by a trained expert is necessary to evaluate a patient with premature ejaculation. There can be several issues specifically with changes in testosterone that can contribute to acquired changes in ejaculation. In many men, a sexual health therapist can be an important adjunct to treatment. Therefore, it is very important to seek out the right help. Fortunately, our team has extensive experience in male sexual dysfunction to improve your health and wellbeing.
I see many patients that have tried a delay spray or wipe, either through their own independent research or recommended from their Urologist. Although this treatment is considered first-line treatment for premature ejaculation, it can be difficult to use and its effectiveness can be limited. Additionally, some of the medicine can be transferred to your partner if you don’t wait long enough. Typically after applying the product (which should really only be applied to the glans and the frenulum of the penis), you should wait 10 minutes to allow it to completely absorb and have full effect. This 10 minutes can feel like eternity when you are in the moment.
Many patients are surprised to learn that certain pills are now recommended first-line therapy in men with premature ejaculation as well. These can be used daily or on-demand. Although these medications are FDA approved for depression/anxiety, they have be safely used for premature ejaculation as well and with favorable results. As with any medication, there is the potential for side effects so it is important to discuss this option with your doctor.
Don’t hesitate to contact Dr. Patel to create an individualized treatment plan for your symptoms of premature ejaculation.
