Premature Ejuculation

Dear Sir,
                I am 36 years old married man having two sons. I am suffering from Premature Ejaculation
problem since before my marriage. I was habitual of masterbation (masturbation) fefore marriege. Please help me.
                                         Thanks,

[Ash Tewari, MD, M.Ch.]

Premature ejaculation is generally defined as, "persistent or recurrent ejaculation with minimal stimulation before, on, or shortly after penetration and before the person wishes it. The disturbance causes marked distress or interpersonal difficulty.1"

There are three essential components for the diagnosis of premature ejaculation. These include; short time interval between penetration and ejaculation; lack of ejaculatory control; and sexual dissatisfaction.

There have been many proposed causes of premature ejaculation. Lue et al. suggest that two are most likely. This includes; penile hypersensitivity and 5-hydroxytryptamine  (5-HT)-receptor sensitivity.

Treatment for PE can be classified in two ways, psychological/behavioral and pharmacological. Psychological/behavioral treatment encourages open communication between partners about intimacy. Drawbacks include, time and money costs, less immediate results. There are a number of pharmacological treatments available and can be discussed with your urologist.

An office evaluation of your current situation should be performed by a sexual medicine expert. A basic medical history, history of the disorder, partner's response, should be recorded.

Best,

Ash Tewari, MD

1 Lue TF and Broderick GA. Evaluation and Nonsurgical Management of Erectile Dysfunction and Premature Ejaculation. Cambell-Walsh Urology 9th ed. 784-786.