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Premature ejaculation

Essential information for patient and partner

Persistent or recurrent onset of ejaculation and orgasm with minimal sexual stimulation before, on or shortly after penetration and before the person wishes it. Most young men learn to delay orgasm with sexual experience and ageing, but some continue to ejaculate prematurely. Premature ejaculation is typically seen in young men and is present from their first attempts at intercourse. When onset occurs later in life, it is often caused by a decreased frequency of sexual activity, intense performance anxiety with a new partner, or loss of ejaculatory control related to erectile dysfunction. It may also occur in men who have stopped regular use of alcohol.

Control of ejaculation is possible and can enhance sexual pleasure for both partners.

General advice and management to patient and partner

Reassure the patient that ejaculation can be delayed by learning new approaches during masturbatory training (eg the squeeze or stop–start technique). This, and other exercises, are set out in self-help books (See Resources for patients and families). 

Medication

In some cases, delay can also be achieved with clomipramine or SSRI medication (paroxetine, sertraline) or clomipramine, but relapse is very common on cessation.  Local anaesthetic sprays, if used cautiously, can delay ejaculation. Durex Performa is a new condom coated with a small amount of anaesthetic cream.

Last edited: 26/1/2004


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