Anonymous

3 years

I have premature ejaculation even before marriage

I have been married for 14 years and I always have premature ejaculation problem even before that. Never lasted more than 1 or 2 minutes most or even less than that. This has always been my problem and issue in my intimate and marriage life. Please help

Dr Ilias Yee,

4 years

Hello there.

Facing this problem must have been extremely frustrating for you and I empathise with your current predicament.

PE is classified into:

  • Primary PE - The problem is almost always or always present since your first sexual experience
  • Secondary PE - Developed after a period of non-problematic ejaculation
  • Variable condition - One experiences a mix of normal and PE

The common complaint for PE is ejaculation within a minute of penetration. It may also happen during other sexual experiences such as masturbation.

Its exact cause is unknown. However, there are psychological and biological factors associated with PE. Psychological factors include depression, stress, sexual abuse and relationship problems while biological factors include abnormal hormone or neurotransmitter levels, prostate infection or inflammation, genetics or comorbidities such as erectile dysfunction.

Should you visit a doctor, you will be asked about your health, sexual habits, social life, drugs/medication and your partner’s sexual history. A physical examination of your abdomen, neurological system, lower limbs and genitalia may be conducted and when necessary, blood tests are performed.

Treatment depends upon the severity of your condition, psychosocial aspects, presence of reversible illnesses and your preference. Medications available include topical anaesthetic agents, antidepressants, phosphodiesterase-5 inhibitors and tramadol. Behavioural therapy such as the ‘stop-start’ and ‘squeeze’ techniques, use of condoms and pelvic floor exercises may be recommended. Psychological therapy is considered when indicated. If necessary, you may be referred to a urologist, sex therapist or psychiatrist.

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