Men often feel embarrassed not being able to last as long as they want, but premature ejaculation (PE) is a serious sexual disorder, and it can be treated. Find out all you need to know about the causes of PE, PE treatment and how to prevent PE in this ultimate guide.
Premature ejaculation (PE) can refer to any instance when a man faces endurance issues during sex, where the man reaches orgasm and ejaculates faster than desired. PE affects 1 in 3 men across their lifetime, and is one of the most common sexual disorders for men in Singapore.
According to a study by Adaikan (2011) involving 243 Singaporean men aged between 18 and 55, one-fifth of the respondents have PE and 14% have Probable PE. However, out of those that were experiencing PE, only 23% consulted with a doctor, a third had no desire to, and only 17% of the respondents were aware of prescription medication for PE. Most of the men only heard of using behavioural techniques to treat PE.
90% of the respondents agreed that PE has a damaging effect on a man’s self-esteem. However, the good thing is, if you are struggling with PE, you don’t have to face it alone.
Some days, our engines get a little more revved up than usual and you might have a false start to the race. So how do you know if PE is really the issue at hand?
When it comes to ejaculation, there is no set time that is considered too soon, it really depends on the extent of PE affecting your sex life as a whole. However, signs that indicate PE include ejaculating under 1 minute into penetration, or the low or absent ability to slow down climax during sex (Porst et al., 2007). Often, the frustration that comes along with PE results in stress and intimacy avoidance with your partner.
There are two types of premature ejaculation—lifelong and acquired.
Lifelong PE refers to the condition where you have not been able to control your ejaculation since your first sexual encounter. Without treatment, some men may struggle with PE throughout their entire life.
Acquired PE is like the name suggests, acquired at a later time after their first sexual encounter, meaning that the man has experienced a time where he was able to control orgasm, before having an issue with PE.
Causes of PE vary between people, and can be due to a variety of factors from biological to psychological reasons. The cause can also vary between lifelong PE and acquired PE.
Lifelong PE can be caused as a result of chemical imbalances in areas of the brain responsible for controlling ejaculation (Andrology Australia, n.d.). With less stimulation needed to reach orgasm, ejaculation happens faster than you would like.
As for acquired PE, performance anxiety, or ‘stage fright’, is often the cause. This could stem from any fears you might have surrounding sex, whether it’s your performance, being caught in the act, or even sometimes as a result of religious or cultural pressures (Andrology Australia, n.d.). Erectile dysfunction may also be a cause of acquired PE.
PE is a common problem for numerous men, but it doesn’t have to be a dirty little secret kept behind closed doors. If PE is putting a damper on your sex life, don’t let it hold you back from getting intimate any longer. Through Noah’s simple medical evaluation service, speak to one of our doctor’s today and find a treatment suitable for you.
We usually prefer to keep our private matters in the bedroom, so it can be uncomfortable trying to find treatment for sensitive conditions like premature ejaculation (PE) in Singapore. Most people think that the only way to treat PE and other sexual disorders is to go to a clinic and have that awkward conversation with a GP - and that can be quite anxiety-inducing. That’s where we come in.
Here at Noah, we understand the discomfort that PE can bring for you and your partner. We believe that getting treatment doesn’t have to be such a daunting experience. That’s why we’ve made it possible to avoid those awkward trips to the doctor by being Singapore’s premiere telemedicine company catering to sensitive health conditions for men such as PE, ED and hair loss, changing the way Singaporean men can find treatment for the embarrassing situations you want to keep private.
From the comfort of your own home, you can consult with our licensed doctors who will help you diagnose your condition and prescribe you the appropriate medication. Within 4-hours, voila - you’ll receive your delivery discreetly.
There are a number of ways to treat PE. Sometimes behavioural techniques are effective, but sometimes you might need that extra bit of help through medication or supplements. In this case, we’d say it’s best to speak to a doctor who can advise you on the best approach for the treatment of PE, tailored to your needs.
Drug medication for the treatment of PE is not available over the counter, you’ll need a doctor’s prescription to get these medicines. This medication is from a class of medicines known as Selective Serotonin Reuptake Inhibitors (SSRIs), which are used in the treatment of anxiety and depression. Priligy (Dapoxetine) is an SSRI indicated in PE treatment in Singapore, and is the treatment of choice at Noah. It is an oral medication taken 1-3 hours prior to sex, that helps you have more control of ejaculation and can delay it. Another SSRI medication used in the treatment of PE is Sertraline, otherwise known under the brand name Zoloft. We’ll go into more detail about these two medications in our following article, along with supplements and behavioural techniques for PE.
Some over the counter creams and sprays are also used to help those with PE troubles, such as mild anesthetics like lidocaine or benzocaine. These creams and gels are applied topically to the tip of the penis and have a numbing effect and reduces sensation for the man, which can help to delay ejaculation. However, this option may not be ideal for everyone because the numbing effect of the creams or sprays may also affect your partner during sex (especially without a condom), and could possibly lead to losing erection.
On the other hand, if you prefer not to take the medication route and you’d like to find out more about how to prevent PE using non-pharmaceutical methods, there are more natural supplements (like zinc and magnesium) and psycho-behavioural techniques that you can try at home for improving endurance and preventing PE. Just look out for the next article in our blog series about PE!
According to O’Leary (2004), all men will potentially experience PE some time in their lives. Thankfully, there are a few options available for the prevention of PE, and it doesn’t always require medication. Through psycho-behavioural techniques, men can improve their endurance, learning to gradually stop PE and prolong the time before orgasm.
In a study by Chen et al. (2009), 58 PE patients were treated with psycho-behavioural therapy 2-3 times a week, over a 6-time course. Following the treatment, almost 80% of the patients reported a longer time before ejaculation, decreased sexual anxiety, and higher satisfaction for both themselves and their spouses during sex.
These psycho-behavioural techniques range from relaxation exercises to physical behavioural methods to stop PE. We’ll provide you with more information on how you can take PE prevention into your own hands, in our next article about how to stop PE. These methods include behavioural techniques such as masturbating before sex, a “start-stop” technique and “squeezing” technique.
A study by Myers and Smith (2019) found that working out your pelvic floor muscles appear to be effective in PE management. The researchers discovered that 83% of participants with PE had improved control over ejaculation after exercising their pelvic floor muscles. The exercises involved tightening and holding the pelvic floor muscles at intervals as they go about their day, to improve control and strength. It’s easiest to pinpoint these muscles when you’re in the toilet, by stopping halfway through urination and drawing your testicles upwards to your stomach. Once you’ve identified your pelvic floor muscles, engage and tense them for 10 seconds and release, repeating this 10 times. This exercise is discreet enough to be done throughout the day and may help you regain more control over ejaculation.
Dr. Tan Kok Kuan (2013) suggests that certain ‘passive’ sex positions may help you delay ejaculation. Studies have apparently shown that positions with your partner on top can slow down ejaculation, so if you don’t mind being on the bottom, it’s worth a try. Apart from different positions, it may do good if you try making shorter thrusts during sex. The decreased surface area of the penis being stimulated may help in delaying ejaculation. One other way to decrease stimulation of the penis with the intention of delaying ejaculation is to use condoms during sex, more specifically, thick ones. Putting on a condom early into an intimate situation may help prevent excessive stimulation leading to PE.
If you find that these methods aren’t working for you, simply speak to one of our doctors here at Noah. They’ll be able to advise you on treatment suited for you, and can also prescribe you the right medication if you need it. Priligy is the prescription of choice at Noah, an antidepressant which works on the area of your brain responsible for controlling ejaculation. Apart from that, the use of supplements for PE has been explored as well. For more information on these pharmaceutical options for the treatment of PE, simply look out for the next few articles in our blog series about PE, which talks about supplements and medication used in the treatment of PE.
Adaikan, P.G., Lim, P., Ng, K.K., & Fok, E.L. (2011). Asian perspective: Premature ejaculation prevalence and attitudes (PEPA) among Singaporean men. Journal of Men’s Health, 8(1), S84-S86. (Link)
Andrology Australia (n.d.). Premature ejaculation. Healthy Male. (Link)
Myers, C., & Smith, M. (2019). Pelvic floor muscle training improves erectile dysfunction and premature ejaculation: a systematic review. Journal of Physiotherapy, 105 (2). pp. 235-243.
Porst, H., Montorsi, F., Rosen, R. C., Gaynor, L., Grupe, S., & Alexander, J. (2007). The Premature Ejaculation Prevalence and Attitudes (PEPA) survey: prevalence, comorbidities, and professional help-seeking. European Urology, 51(3), 816–824. (Link)
O'leary M. P. (2004). Managing early ejaculation: What does the future hold? Reviews in Urology, 6(1), 5–10.
Tan, K. K. (2013). How to last longer in bed – Tips, tricks and treatments for premature ejaculation. (Link)