Premature Ejaculation

Premature Ejaculation

There may be no more embarrassing and closeted sexual complaint in men than premature ejaculation.  Premature ejaculation is when ejaculation occurs when a man has an orgasm sooner during sexual activity than he or his partner wishes. Premature ejaculation that occurs repeatedly can cause severe aversion to sexual relationship, poor sexual self-image, partner sexual dissatisfaction and even infertility.

We have treated many patients whose sexual relationships have deteriorated significantly before they sought treatment.

Premature ejaculation may be felt to be a psychological disease. However, at North Austin Urology, we recognize that ejaculation and orgasm can be considered a ‘reflex.’  This reflex model of premature ejaculation can explain why alcohol and fatigue can sometimes allow prolonged time for ejaculation.

Partners of men with premature ejaculation may also fall into the trap of believing that the condition is ‘all in their head’ and contribute to lower self esteem and performance anxiety.

Evaluation of patients with premature ejaculation is fairly straight-forward, however, there is some evidence that low testosterone or erectile dysfunction can contribute to premature ejaculation in patients who had no problems early in their life but developed problems later.

The medications and treatments used for premature ejaculation are considered ‘off-label’ and are not included in the official Food and Drug Administration approval of these drugs. For those patients with low testosterone or erectile dysfunction, treatment begins with these conditions.

More commonly, we deal with patients with a long history of premature ejaculation. Official recommendations from the American Urological Association recommend use of SSRI medications. Our experience has been very good with these medications.  
http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/pme/pme_2004.pdf


We often use a medication called Tramadol to help prolong orgasm. Use of this medication is a result of a peer-reviewed study of this medication.
http://www.ncbi.nlm.nih.gov/pubmed/17362279

Another option includes medications that make the penis less sensitive in hopes of prolonging intercourse. Topical penile numbing agents should not be used without careful consideration. There are condoms available that will numb the penis to allow for prolonged ejaculation and it is possible to prescribe creams to apply to the penis to decrease sensation.

Condoms can cause other problems and topical gels can decrease the sexual satisfaction of their partner if transferred to them. Based on research on a similar agent (http://www.ncbi.nlm.nih.gov/pubmed/20584124), we have developed a spray that can numb the penis and reduce transfer to the female partner.

Most men with premature ejaculation have learned that the ‘squeeze technique’ may be a way to help them. Unfortunately, there are many men who are use the technique improperly. We utilize the services of a pelvic floor therapist who teaches men the proper techniques with great success.
http://www.ncbi.nlm.nih.gov/pubmed?term=PE%20and%20pelvic%20floor

In summary, for many couples, premature ejaculation is more than a nuisance, and may negatively impact their relationship. Finding a doctor that can aggressively address the condition and offer more than the ‘standard’ treatment can make all the difference.

Contact Us

contact-right

Round Rock Location

970 Hester's Crossing Road
Suite 101
Round Rock,TX 78681

Phone 512-238-0762
Fax 512-341-7370

 

Lakeline Location

12505 Hymeadow Drive
Suite 2C
Austin, TX 78750

Phone 512-238-0762
Fax 512-341-7370 

 

South Austin Location

4534 Westgate Blvd
Suite 108
Austin, TX 78745

Phone 512-238-0762
Fax 512-341-7370