Too fast, too slow or not at all? We get to the root cause for you.
An estimated 1 in 3 men have faced premature ejaculation, with 1 in 25 men experience delayed ejaculation. There’s no one-size-fits-all answer to what constitutes a “normal” sex drive. Instead, what’s considered normal depends on your personal needs, preferences, and circumstances. A healthy libido varies from person to person and can change over time due to factors such as stress, relationship dynamics, hormonal fluctuations, and physical health. However, if a low sex drive, or hypoactive sexual desire, starts to negatively impact your quality of life, emotional well-being, or relationships, it’s important to seek help.
Premature Ejaculation
Ejaculations always or nearly always occur within a minute or so of penetration are considered premature. In most instances, there is difficulty delaying the ejaculation, causing men and their partners significant distress and frustration. It can then lead to avoidance of sexual intimacy.
Premature ejaculation can be classified as acquired or lifelong. Men can acquire the condition at some point in their life, such as after a significant event or change. It can also be a lifelong issue, where they have known this to be the case from their very first penetrative sexual experience.
Delayed Ejaculation
There are 2 types of delayed ejaculation: primary and secondary.
Primary delayed ejaculation applies to men who have always had difficulty ejaculating. Secondary delayed ejaculation occurs in men who previously had no issues with intercourse but developed this problem. Delayed ejaculation can be caused by physical and psychological factors.
Physical factors include:
Psychological factors include:
Treatment Options
There is a wide range of treatment options. We will work with you to select the best option for your needs.
(ESWT)
Extracorporeal Shockwave Therapy (ESWT) is an advanced treatment designed to stimulate blood flow, promote tissue regeneration and enhance overall penile health. Many prefer it as an alternative to medication due to its natural and long-lasting benefits. Quick non-invasive procedure in under 30 minutes!
Find out more here.
A pill called Dapoxetine (Priligy) has been formulated to be taken just a few hours before intended sexual intercourse to lengthen time for penetrative sex. Paroxetine, a common antidepressant pill can be used daily to treat more severe PE.
In some cases, PE happens due to a coexisting erectile dysfunction hence treating the erectile dysfunction with medications like Viagra, Cialis etc can alongside resolve the PE Issue.
Sprays
Numbing sprays are another way to treat premature ejaculation on an on-demand basis. Local, topical aesthetic sprays can be applied to the head of the penis approximately an hour before sex. The spray then reduces sensitivity to touch, so ejaculation does not happen undesirably early.
A melanocortin receptor agonist that has been approved by the FDA for the treatment of HSDD in premenopausal women. It is a self-administered, injectable medication that is taken about 45 minutes before anticipated sexual activity. It works by activating specific receptors in the brain that are involved in sexual arousal and desire.
While bremelanotide has shown promise in women, it is not currently approved for use in men. Research into its efficacy and safety for men is ongoing, but there are no FDA-approved indications for its use in men at this time.
Testosterone replacement therapies work by increasing levels of available testosterone in your body, such as injections and gels.
If your ejaculation disorders are caused by a shortage of testosterone, you may benefit from testosterone replacement therapy.
Find out more here.
Flibanserin is a medication primarily approved for the treatment of HSDD in premenopausal women. It is a daily oral medication that works by balancing the neurotransmitters in the brain (dopamine, norepinephrine, and serotonin), which can help improve sexual desire.
However, flibanserin is not approved for use in men. It has been studied for use in men with low libido, but it has not demonstrated consistent or significant efficacy in male populations. Therefore, it is not currently considered a treatment option for male sexual desire issues.
Don’t Keep Your Ejaculation Problems To Yourself
When men touch themselves, the speed, pressure, duration and intensity necessary to produce an orgasm tend to be very dissimilar to what they may experience with a partner. This means that the orgasms may be difficult to reproduce in partner-related sexual activity. If you feel that something isn’t right, please reach out – help is available, and there are many options!
FAQ
How can one enjoy sex with premature ejaculation?
If couples define sex as the time period between penetration and ejaculation (also known as the latency period), then it might last just a few minutes when there is an issue of premature ejaculation. But if they include foreplay and other sexual activities such as massage and oral sex etc, the experience can last for a much longer period.
If the individuals are satisfied with the duration of vaginal penetrative sex, even if it lasts for just over a few minutes, then the couple does not have an issue as they are both satisfied with that duration of penetrative sex and it does not cause them distress or frustration.
However, in a couple setting where penetrative vaginal sex mostly occurs under a few minutes (eg 2-3 mins), and one or both partners are unsatisfied, bothered and negatively affected by this, then this can be classified as premature ejaculation.
It is helpful to have realistic expectations – typically, the normal time to ejaculation is between 5 to 7 mins.
Do drugs like Viagra help to manage premature ejaculation?
Yes! Common drugs for erectile dysfunction like Cialis, Viagra and Levitra can actually alleviate some of the problems with premature ejaculation. As these drugs provide men with stronger vigour of erection, they also reduce what many men call ”performance anxiety”. Since anxiety is often a concern for men with premature ejaculation, a man using drugs like Viagra, Cialis and Levitra then find that not only are their erections stronger, they may also ‘last longer’.
Can delayed ejaculation be circumstantial?
Yes. Sometimes, it only occurs in specific circumstances, such as only with specific sex partners or it occurs with sexual intercourse with a partner but not with masturbation. A man who masturbates a certain way, with a specific intensity or speed that gets him off, might not reach that required threshold of stimulation during intercourse with a partner.
Does not ejaculating cause any problems?
For some men who suffer from delayed ejaculation, ejaculation cannot be achieved at all. While this condition does not pose any serious medical risks, it can be a source of stress and may create problems in your sex life and personal relationships.
Our Doctors
Dr Samuel
MB BCh, BaO (Ireland),
MRCS (England)
Dr Jess
BSc (S’pore), MBBS (Aus)
FECSM (Fellow of the European Committee Sexual Medicine)
