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Premature Ejaculation

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Premature Ejaculation key facts

Navin Khosla NowPatientGreen tick
Created on 24 Jul 2024
Updated on 24 Jul 2024

Premature ejaculation is a type of sexual dysfunction that occurs during sex, where a man is unable to prevent ejaculation. Here, we will take a closer look at the causes, symptoms, and treatments available for this condition.

What is Premature Ejaculation?

Premature ejaculation is when you are unable to delay ejaculation long enough during sexual intercourse, for sexual satisfaction. There is no measure for premature ejaculation, but if it occurs during foreplay, within a minute or shortly after sexual penetration, this may be classed as premature ejaculation.

Causes of Premature Ejaculation

Premature ejaculation can be caused by:

  • Psychological factors, such as anxiety, stress, depression, guilt, and relationship problems, or
  • Physical factors such as erectile dysfunction, imbalances in hormone levels, inflammation or infection of the prostate gland or urethra, recreational drugs, or genetics

Premature ejaculation, on rare occasions may result from nervous system damage due to surgery or trauma.

Diagnosing Premature Ejaculation

Speak to your doctor or a sexual health provider if premature ejaculation is affecting your sex life. They will carry out physical examinations, discuss your medical history and any other medical conditions you have, and potentially carry out blood tests to rule out any underlying health conditions.

Behavioral techniques for managing Premature Ejaculation

These aim to improve your control over ejaculation and delay orgasm. Two common methods are:

  • The stop-start technique, where you stimulate the penis until you feel close to orgasm, then pause until the sensation stops
  • The squeeze technique, where you apply pressure to the base of the penis to temporarily reduce arousal

Other therapy may include masturbating 1 or 2 hours before sex, to prevent early ejaculation when you are with your partner.

Pelvic floor exercises for Premature Ejaculation

Strengthening pelvic floor muscles through Kegel exercises, can also help improve ejaculatory control. Kegel exercises involve contracting the muscles used to stop you peeing midstream, holding them for a few seconds, and then relaxing. Repeating this exercise multiple times a day will help strengthen your muscles.

Medications for Premature Ejaculation

  • Antidepressants, such as tricyclic antidepressants (clomipramine) and selective serotonin reuptake inhibitors (SSRIs), such as paroxetine, sertraline, fluoxetine, dapoxetine or Priligy. These may be prescribed off-label (for a reason other than the drug’s original use)
  • Anesthetic creams or sprays containing lidocaine or prilocaine, such as Emla, applied to the head of the penis to reduce sensitivity and delay ejaculation

Lifestyle modifications

Maintaining a healthy lifestyle, regular exercise, managing stress levels, and practising relaxation techniques can all help with your sexual health. Avoiding excess alcohol consumption, recreational drug use and smoking can all have an impact on sexual function.

Psychological counselling for Premature Ejaculation

A mental health or sex therapist can help address psychological factors such as anxiety and provide coping strategies and techniques to manage performance anxiety. In some cases, a combination of medications and counselling may be recommended.

Communication and support

Honest, open discussions, with your partner, can help strengthen your emotional connection and couples or sex therapy may be beneficial in addressing your sexual relationship.

Frequently asked questions about Premature Ejaculation

Who does Premature Ejaculation affect?

Premature ejaculation can affect men of all ages and nationalities, with up to one out of three men displaying symptoms.

What causes Premature Ejaculation?

Psychological factors such as low confidence, performance anxiety, and relationship issues, as well as biological factors such as neurotransmitter dysfunction, hormone imbalance and physical health conditions, can all play a role.

Does anxiety cause Premature Ejaculation?

Anxiety may be a factor when it comes to sexual performance, but it is not the only cause of premature ejaculation. Premature ejaculation is classed as a physical problem, but, psychological factors, such as anxiety can make it worse.

How do I know I have Premature Ejaculation?

Your doctor will carry out an assessment of your medical and sexual history to rule out any underlying health conditions. This will need you to be open and honest in order for them to give you an accurate diagnosis.

Can Premature Ejaculation be treated with medication?

Yes. Selective Serotonin Reuptake Inhibitors (SSRIs) are used to treat premature ejaculation due to their side effect of causing delayed ejaculation. Speak to a healthcare professional to discuss the most appropriate treatment for your specific situation.

What other treatment options are available for Premature Ejaculation?

Other treatment options include:

  • The pause and squeeze technique
  • Kegel exercises
  • Counselling and therapy
  • Yoga and relaxation techniques
  • Climax delaying gels and condoms

When should I get professional help for Premature Ejaculation?

Seek professional help if premature ejaculation is causing sexual problems, affecting your relationship or quality of life. Speak to a urologist, or sexologist for guidance, to develop a treatment plan based on your needs.

Conclusion

Premature ejaculation is a common problem caused by psychological, physical or a combination of both factors. With a proper diagnosis and treatment, it can, however, be managed. Behavioural therapy, Kegel exercises, medication, counselling, and changes to your lifestyle can all help improve your sexual experiences.

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Service Guide

Everything you need to know about Getting Treated Privately

What does the Get Treated Privately service do?

The Get Treated Privately service is a private prescribing service which is designed for adults aged 18 years and over, who are experiencing health issues and who would like to receive a fast-track assessment and if applicable, a treatment plan from a qualified prescribing clinician. Treatments are dispensed and delivered to your home or workplace from our regulated online pharmacy.

Is this a safe service?

Yes. Our formulary of medications prescribed and conditions treated are controlled, governed, and continuously risk-assessed by our Medical Director, Dr. Aseel Hamoud. Unlike other prescribing services which operate using faceless questionnaires, our service is conducted through remote video consultations, also known as synchronous consultations. This builds patient safety and prescribing appropriateness into our service, ensuring our prescribing clinicians can be satisfied with who and what they are treating. There is no guarantee of supply of medications, and any prescriptions supplied are at the sole discretion of our clinician prescriber. There is no charge for the consultation.

What is a prescribing clinician and is it safe for me to use them on the NowPatient platform?

Our prescribing clinicians are board-certified pharmacists, nurses, or doctors who can also prescribe any medicine for any medical condition, subject to accepted accreditation and good clinical practice. They are all registered with their respective regulatory bodies. For example, a pharmacist independent prescriber is registered with the General Pharmaceutical Council (GPhC). Each prescribing clinician undergoes an extensive background check including a disclosure and barring service check (DBS). In addition, they undergo a rigorous license verification process. When you book an appointment with our prescribing clinicians you will see their full name, license number, and any specialized credentials they have.

Is the service available worldwide?

Yes, the Get Treated Privately service is available worldwide.

Do I need to pay for this service?

Yes. This is a private service. You do not need to pay for the consultation. You only pay for the cost of the medication you are prescribed.

How do I book a consultation?

Once you have logged into your account, you will need to navigate to the Get Treated Privately quick action widget which is located at the bottom of your dashboard. You can then select one of the following actions – ‘Search Treatments’ or ‘Search Conditions’.

Depending on the search type, you will be taken to a consultation booking screen. You will then need to select a date and time that is convenient for you, along with the preferred language of the prescribing clinician you wish to choose. You will then see a list of all available clinicians. From this list, you can filter clinicians by gender and then select the clinician you would like to confirm for your booking.

Once you have approved this, you will see a summary of the appointment including preliminary information about the consultation. At this point, you will also be able to add a reminder to your calendar. Always ensure your account health profile is up to date before any consultation. This ensures that our clinicians have the most up-to-date information about your current health status and anything that may influence their prescribing decisions. You will receive a push notification and email reminding you of your consultation, 30 minutes before it is due to start.

You can ‘star’ the Get Treated Privately quick action widget to have it display in the ‘My Favourite Widgets’ section of your dashboard, for ease of future booking or checking active or past orders.

What happens during the remote video consultation?

During the consultation, the clinician will ask you a series of questions that will allow the clinician to diagnose your health condition and consider possible treatment options. At the end of the consultation, the clinician will decide if a treatment plan is a safe and appropriate option for you.

If it is, the clinician will discuss the various treatment options that may be available, so that you can jointly agree on the option that is most suited to you. Once you have jointly agreed on a treatment plan, the clinician will issue a prescription order which will be available in your ‘shopping cart’ at the end of the consultation.

Also, with your consent, the clinician may wish to inform your GP of the treatment that was prescribed. We recommend that you agree to this since your GP is responsible for your overall care and they should have a record of this consultation and medication prescribed. In addition, our clinician may take the opportunity to advise you on your overall health including advice on healthy living or stop smoking.

What happens at the end of the consultation?

At the end of the consultation, you will receive a notification which will summarise the outcome. It will also advise if any referrals were made to your GP, along with any other advice that was given to you by the clinician.

If a GP referral letter was issued, you will be able to view a copy of this in the ‘My Documents’ section of your dashboard.

If you were prescribed a treatment plan, it will now be available in your shopping cart. When you go to your shopping cart, you will be able to checkout and make payment. Once the checkout is complete, your prescription order will be sent to our regulated online pharmacy for processing.

What if the prescriber does not prescribe what I want?

We operate a safe and effective service. This means that our prescribing clinicians always exercise their clinical judgment when prescribing. Unfortunately, we do not operate a service where you can demand a certain medication. If you are not prescribed anything, then you will not be charged.

Will I get status updates for my order?

Yes. When you place an order with NowPatient, we will keep you fully updated with the status of your order. Every time the status of your order changes, you will be notified immediately. These notifications will appear in your ‘My Notifications’ section on your dashboard. You can click the notification and it will take you to your active orders screen which will give you a timeline overview of the progress of your order. This can also be accessed using the ‘My Orders’ quick action widget which is on your dashboard. Here, you can access active and past orders.

How will my order be delivered?

All orders are shipped in discreet and unmarked packaging. This means it is suitable for delivery wherever you require (home, work, or a neighbour). For thermo-sensitive orders (e.g. Insulin or weight loss injections) we use cold chain-validated packaging. Your parcel will normally receive an estimated delivery window from the courier on the day of delivery.

For your protection and safety, your first order can only be delivered to the address that is registered with NowPatient. Future orders can be delivered to any other address, for example, your workplace.

Do you ship cold-chain or temperature sensitive products?

Yes. We use a specialist courier service for all thermo-sensitive deliveries. This is to ensure that cold chain integrity is always maintained and thus the product quality, safety and efficacy.

Learn more about how we handle the delivery of temperature sensitive products.

Where do you deliver?

We currently deliver to all postcodes/zipcodes worldwide. Some postcodes in rural areas may have a slightly longer delivery time.

When will my order arrive?

We aim to ship all orders placed Monday – Friday before 3pm on the same day. Orders placed outside these times will be shipped the next working day. All deliveries are shipped by Royal Mail, which delivers Monday through Saturday in the UK. For deliveries outside of the UK, please check with your national postal service for accurate delivery days.
Our delivery options have the following delivery times:
  • UK – Royal Mail Tracked 24 & Signed for Delivery – Next day delivery
  • Europe – Royal Mail Tracked – Typical delivery of 3-5 working days
  • Worldwide – Royal Mail – Typical delivery of 5-7 working days. If a tracked option is available for your country via Royal Mail, this service will be applied.

What should I do if my order has not arrived?

Delivery is normally made promptly after your dispatch notification is received. You can check the tracking details of your order in the ‘My Notifications’ section of your dashboard, at any point after dispatch.

Unfortunately, packages can sometimes get lost in the delivery system, if after 10 days you have not received your delivery, please contact us and we will do all we can to resolve the problem.

Can you prescribe GLP-1 weight loss injections?

Yes. However, with GLP-1 weight loss medications, the license requires that there are support resources put in place as part of the plan including coaching for a healthy lifestyle, exercise, and diet. Our clinicians will discuss this with you, if you are prescribed this type of treatment.

You can learn more on our Weight Loss Programs feature page.

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