PE is characterized by a short latency, a perceived lack of control about the timing of arousal, and distress and interpersonal difficulty related to discharging too quickly.
PE is generally divided into two types:
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Lifelong PE, in which symptoms have been present for all or most of a person’s intimate life.
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Acquired PE, in which PE symptoms develop later in life after a period of normal latency.
And how common is PE? Research shows that it’s one of the most common forms of dysfunction, affecting as many as 39 percent of the male population (although reports vary). It can affect men of all ages and may potentially contribute to everything from frustration during intimacy to issues such as depression.
As a medical condition, PE is sometimes referred to as “rapid” or “early” discharge. On the opposite end of the discharge trouble spectrum, you’ll find delayed discharge or delayed arousal — but those are topics for another day.
No matter what you choose to call it, PE is a serious issue that can have significant personal consequences for both your intimate life and your general well-being.
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PE Symptoms
The most significant symptoms of PE are reaching arousal and discharging very quickly during intimate activity.
If you think you might be dealing with PE, some of the symptoms you may experience include:
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You discharge very soon after climax. Mild PE typically involves climaxing one to two minutes after arousal. In contrast, severe PE can involve climaxing before you insert your privates into your partner.
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You don’t want to come this early. For example, you aren’t in a hurry to finish and would prefer to have intimacy for longer, but doing so is difficult or impossible.
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You feel distressed because of your early arousal. You might feel less interested in having intimacy due to embarrassment or anxiety, feel like you have a low drive or feel as if your short time to arousal affects your general quality of life.
However, it’s important to remember that reaching climax and coming quickly happens to everyone from time to time. To be considered PE, these symptoms must occur during most or all activity.
Not all cases of coming early are explicitly viewed as PE. For example, if you want to reach climax quickly during intimacy, this typically isn’t considered a form of dysfunction.
However, if you often come within a minute or two of climax, feel unhappy or concerned about it, or simply feel as if you don’t have normal control or stamina, you could be affected by some form of PE.
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PE Causes
What causes PE? Researchers believe that a range of factors could all contribute to PE in certain ways, from physical factors to psychological ones.
As with other function issues (like ED), there are many widely shared — but scientifically inaccurate — “theories” about why PE develops in men.
You may have read that PE occurs when you don’t have intimacy on a frequent enough basis or are using the wrong bedroom techniques. However, there’s no scientific backing to support either of these hypotheses.
The reality is that researchers still aren’t sure what causes PE to develop, nor is there a one-size-fits-all explanation for PE and other forms of dysfunction in men.
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Physical Causes of PE
Certain physical and biological factors may cause or contribute to PE. These include:
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Abnormal hormone levels. Certain hormones, such as prolactin, luteinizing hormone (LH), and thyroid stimulating hormone (TSH) may contribute to PE.
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Abnormal serotonin levels. Research suggests that low levels of the neurotransmitter serotonin may shorten the amount of time required to reach climax.
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Inflammation and/or infection. Infections and/or inflammation that affect your prostate or urethra may affect your intimate function and contribute to PE.
Some experts also believe that the physical sensitivity level of your privates may play a role in the amount of time it takes for you to reach climax during intimacy.
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Psychological Causes of PE
Research suggests that psychological factors may contribute to several different types of dysfunction, including PE.
Psychological factors linked to PE include:
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Depression
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Stress
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Anxiety
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Guilt
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Poor body image
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A lack of confidence
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A history of intimate abuse
PE may also be caused by performance anxiety, a form of anxiety related to performance that can also play a role in issues such as (ED).
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PE Risk Factors
Just like researchers don’t exactly understand the causes of PE, it can also be difficult to pinpoint the risk factors. Having a physical or mental health condition that could cause PE — such as abnormal hormone levels or stress — puts you at an increased risk.
Additionally, ED is sometimes considered a risk factor for PE. People with ED have difficulty getting or maintaining an arousal that’s hard enough for satisfying intimacy.
This could be a risk factor for PE because if you have ED, you might feel compelled to “rush” through intimacy in the hopes that your arousals lasts the whole time, even if you aren’t conscious of doing so. The end result might be climaxing much sooner than you’d like.
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PE Diagnosis
Because the average time to come can vary so much from one man to another, PE can be a challenging condition to diagnose.
To be diagnosed with PE, you’ll typically need to have the symptoms listed above — such as rapid discharge after entering your partner and some level of distress due to your lack of control — and experience those symptoms consistently for at least six months.
Your symptoms will also need to occur without a clear explanation, such as medication or drug use, a related medical condition, or an issue in your relationship that affects your function and performance.
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Confusing PE Symptoms With Common Experiences
In some cases, you may reach climax and come earlier than you’d like to, even if you don’t have clinical PE.
It’s not uncommon to climax relatively quite quickly if you haven’t had intimacy in a long time. In this situation, it’s normal to feel more aroused than usual and reach climax faster than you typically might because of it.
It’s also common to feel as if you reach climax and come too fast, even if your latency time (the time it takes you to discharge) is within the normal range.
During a consultation for PE, your healthcare provider may ask you about your intimate history to determine how long you’ve been affected by these symptoms.
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Lifelong vs. Acquired PE
As we mentioned above, PE can be lifelong (meaning it’s present since your first encounter) or acquired (meaning it develops after some amount of normal function). It can also occur generally or in certain situations, such as when you have intimacy with a specific partner.
If your healthcare provider asks you questions about your average time to come, “success rate” during intimacy, or about other factors that may play a role in arousal, try to answer them as clearly and honestly as you can.
While arousal can be an embarrassing and awkward topic to discuss, keep in mind that your healthcare provider is there to help you — not to make any assumptions about your general intimate life or current relationship.
The more information you can provide and the more accurately you can answer your provider’s questions, the more likely it is that they’ll be able to provide an accurate diagnosis, help you to overcome PE, and improve your intimate experiences.
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PE Treatment
Is PE treatable? Although PE can be frustrating to deal with, there are a variety of different techniques are used as treatments for PE, including several types of medication, behavioral techniques, and counseling.
Antidepressants For PE
Currently, there are no medications that are approved by the U.S Food and Drug Administration (FDA) specifically as treatments for PE. However, your healthcare provider — likely a urologist — may treat PE off-label with a class of antidepressants called selective serotonin reuptake inhibitors, or SSRIs.
Research shows that SSRIs may help men last longer.
For example, in one study from 1998, men affected by PE who were treated with sertraline — an SSRI — observed an increase in their average interval (the amount of time before reaching climax and coming) from one minute to a maximum of 16.4 minutes.
Sertraline, the generic for Zoloft, is one of the most widely used SSRIs for PE.
Other SSRIs prescribed by providers off-label to treat PE include:
Like other SSRIs, sertraline can cause side effects.
We offer sertraline as a treatment for PE online, following a consultation with a licensed healthcare professional who will determine if a prescription is appropriate for you.
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(ED) Medications for PE
Research shows that some medications for ED may also help with PE. Namely, these are the phosphodiesterase type 5 inhibitors (PDE5 inhibitors).
For example, several studies have found that sildenafil, the active ingredient in Viagra or generic Viagra, either increases latency time or improves satisfaction and self-confidence in men affected by PE.
There are several proposed mechanisms for how PDE5 inhibitors could help with PE. They might have actions on the sensitivity of the privates, the muscles involved in climaxing, or the nervous system.
Our full guide to sildenafil and PE goes into more detail about these treatments, as well as the potential benefits they may offer.
In addition to sildenafil, other medications for treating ED include
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Tadalafil (the active ingredient in Cialis)
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Vardenafil (the active ingredient in Levitra)
We offer numerous oral ED medications online, following a consultation with a licensed healthcare provider who will determine if a prescription is appropriate.
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Creams, Sprays, and Wipes for PE
PE is often treatable using topical creams, sprays, and wipes that alter the sensitivity level of your privates.
These products are designed for use before intimacy and contain topical anesthetics like lidocaine, benzocaine, or prilocaine. The ingredients are absorbed by the skin on your privates to limit sensitivity without affecting your partner.
Research shows that sprays, wipes, and anesthetic creams for PE can slow down the process of reaching climax.
One placebo-controlled study found that benzocaine wipes significantly increased time to climax in men with PE when applied to the privates before intimacy.
Unlike SSRIs and PDE5 inhibitors that require a prescription, most creams, sprays, and wipes for PE are available over the counter.
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Behavioral Therapy for PE
Behavioral therapy involves identifying unhealthy or harmful behaviors and then taking meaningful steps to change them. When this type of therapy is used to treat health issues like PE, it’s often referred to as intimacy therapy.
Behavioral therapy for PE may involve a combination of psychotherapy and physical techniques to delay or prevent arousal.
Common physical techniques involve the “stop-start” approach, which involves stopping during intimacy to prevent arousal, and then starting again after the urge goes away. Another is the “squeeze technique”, which involves squeezing the privates where the head meets the shaft during a pause in intimacy.
You can learn more about these techniques and their effects in our guide to home remedies for PE.
Some physical exercises that strengthen the muscles around your privates and bladder may help improve control and reduce the severity of PE.
Research shows that kegel exercises — exercises that involve training your pelvic floor muscles — can improve control over reflex and increase latency for men with PE.
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Counseling for PE
Counseling is a helpful and effective treatment option for many function issues, including PE.
During counseling, you’ll work with a mental health provider or therapist to discuss your PE symptoms, their effects on your quality of life, and the factors that you think may contribute to them, such as relationship or intimate problems.
Over time, counseling can help you gain control over your feelings and deal with issues that could play a role in PE, such as intimate performance anxiety or body image issues.
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PE Prevention Tips
Although there’s limited research on the most effective ways to prevent PE, living a physically and mentally healthy lifestyle can help improve your performance and reduce your risk of developing many common issues.
Try to:
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Exercise regularly. Research shows that men who exercise regularly are less likely to experience PE than those with a sedentary lifestyle. While there’s no need to train like an Olympian, maintaining a regular workout routine can improve your physical health and performance.
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Focus on your mental health. Like other issues, PE often occurs at the same time as mental health issues like depression or certain anxiety disorders. If you’re concerned about PE, focus on improving and maintaining your mental health.
If you’re affected by PE or if you simply think you reach climax too early, you can also try the following techniques to enhance your experiences.
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Solo-time before intimacy. Many men find that they’re more able to delay climax on “round two.” If you’re prone to PE, try solo-time a few hours before intimacy — just make sure to keep your refractory period (the time after arousal during which it is difficult or impossible to climax again) in mind.
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Use PE condoms. Some condoms contain a topical anesthetic to reduce sensitivity, which may allow you to last longer during intimacy. You can find these in most convenience stores and supermarkets.
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Talk to your partner. When PE is caused by a psychological issue or a problem in your relationship, talking openly and honestly with your partner may help you overcome it together. Deciding to focus on before-intimacy time together, for example, is one way you can extend your intimate time together and have other types of stimulation.
This article originally appeared on Hims.com and was syndicated by MediaFeed.org.
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