Premature ejaculation (PE) is the most common male sexual dysfunction, affecting an estimated 20 to 30% of men across all age groups. Despite being more prevalent than erectile dysfunction, it is significantly underreported — many men assume nothing can be done, or feel too embarrassed to raise it with their doctor.
Causes
Neurobiological factors — particularly serotonin levels and sensitivity of penile sensory receptors — play a central role in lifelong PE. Acquired PE may be related to erectile dysfunction, prostatitis, thyroid dysfunction, or psychological factors including anxiety and relationship stress. In many men, it is a combination of biological and psychological elements.
Treatment Options
Behavioral techniques — the squeeze technique and stop-start method — help men develop greater awareness and control. Topical anesthetic agents (lidocaine-prilocaine creams or sprays) applied before intercourse reduce penile sensitivity effectively. Oral SSRIs delay ejaculation as a recognized mechanism; dapoxetine is a short-acting SSRI specifically developed for PE and taken on demand.
For cases with evidence of penile hypersensitivity, selective dorsal nerve block or glans augmentation procedures have shown effectiveness and are available in our practice.
Seeking Help
PE causes significant psychological distress and can profoundly affect relationship satisfaction and self-esteem. Effective treatment is available. We approach PE with sensitivity and discretion, focusing on each patient’s specific situation and goals.