Ejaculatory Dysfunction

Definition:

  • Ejaculation which is not under control and occurs either before or shortly after penetration is called Premature Ejaculation or PE.
  • In Premature Ejaculation, Ejaculation occurs involuntarily before the person wishes it.
  • Premature Ejaculation is one of the most common forms of sexual dysfunction.

Causes of Premature Ejaculation:

  • In most cases there is no obvious cause.
  • Increasing age is one of the commonest factors.
  • Anxiety, Stress, Depression are common psychological problems which cause PE.
  • Medical Causes like Hormonal imbalance, trauma or adverse side effect of various medications.
  • Excessive tobacco, alcohol, illicit drug usage can cause Premature Ejaculation.

Diagnosis of Premature Ejaculation:

  • Diagnosis is mainly by history and clinical evaluation.
  • Tests to rule out systemic disorders like Hypertension, Diabetes, Hormonal disturbances may be done.

Treatment of Premature Ejaculation:

  • In most cases as there is no cause, it gets better on its own with simple reassurance, counselling and behavioral therapy.
  • Relaxation therapy is recommended.
  • Antidepressant medicines such as Clomipramine and Paroxetine have side effect of delayed orgasm. This can be used to treat PE at times but only for limited time period.
  • Sensation altering medicines such as Lignocaine impregnated gels, sprays or condoms can be used.
  • Tramadol is a medicine which is also prescribed for increasing the ejaculation time.
  • The problem with medical treatment used for PE is that all the drugs have their own side effects therefore therapy is usually for a short duration and under direct supervision of Andrologist.