Premature Ejaculation (PE)

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Premature ejaculation or PE as it is commonly known is by far the MOST common sexual problem in men younger than 40 years.

Before we even start, we have to establish some facts and definitions.

How do we know if someone has premature ejaculation?

There are many expert definitions.

  1. WHO defines PE as men who ‘ejaculate before they want to’. According to their definition as many as 33% to 50% of people in the world have premature ejaculation.
  2. Another definition by some US researchers defines PE as ‘ejaculating before the partner achieves an orgasm’. They found up to 70% of people have PE.
  3. Another definition by some European researchers is by measuring the IELT (Intra-vaginal Ejaculatory Latency Time).These researchers found that the average IELT is about 4 to 5 minutes. So by statistical definition, any duration below 2.5% of the mean is considered premature ejaculation which is 90 seconds.
  4. Then there is the definition according to the DSM (Diagnostic and Statistical Manual of Mental Disorders) which is:
  • Persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it. The clinician must take into account factors that affect duration of the excitement phase, such as age, novelty of the sexual partner or situation, and recent frequency of sexual activity.
  • The disturbance causes marked distress or interpersonal difficulty.
  • The premature ejaculation is not due exclusively to the direct effects of a substance (e.g., withdrawal from opioids).

So who has premature ejaculation and who doesn’t?

First, PE is NOT an illness or a disease. It is a lifestyle choice. There was a person in one of the studies who could last for 25 minutes and yet still said that he has premature ejaculation. There is this place in Italy where the faster a man ejaculates the more of a man he is considered to be. There is also the famous caveman analogy. In ancient times the faster a man ejaculates greatly increases his chances of making a woman pregnant. So according to Darwin’s law of evolution, his DNA is passed down more than the man who takes a very long time to ejaculate. So in terms of nature and survival, ‘premature ejaculation’ is an evolutionary advantage.

Of course, PE is a real problem if:

  1. It is causing or arising from inter-personal relationship problems.
  2. It is causing or arising from psychological issues like anxiety and depression.
  3. It is a sign of hidden erectile dysfunction (ED).
  4. It is due to a low serum Testosterone level.
  5.  It is a sign of an underlying medical disease.
  6. It is due to stopping a drug.
  7. It is severe enough to affect fertility.

When you consult our Doctors for premature ejaculation, we will first make sure you don’t suffer from the above illnesses. Treatment will depend on what problem you have. So if you have anxiety, we treat the anxiety. If you have ED or heart problem, we treat these problems.

If you have none of the above then we can talk about treating premature ejaculation itself. There are several methods below:

  1. Distraction Method.
  2. Start and stop method.
  3. Masters and Johnson Method.
  4. Hypnosis.

All the methods have varying success reports on scientific studies.

The more established medical methods to treat premature ejaculation are:

  1. Anaesthetic creams, gels and sprays. The spray has had best results in scientific studies. Just spray on 5 minutes before and it numbs the head of the penis. The problem with cream and gels is you need to leave it on for at least 30 minutes and might also numb your partner.
  2. Tramadol. This is a pain-killer medicine derived from opium. It changes the chemical content at nerve endings and gives more control over ejaculation. It may cause nausea and vomiting.
  3. SSRIs. Also known as Selective Serotonin Re-uptake Inhibitors. These are a class of medicines that are used to treat anxiety and depression. They increase a chemical known as Serotonin at our nerves thereby giving us more control over when we ejaculate. There are various types and various ways of dosing. The side effects are usually limited to mild sedation and nausea. The only SSRI indicated in the treatment of PE is Dapoxetine (Priligy).
  4. Levitra (Vardenafil). The ‘Duration Study’ is a scientific study that proves Levitra can increase duration of sex from 4 minutes to 12 minutes. It has the usual possible side effects of these drugs like headache and flushing.
  5. Cialis (Tadalafil) 5mg low-dose once-a-day pill taken in conjunction with Priligy (Dapoxetine) before sexual activity has been found to be very effective in improving Premature Ejaculation.

If you feel these symptoms apply to you, come visit our clinics and see our doctors for an open discussion.

We are a walk in clinic, you do not need an appointment.

Visit Our Clinics now.

If you have any questions, visit our free online forum on sexual health, HIV and STDs.

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If you feel that you might be suffering from premature ejaculation, please contact us for an appointment.

Related Topics:

Erectile Dysfunction

Testosterone Deficiency Syndrome / Andropause

Prostatitis

HPV Vaccines for Men

Laser Treatment for Pearly Penile Papules

About Dr. Tan
Dr. Tan graduated from the National University of Singapore in 2001. His residency was in the two largest public hospitals in Singapore; Tan Tock Seng Hospital and Singapore General Hospital.

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9 Comments

  1. Im 40 yrs old now…2 years ago I went for angiogram due to agina pain in chest and now im on some meds like blood thinner,cholestrol,High BP and also im diabetic on oral meds.Notice that I got Ed and PE problem since…im also weigh more than 100kg..so I don’t know what is the cause…what do u suggest?

    • I suspect your primary problem is ED and your PE is secondary to that. With your history, your ED could well be due to blood vessel blockages and side effects of your medications. If you are on Nitrates for your heart, you cannot take PDE5Is. Which means the only options open to you are ESWT and/or penile injections. Also, given your history, I am sure your Testosterone levels are also low. You have a lot of things going on which also means there are many avenues for treatment.

  2. Hi Dr,

    I have a PE problem. Can you pls let me know about priligy and how much will it cost ?

    Thanks you

  3. Hi Doc,

    So based on what i described any hope for me? Also what is the typical treatment like and duration to ‘cure’ ?

    Which doctor can i approach – any normal GP or best to look for you?

    Thanks.

  4. Hi Dr,

    Been married since 2009 and sad to say my intercourse with my wife never exceeds more then 5mins… (Or worst i come while putting on condom)

    I tried maintaining a healthier lifestyle (jogs 3 times a week, dont drink nor smoke, take men supplements, durex performance… but no avail.

    Guess its better late then never to seek treatment. What are you recommendations?

    Thanks Doc!

    • There are several medications available in the market. However, the only one specifically indicated to treat PE is Dapoxetine. Speak to your doctor about this.

  5. Hi Dr.Tan… im have a PE problem and its so stress full of me and me
    Partner…. do the clinic is singapore have any medication for this problem
    And how much its cost?? Hope to hear from u soon.. thanks

    • The medicine used most commonly now for treatment or PE is Priligy. At our clinic is costs $54 for 3 tablets.

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