Premature ejaculation occurs when a man reached ejaculation too quickly and without control. In other words ejaculation happens shortly after sexual activity begins . One in five men experience this problem. When it happens so frequently that it interferes with the sexual pleasure of the man or his partner , it becomes a medical problem. Premature ejaculation causes a lot of stress for the patient and his partner. 

Exact cause of premature ejaculation has not been known. It was earlier thought to be physiological but now it is thought to be a combination of physiological and biological factors.. 

Physiological causes

• First sexual experience

• Poor body image 

• Worrying about premature ejaculation

• Guilty feelings

• Sexual abuse

Biological causes

• Abnormal hormone levels 

• Abnormal neurotransmitter levels 

• Inflammation of the prostate/urethra

Other factors

• Anxiety

• Depression

• Erectile dysfunction

The patient experiences early ejaculation that is before 1 min of penetration . However sometimes it may also occur during masturbation. 

Lifelong(Primary) 

It occurs all of the time beginning from your first sexual intercourse. 

Acquired (AfteAfte Secondary) 

It develops after you had previous normal sexual experiences without any ejaculatory problems. 

Premature ejaculation is a common problem but many a times symptoms do not meet the diagnostic criterion. Sometimes these men experience a variable ejaculation problems with normal intermittent normal ejaculation.

How I cured my premature ejaculation

The main stay of treatment lies with psychological therapy, behavioural therapy and drugs. You must talk to your doctor to decide what is best for you. It is also possible to use more than one type of treatments at a time.

It is an integration of psychodynamic stats, behavioural and cognitive approaches. The therapy lays the principle to control ejaculation and manage and resolve the ever expanding effect that premature ejaculation has on the man or his partner. These effects include anxiety, low self esteem , performance anxiety , avoidance of sexual activity , partner’s dissatisfaction , anger and degradation of interpersonal relationships . Psychodynamic clinicians highlight unconscious hostile emotional states towards women, excessive narcissism , fears of vagina , passive pleasure in losing control of urination . Cognitive therapists examine the distortion in thinking that maintain or worsen premature ejaculation . Family therapists emphasize the dynamics of the relationship , power and control issues. In most cases therapists blend the ideas from different theories.  

The psychological treatment of Premature ejaculation has multiple goals. These include: 

1) Learning techniques to control and/or delay ejaculation.

2) Gaining confidence in their sexual performance.

3) Decreasing performance anxiety 

4) Modifying rigid sexual repertoire

5) Surmounting barriers to intimacy 

6) Resolving interpersonal issues that precipitate and maintain the dysfunction 

7) Coming to terms with feelings that interfere with sexual function. 

8) Increase communication

In treating Premature ejaculation therapists employ specific behavioural techniques like stop start exercise or stop technique. The ISSM premature ejaculation guideline Committee recommend specific forms of treatment intervention for lifelong , natural , acquired and subjective types of premature ejaculation . Men with lifelong premature ejaculation have never had extended intercourse while men with acquired pre mature ejaculation have previously experienced normal intercourse. Men with subjective pre mature ejaculation believe they suffer from it in spite of having extended intercourse latencies. These differences between subtypes require clinicians to tailor their psychological intervention to the overall and specific experiences of men and their partners with each subtype of pre mature ejaculation.

Topical anaesthetics 

Anaesthetic creams and sprays like benzocaine, lidocaine are used to treat premature ejaculation. These products are applied to penis 10 to 15 minutes before sex to reduce sensations and hence delay ejaculation. Lidocaine sprays for premature ejaculation are available over the counter. There side effects include loss of sexual pleasure and sensitivity . 

Medicines for premature ejaculation

Many drugs do delay orgasms . However none of these drugs are approved by FDA. 

Antidepressants : Side effect of certain antidepressants is delayed orgasm. For this reason SSRIs like Sertaline, fluoxetine are used to help delay ejaculation. Paroxetine is approved in USA and is the most potent. If there is no benefit with SSRIs doctors might prescribe tricyclic antidepressants. 

Analgesics: Tramadol is the medication used to treat pain . It has side effect that delays ejaculation. 

Phosphodiesterase -5- inhibitors : Some medications used to treat erectile dysfunction such as Sildenafil(viagra) might help in premature ejaculation. These drugs are more effective when used with SSRIs. Side effects might include nausea, vomitting and flushing.

Zinc and Magnesium-rich Foods : There is scientific evidence for certain foods that have impact on libido, premature ejaculation and sexual health. Foods rich in Zinc and Magnesium boosts testosterone and improves the endurance and energy. Although there is no direct link between low seminal Mg levels and premature ejaculation researchers believe that low magnesium levels lead to vasoconstriction which affects sexual performance and lead to premature ejaculation. 

Food rich in Magnesium like green leafy vegetables, fruits,legumes, nuts , seeds, salmon are also rich in Zinc.

Masturbating before Sex: Masturbating before sex is a common method of increasing ejaculation time . It is believed to work by putting the body in refractory period between orgasms in which you will find more difficult to orgasm again. Timing is important here . It is also important to provide enough time for the body to partially recover in order to avoid erectile dysfunction.

1) Practice yoga and Pranayama daily

2) Stop fantasizing too much about women or sex

3) Having nutmeg(jaiphal ) mixed in milk also prevents premature ejaculation.

4) Having white butter mixed with rock sugar( mishri) is also beneficial in premature ejaculation.

5) Ginger is an excellent product to increase blood circulation. Having it regularly increase the blood flow to sexual organs.

6) Have approx 10 g of gooseberry(amla) with 50g of honey to increase the amount of semen being produced.

7) Avoid raw onions 

8) Soak 7-8 almonds overnight. Next morning crush them and have them with milk