​Premature Ejaculation​​

Ejaculation refers to the discharge of semen in males. This may occur prior to when one or both partners desire it (prematurely). Normally, mental and physical sensual stimuli induce neural signals that result in rapid contraction of male reproductive ducts and accessory glands. This conveys sperm and fluid (collectively called semen) into the urethra, which is also the tube that passes urine from the bladder to outside the body. The subsequent contraction reflex expelling this semen from the penis is known as ‘orgasm’. 

Those affected would be relieved to know that premature ejaculation is a very common and treatable complaint. If it happens randomly and not too often, there is usually no need for concern. Certain criteria have been outlined for premature ejaculation to be significant:

  • Ejaculation always or nearly always takes place either before or within one minute of penetration

  • You are not able to delay ejaculation at all or nearly all of the time during intercourse

  • There are negative personal consequences such that you feel distressed and frustrated due to which you may avoid intimacy

The disorder can be divided into two types. It is primary (lifelong) if all previous sexual experiences have had premature ejaculation and secondary (acquired) if you once had acceptable ejaculatory control, but now it occurs too soon. 

A specific cause for the disorder has not been identified, although various psychological factors play a central role. If initial sexual encounters were performed in a hurried manner, it is possible that this establishes a habit in later life. As we all know, habits are generally not easy to change. Another closely related disorder, erectile dysfunction​ can encourage your tendency to consciously or unconsciously, rush through intercourse. It thus follows that any sort of anxiety or stress can contribute towards premature ejaculation. Relationship problems would put a strain on intimacy too.  

Additionally, certain biological factors are thought to be involved in this complex diseases process. To name a few – abnormal levels of hormones, or chemicals in brain; thyroid disease; abnormality of the ‘orgasm’ reflex; infection or inflammation of the prostate (gland that secretes fluid component of semen) or urethra (tube through which urine and semen pass out); damage to nerves from surgery or injury; inherited traits – could be considered. Cigarette smoking, diabetes, heart diseases and drug abuse are associated risk factors.​

Your central complaint would be that you are unable to delay ejaculation as it happens too early. Being frustrated or anxious is quite expected.

You may feel embarrassed to talk to anyone about this but do not let that stop you from seeking medical advice. Remember, premature ejaculation is a treatable disorder and you can always get an appointment at the Kidney and Bladder Service Line at the Aga Khan University Hospital.

Feel free to discuss any query or doubt with them; sometimes a simple discussion can lead to personal satisfaction and a healthy mental state. 

Also, try not to postpone going to a doctor as sometimes, a serious underlying medical illness may be present which could be influencing ejaculation. ​​

Your time with your doctor maybe limited, so make sure to prepare for your visit beforehand. Here are some tips to help get you started.​ ​ ​
A detailed talk and physical examination will be performed by your doctor. Of course you can expect some personal questions; try to answer them as best as you can. Physicians from the Kidney and Bladder Service Line at the Aga Khan University Hospital, are well versed with such cases and display a sincere adherence to medical ethics. You do not need to be ashamed of anything, especially with your health care provider, who will maintain confidentiality of your meeting.
At times, some blood tests may also be required to check hormone levels or urine test to exclude infection. ​​

Primarily your doctor will make sure that you do not have any other medical disease which might be a hidden cause. If found, then treating that disorder could counteract premature ejaculation. Further options to manage your symptoms are:

  • Medications to make the genital area numb so the reduced sensation assists in delaying ejaculation

  • Oral Medications: some pills defer ejaculation as a side effect and this property is utilized 

Physicians from the Mind and Brain Service Line at the Aga Khan University Hospital, may be involved in your treatment, to counteract psychological factors.  

  • Behaviour therapy: learning mental and physical techniques, often with your partner, to modify certain habits 

  • Counselling/talk therapy: these sessions can help you discover ways to cope with stress and reduce performance anxiety.

A combination of these are usually more effective and your doctor will work with you plan out everything.​​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.
The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the 'Important Numbers' section on the website homepage.
The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments' costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the 'Important Numbers' section on the website homepage.​
Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the 'Important Numbers' section on the website homepage.

The information provided on our website is for educational purposes and not intended to be a substitute for medical advice, diagnosis or treatment. You should always seek the advice of your doctor or other healthcare professional provider.