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How to beat premature ejaculation



Stay the course

JOKES. That's what you usually get when you talk about premature ejaculation with anyone. Even my colleagues, when they found out that I was working on this story, quipped: "You can write from experience, eh?"

"We've all heard the jokes before," said Assoc Prof Dr George Lee, consultant urological surgeon at Universiti Malaya. "When I told my friends I was going to South Korea to give a talk on premature ejaculation, they told me, "You better get there quick before it's over!" "

Certainly in our Asian culture, where men often pride themselves on their virility and the number of children they father, premature ejaculation (PE) is naturally a scary and humiliating subject deemed to affect the manhood of those who suffer from it. The social stigma and jokes only worsen the sufferers' perception that they are the odd ones out. So, they suffer in silence rather than seek help.

But how many of us know that 30% of the male population suffer from PE?

That's right, that's one in every three men aged 19 to 80. The percentage in South-East Asia differs little from that in the West, which is 28%. With this in mind, PE doesn't seem that uncommon a condition anymore.

"However, the number of men who come forward (to report the condition) is miniscule," says Lee. "Nobody wants to. People who come to see me talk about something else, about their prostate or something like that. You can see that they are undecided on whether they want to tell you. And when they're about to walk out the door, they come back and want to say it. They need time. Embarrassment is a big issue."

Lack of awareness also contributes to their hesitation, as there are still those who do not know the difference between premature ejaculation and erectile dysfunction (ED). Unsure of whether their predicament is pathological or physiological, the men might avoid intimacy altogether.

Lee says the International Society of Sexual Medicine defines PE as "ejaculating shortly after penetration" or "ejaculating before one desires to". All studies of PE have shown that ejaculation happens within a minute or less. When it affects the relationship between partners, then it becomes a problem.

But things are about to change, says Lee.

"We are gradually moving towards recognising PE as a medical condition. Before this, PE was thought to be psychological, that the person may be too anxious during intercourse. All sorts of methods were then recommended, such as certain physical manipulations and even anaesthetic creams and sprays, which were largely ineffective. Now, opinion has shifted to recognising the cause as a neuro-biological one.

"We increasingly understand that there are people who suffer from primary PE," says Lee. "They are born that way and it's because of their central nervous system. There are certain components in there that lower the threshold of climax. And the whole system is controlled by the seratonin system, which controls our mood, appetite, anger, pain and sexual pleasure."

This is where therapeutic intervention comes into the picture, where seratonin inhibitors can be manipulated so that the threshold can be elevated. Anti-depressants are usually used, but there are actually no anti-depressants licensed for PE.

"Prozac, probably the most common anti-depressant, is used for this," Lee explains. "But a majority of them are long-acting. So, technically that is not a suitable medication to treat PE. You want to treat PE during sexual intercourse, but not beyond that especially if the person suffers from side-effects."

But now there is a new medication that is short-acting. It has already been tested, and is being marketed in seven countries.

"I'm predicting that it should be released (in Malaysia) by next year," says Lee. "It is a prescription drug because it carries the side-effects of nausea, headache and vomiting, so it needs to be handled with care."

Even though treatment is within reach, the biggest obstacle is still to get men to come forward for help.

"I guess there will always be jokes about the condition," says Lee. "But if you notice, impotency jokes are no longer around. But there are a lot of jokes about Viagra now. So the jokes are no longer on the men but on the success of the treatment. That's the key to it - do not humiliate the men who suffer from this. It's already bad enough that they suffer in silence, so there's no need to humiliate them. Cultural change takes time."

With more education and awareness about PE. and in recognising PE as a medical condition, hopefully embarrassment will diminish and more men will come forward to talk about it.

Lee adds that PE is not solely a man's problem; it is also a condition from which women suffer, as they might not find satisfaction in their sexual relationship. Communication is important, as usually the man recognises that he has a problem and tells his wife. Then she would suggest that they see a doctor about it.

Lee draws a parallel between what is happening now in the treatment of PE and the advent of Viagra which he says was "the first sexual revolution for men." Previously, ED was known as impotence, which was very demeaning. But now it is recognised as a medical condition and is treated with medical respect, says Lee.

"If you look at the pre-Viagra era, the jokes were always about impotent men," he says. "At the time, before there was a treatment, men were suffering in silence. Now, 10 years on, it has helped millions, about 233 million men. Every second, six tablets are consumed. That has improved men's sexual experiences, and also improved the relationship between many husbands and wives.

"Hopefully, (with the treatment for PE) we will have a second sexual revolution that will change many men's relationships with their wives."

Source: http://www.asiaone.com/Health/Men%25...14-173554.html