Premature Ejaculation

The three main medications for erectile dysfunction include sildenafil or Viagra, vardenafil or Cialis, and tadalafil or Cialis. These are taken orally and are called phosphodiesterase-5 inhibitors. There is a cream called alprostadil used in Canada, while alprostadil, phentolamine, and papaverine are used as injections into the penis to get an erection. Alprostadil is a urethral suppository that works within ten minutes. Testosterone can be used for those with low levels of this hormone.

PREMATURE EJACULATION

Premature ejaculation involves having an orgasm and ejaculation within a few seconds after initiating sex and without much stimulation. The cutoff for what constitutes “premature” ranges from 15 seconds to 1 minute. While most men say they wish they could go longer without ejaculating, the average is about 4 minutes. The opposite of premature ejaculation is delayed ejaculation. Premature ejaculation can be embarrassing and can lead to both relationship and emotional issues.

No one knows the causes of premature ejaculation. There are theories about the possible psychological causes of this but there has been no consistent proof of a psychological cause. There is a nucleus in the brain responsible for the control of ejaculation, which may play a role. Genetic causes have been suggested and it is thought that there is simply a faster neurological reflex in these men.

There are two actions that need to happen in ejaculation. The first phase is emission, when the fluid gets mixed and deposited into the upper part of the urethra. The second phase is expulsion, where the bladder neck gets closed off and there is contraction of urethral and pelvic muscles to expel the semen. The emission phase involves the sympathetic nervous system and the expulsion phase involves the motor nervous system. The central nervous system, as mentioned, plays a role in control over ejaculation.

The diagnosis is based on the patient’s history of their problem as there are no tests for the disorder. According to the International Society of Sexual Medicine, the problem cannot be related to a mental illness, a relationship problem, or a medication. As