Among all sexual dysfunctions, premature ejaculation is one of the most common, affecting one in four men. 

It is essential to understand what premature ejaculation entails, its causes, and available treatments. 

What Is Premature Ejaculation?

Premature ejaculation is when ejaculation occurs approximately one minute after vaginal penetration and before the man desires it. This inability to control the timing of ejaculation typically happens during most (or all) sexual encounters for a minimum of six months. This problem not only affects the individual but often also their partner. 

For the condition to be considered as premature ejaculation, it should not be attributed to the effects of:

  • Substances
  • Medications
  • Underlying medical conditions

Additionally, individuals experiencing this dysfunction often express a sense of lacking control and anxiety when it comes to engaging in sexual intercourse, fearing their inability to delay ejaculation. 

In some cases, premature ejaculation can be classified as “lifelong”, meaning it has occurred since the individual’s first sexual experiences and has persisted over time.

Premature Ejaculation: What Are the Causes? 

The causes of premature ejaculation are diverse, often requiring the involvement of different specialists. Research shows the importance of utilizing a multidisciplinary approach involving:

  • Clinical sexologist-psychotherapists
  • Andrologists
  • Gynecologists
  • Psychiatrists with expertise in sexology  

Premature ejaculation typically involves a combination of the following:

  • Psychological factors
  • Relational factors
  • Biological factors
  • Organic causes, such as hyperthyroidism and prostatitis

Therefore, patients must consult an andrologist endocrinologist for an accurate differential diagnosis. 

Even if an organic cause is identified, the man can still benefit from psychotherapeutic treatment provided by a clinical sexologist, as premature ejaculation encompasses not only the man’s emotions, thoughts, and behaviors, but also those of his partner.

In more severe cases, premature ejaculation can even pose difficulties in achieving conception when it occurs prior to penetration. 

What to Do in Case of Premature Ejaculation?

Premature ejaculation is more common among younger individuals and tends to improve over time. 

As the patient ages, the “latency time,” which starts with penile stimulation and ends with ejaculation, naturally becomes longer. 

Individuals suffering from premature ejaculation often experience significant emotional distress during sexual intercourse. In more severe cases, they may exhibit avoidance behaviors, opting for masturbation over intercourse. The partner involved in the experience of premature ejaculation, mainly if it occurs repeatedly, may also experience a decrease in desire due to sexual dissatisfaction. 

It is essential for couples to discuss the issue, acknowledge it together, and address it. In this regard, the assistance of a psychotherapist, sexologist, and other multidisciplinary team members can be essential.

How Does the Visit to the Sexologist Work? 

The visit to a sexologist typically involves using clinical interview tools, including tests and questionnaires, to gather the patient’s and couple’s medical history. The sexologist’s job includes:

  • Formulating a diagnostic hypothesis
  • Establishing specific goals based on the patient’s current stage of life
  • Understanding the problems and needs presented during the consultation 

Typically, it takes around three meetings before a comprehensive psychosexual evaluation is conducted, whether for individuals or couples. 

How Is Premature Ejaculation Treated?

Treatment for premature ejaculation usually lasts about 3-6 months, with sessions typically scheduled weekly. 

In between sessions, the psychotherapeutic sexologist may prescribe individual sexual exercises for the patient to practice alone or as a couple. These exercises help individuals learn how to manage their ejaculation and respect each other’s needs.

Before suggesting specific strategies to improve the quality of the intimate life, the psychotherapeutic sexologist explains the fundamental aspects of sexual functioning, including its physiology and associated emotional and relational factors.

When Should a Couple’s Psychotherapist Be Consulted?

Regardless of the specific causes of premature ejaculation or the relational condition of the patient, it is advisable to address the couple aspects with a psychotherapeutic sexologist.

The therapy process will involve both partners, aiming to:

  • Enhance communication
  • Find solutions to problems
  • Improve the understanding of each other’s intimate needs
  • Manage hostility and anxiety

With the guidance of a psychotherapist sexologist, the partners can learn techniques and new approaches to collaborate for pleasure and satisfaction.