Premature ejaculation

Premature ejaculation most commonly affects younger men at the beginning of their sexual life. However, when specifically asked, approximately one-third of men report dissatisfaction with the duration of sexual intercourse, and the causes of premature ejaculation extend beyond a lack of sexual experience.

The main physiological cause is increased sensitivity of the nerve endings in the penis. This may be congenital or acquired, for example as a result of illness. Premature ejaculation may also be associated with thyroid disorders or low testosterone levels.

Infrequent sexual activity may also contribute, as prolonged abstinence can increase sexual sensitivity. Other contributing factors include anxiety during intercourse and concern about satisfying one's partner. Men may also develop a habit of ejaculating quickly if they regularly have sexual intercourse under stressful or unfavourable conditions.

Treatment of premature ejaculation usually involves a combination of therapeutic approaches and requires active cooperation from the patient.

Behavioural techniques designed to delay ejaculation, such as the squeeze technique or the stop-start method, are considered effective first-line treatment. Topical local anaesthetics in the form of creams or gels applied to the penis may also help reduce sensitivity.

Pharmacological treatment options are available as well. These medications increase serotonin activity within the nervous system, helping to delay ejaculation during sexual intercourse.

In patients whose symptoms are primarily related to psychological factors, certain psychotropic medications, such as sedatives or antidepressants, may be beneficial. However, these drugs can have significant side effects, including reduced sexual desire, and are generally prescribed only when there is a clear psychiatric indication.