Premature ejaculation consultations, treatment, and prescription medications

Premature ejaculation is a very common condition that occurs when a male ejaculates during sexual activity sooner than sexual partners would like. The Mayo Clinic estimates that 1 in 3 men experience this sexual problem at some time. There is no single cause of premature or early ejaculation. It is usually not a cause for concern, but some individuals may experience rapid ejaculation frequently enough to cause sexual dysfunction in their relationship. Some common psychological factors that may cause premature ejaculation are:

• Performance anxiety
  
• Little sexual experience
  
• Self-consciousness
  
• Depression
  

In addition to psychological factors, there may be several medical conditions that cause premature ejaculation. These conditions include:

• Erectile dysfunction
  
• Low serotonin levels
  
• Aging
  

Premature ejaculation is very common and is not usually a risk factor in sexual health. In some cases, premature ejaculation can affect a couple's sex life and lead to stress. Persistent and lifelong premature ejaculation may result in depression and anxiety around sexual intercourse. If you want to get treatment to help you stop ejaculating prematurely, book an affordable and convenient visit on Sesame with a real, quality doctor in San Luis Obispo, CA. Doctors on Sesame can discuss your symptoms, offer referrals, and help with the management of premature ejaculation. Save up to 60% when you book a consultation through Sesame and get treatment right away.

Premature ejaculation can cause stress and anxiety for men and may lead to sexual intimacy problems between couples. There is a wide range of psychological and behavioral factors that may cause early ejaculation, just as there is a wide range of treatment options to help with the treatment of premature ejaculation.

During a premature ejaculation consultation, doctors will discuss your symptoms and health history to help determine factors that may be causing you to ejaculate prematurely. Unless you are experiencing male sexual dysfunction due to a medical condition, doctors can help control ejaculation with behavioral therapy and sexual medicine. During a consultation, your doctor may perform a physical exam to check for underlying health conditions, blood pressure, and hormone levels, as these can all affect sexual performance.

Some common treatment options include:

Behavioral therapy: Doctors can recommend several behavior techniques to help delay ejaculation. Techniques such as the squeeze technique and the stop-start technique help you control sexual satisfaction and learn to control the ejaculatory impulse. Doctors may also recommend masturbating an hour or two before sexual intercourse to delay ejaculation during sex.

Psychological therapy: Some men experience premature ejaculation as a side effect of psychological conditions such as performance anxiety around sexual intercourse. Psychological therapy can help patients talk about their relationship and sex life in a safe space. This can help with self-confidence, anxiety, and depression related to sexual relationships.

Exercises: Exercises to help strengthen the pelvic floor muscles can help delay ejaculation. To locate pelvic floor muscles, stop yourself from urinating midstream and hold the stream. The muscles that you use to perform that action can also help control ejaculation during sexual intercourse. Constrict those muscles for several seconds every day to strengthen the pelvic floor.

In addition to behavioral and therapeutic techniques to prevent premature ejaculation, doctors may recommend or prescribe oral medication to help. Do not self-diagnose and self-treat premature ejaculation with oral medication. Talk to a health care provider (such as a primary care provider or men's health specialist) to help create a treatment plan that's right for you.

Along with behavioral techniques and psychological therapy, doctors may recommend medication to help delay ejaculation. Types of medication that can help with premature ejaculation include:

Topical anesthetic creams (or sprays) numb the penis before sex to help control ejaculation. These medications usually feature lidocaine and/or prilocaine as active ingredients to help reduce sensation in the penis during sexual activity. The topical anesthetic is applied to the penis 1/2-1 hour before sex and should be washed off before sexual activity (as they are numbing agents). Topical anesthetics that help premature ejaculation can be purchased over-the-counter at most drugstores.

The FDA has not specifically approved any oral medication as a treatment for premature ejaculation, but many drugs have been shown to help delay ejaculation. A doctor may prescribe oral medication as an "off-label" therapy, meaning the drugs are being prescribed to treat something they have not been approved to treat. Don't worry; this practice is common and legal. Off-label prescription medications used as a treatment of premature ejaculation include:

Antidepressants: Antidepressants, specifically Selective Serotonin Reuptake Inhibitors (SSRIs), may cause delayed orgasm as a side effect. If you are experiencing persistent early ejaculation, you may be prescribed drugs such as paroxetine (Paxil), sertraline (Zoloft), fluoxetine (Prozac), or tricyclic antidepressant clomipramine. These drugs cannot be purchased over-the-counter and may result in depressed libido, nausea, and drowsiness.

Pain medication: The drug tramadol (Ultram) is known as an analgesic or a medication that changes the way your brain responds to pain. Tramadol is used to treat moderate to severe pain and may delay ejaculation as a side effect. Analgesics cannot be purchased over-the-counter and cannot be used at the same time as SSRIs.

PDE5 Inhibitors: Phosphodiesterase-5 inhibitors are a class of drugs that can strengthen erections and delay orgasms. PDE5 inhibitors work by relaxing blood vessels, allowing blood to flow more freely through the arteries. To treat premature ejaculation, a doctor may prescribe a PDE5 inhibitor such as sildenafil (Viagra), dapoxetine (Priligy), tadalafil (Cialis), or vardenafil (Levitra). PDE5 inhibitors are prescription medication, and cannot be purchased over the counter.

Masturbation before sexual activity can help delay ejaculation during sexual intercourse. Along with sex therapy, behavioral techniques such as masturbating 1-2 hours before sex can help reduce anxiety and improve performance time during sexual intercourse.

Additionally, if you are experiencing persistent premature ejaculation, a sex therapist may suggest desensitizing techniques such as the stop-start method (stopping sexual activity just before ejaculation until the urge goes away) or the squeeze method (squeezing the head of the penis just before ejaculation until the urge goes away). These methods can help train you to resist the urge to orgasm and improve performance time during sex. Sex therapy may also encourage the use of foreplay and other sexual acts to help reduce the anxiety around sexual intercourse.

Pre-sex masturbating, desensitizing exercises and a variety of sexual activities can help alleviate performance anxiety and train you to resist the urge to ejaculate right away. If these techniques do not adequately address the problem, your doctor may prescribe a topical anesthetic or oral medication to help supplement these therapeutic measures.

Not sure where to get help for early ejaculation? First of all, don't stress. This is one of the most common sexual problems men deal with and is rarely a risk factor for other health concerns. If you're wondering about treatment options to help with premature ejaculation, book a convenient and affordable consult with an andrology (men's health) specialist on Sesame to discuss what's going on. Doctors on Sesame can perform exams, offer medical advice, and prescribe medication to treat a wide range of men's health/ sexual health conditions. Save up to 60% when you book a consult through Sesame and get quality care right away without the hassle of insurance networks and wait times.

Sildenafil (Viagra) is often prescribed by Doctors of Urology to treat erectile dysfunction. As a PDE5 inhibitor, Viagra relaxes blood vessels, encouraging blood to flow freely through them. This can lead to longer, and stronger erections. This blood flow to the penis can also help combat premature ejaculation, as the erection is more firm.

Outside of sexual health, Viagra may help prevent heart attacks and improve the ability to urinate (by easing muscles in the prostate). These side effects are "off-label", meaning that Viagra has not been approved by the FDA to address these conditions, but they are potential benefits to taking Viagra every day.

Note: Do not take more than one dose of Viagra within 24 hours. This can lead to severe side effects such as nausea, dizziness, and blurred vision. Before taking Viagra every day, consult with your doctor about your dosage.

Most types of sexual dysfunction can be broken into four groupings, depending on the causes and symptoms of the sexual problem. Here's an overview of sexual dysfunction classes:

Desire disorders: Desire disorders are characterized by a lack of sex drive or desire for sexual intercourse. Desire disorders may be caused by low hormone production (low testosterone levels or low estrogen levels), pre-existing psychological conditions (such as depression/ anxiety), or medication usage (antidepressants known as SSRIs can cause low libido as a side effect).

Arousal disorder: Arousal disorders are characterized by an inability to become physically aroused enough during sexual activity. In male sexual dysfunction, arousal disorders usually show up as erectile dysfunction, or the inability to get or keep an erection for sexual intercourse. In female sexual dysfunction, this may cause dryness and lack of lubrication in the vagina.

Orgasm disorders: Orgasm disorders occur when an individual either has a delayed orgasm or experiences no orgasm at all during sexual activity. In men, orgasm disorders can also show up as premature ejaculation. In women, orgasm disorders often occur after menopause. With the hormonal changes brought on by menopause, women may experience difficulty having an orgasm during sexual activity.

Pain disorders: Sexual pain disorders occur primarily and women, and result in pain during intercourse. The two common conditions that cause intercourse are known as dyspareunia (lack of lubrication in the vagina during intercourse) and vaginismus (painful spasms in the vaginal muscles and pelvic floor during intercourse). There are several physical and psychological causes behind these conditions, including previous sexual trauma or changes in hormone levels.

There are a number of physical factors and health concerns that may cause sexual dysfunction in both men and women. Sexual function can often be a sign of health and well-being, while dysfunction may be caused by physical conditions such as:

• Obesity
  
• Vascular problems (heart disease, high blood pressure)
  
• Diabetes
  
• Thyroid disease (hyper/hypothyroidism)
  
• Hormone imbalances
  
• Substance abuse
  

There are many causes of sexual dysfunction, but there are also many ways to treat it. If you are struggling with sexual performance or experiencing anxiety about sex, book a video visit with health care providers on Sesame to discuss your symptoms and talk about treatment options.

Erectile dysfunction can certainly be a physical side effect of several medical conditions and psychological issues.

Erectile dysfunction is one of the most common forms of male sexual dysfunction. In fact, ED affects nearly 30 million men worldwide. The prevalence of ED cases can be attributed to aging. However, men of all ages experience sexual dysfunction caused by a wide range of health conditions.

Aside from age, common causes of ED include:

• Poor vascular health (heart disease, high blood pressure, lack of blood flow)
  
• Substance abuse
  
• Diabetes
  
• Obesity
  
• Multiple sclerosis (MS)
  
• Psychological problems (such as depression or anxiety)
  
• Peyronie's disease (scar tissue inside the penis)
  
• Spinal cord injuries
  
• Medications
  

Erectile dysfunction can be a touchy subject for a lot of guys. If you have difficulty getting or keeping an erection once in a while, you are not alone. Millions of men worldwide experience some form of ED at some point in time. If your ED is persistent, or if you're worried that it's a side effect of other health conditions, speak to a men's health care provider or Doctor of Urology as soon as you can. ED is extremely common but can signify underlying health risks such as heart disease, diabetes, or obesity. The good news? Most cases of ED are easily treatable with a prescription.

If you or your partner's sexual dysfunction is being caused by physical factors, a doctor may be able to prescribe medication to help treat the condition and improve sexual performance.

For men, oral medication such as the PED5 inhibitors sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) can improve blood flow to the penis as in response to sexual behavior. These drugs can stimulate a sexual response to treat persistent erectile dysfunction. Mechanical aids such as penile implants and vacuum devices may also help treat erectile dysfunction.

Women may be prescribed bremelanotide (Vyleesi) or flibanserin (Addyi) to help treat hypoactive sexual desire disorder (HSDD), or decreased sexual desire.

Hormone imbalances, such as low testosterone, can cause sexual dysfunction and decreased sex drive in both men and women. If sexual dysfunction is being caused by hormone imbalances or changes, your doctor may prescribe a hormone pill, shot, or cream (such as Estrace) to help.

If you are experiencing sexual dysfunction as a result of psychological causes, therapy can help address the sexual problems you may have. Common psychological causes of sexual dysfunction include:

• Anxiety
  
• Depression
  
• Body image/ self-confidence problems
  
• Stress
  
• Trauma (such history of rape or abuse)
  

Sex is complicated. Not only do physical factors contribute to dysfunction, but emotional and psychological conditions can reduce your ability to experience sexual arousal and pleasure from sex. Sex therapists can help couples communicate about sex in a safe and open environment. Therapists may also work with individual patients to address trauma, body image, anxiety, and other psychological causes that could be contributing to sexual dysfunction. A sex therapist can also provide behavioral therapy to help patients with self-stimulation or ejaculation control to enhance sexual performance or increase arousal.