What is Premature Ejaculation (PE)?
Premature ejaculation (PE) is a condition where a person ejaculates sooner than desired during sexual activity, typically within a minute of penetration. Individuals with PE often feel they have little to no control over when they ejaculate, leading to distress for both themselves and their partners.
Research Findings on Anxiety and prematur ejaculation
Recent studies have highlighted the strong association between anxiety and PE:
- High Rate of Anxiety: Research indicates that 70% of patients with acquired PE experience high levels of anxiety, significantly higher than those with lifelong PE or other forms of PE.
- Autonomic Dysfunction: Anxiety may contribute to PE through autonomic dysfunction, which affects bodily functions like ejaculation.
- Social Phobia: There is a significant association between PE and social phobia, a condition characterised by performance anxiety.
- Serotonergic Dysfunction: Both anxiety and PE may be linked to serotonergic dysfunction (issues with serotonin regulation), as evidenced by the effectiveness of serotonin reuptake inhibitors (SSRIs) in treating both conditions.
How is PE Related to Anxiety?
The Vicious Cycle of Anxiety and coming too soon
Anxiety and PE are closely linked, often creating a self-perpetuating cycle. Performance anxiety, where a person worries about their sexual performance, can lead to increased self-consciousness and heightened arousal, causing quicker ejaculation. This anxiety then reinforces the cycle, making PE more likely to occur.
Negative Thought Patterns
Anxiety can foster negative thought patterns, such as fears about not satisfying a partner or feelings of inadequacy. These thoughts increase stress and anxiety, making it harder to control ejaculation.
Physical Manifestations of Anxiety
Anxiety often manifests physically, causing involuntary muscle tension, particularly in the pelvic floor muscles, which play a key role in ejaculation. This tension can lead to PE.
Distractions and Intrusive Thoughts
Anxiety can also cause distractions and intrusive thoughts during sexual activity, making it challenging to focus on the sensations and enjoyment of the moment, further contributing to PE.
What Are the Treatment Options for Premature Ejaculation?
Medications for coming too soon
Treating premature ejaculation involves a combination of strategies that address both the physical and psychological aspects of the condition. Common treatments include:
- Selective Serotonin Reuptake Inhibitors (SSRIs): Oral medications commonly used to treat depression and anxiety such as sertraline or paroxetine help in delaying ejaculation.
- Topical Anaesthetics: In the form of creams or sprays applied to the penile head to lower sensitivity and slow the time when ejaculation happens.
- Dapoxetine: A short-acting SSRI specifically developed for treating premature ejaculation, Dapoxetine (there are two doses one of 30mg and one of 60mg) is taken 1-3 hours before sexual activity. Effective in improving ejaculatory latency time and enhances sexual satisfaction.
Psychological and Behavioural Therapies
- Open Communication with Your Partner: Talking openly and honestly with your partner about your concerns and anxieties around PE can reduce stress and create a more relaxed sexual environment.
- Relaxation Techniques: Practicing relaxation techniques such as deep breathing, mindfulness, or yoga can help manage anxiety and promote better control over ejaculation. These techniques enable individuals to stay focused during sexual activity.
- Professional Help: If anxiety significantly impacts your life and sexual performance, consider seeking help from a therapist or counsellor. Cognitive-behavioural therapy (CBT) and other therapeutic approaches can provide tools and coping strategies to manage anxiety.
Words of Wisdom from a Consultant Urologist
Managing PE often requires addressing underlying anxiety. Open communication, relaxation techniques, and professional therapy can make a significant difference. Remember, PE is a common issue, and seeking help is a positive step towards improvement.
