What is rapid ejaculation?

The embarrassment of talking about rapid or premature ejaculation keeps many men from seeking medical help. However, premature ejaculation is a very common men’s health condition with a number of treatment options; the first step is simply discussing the condition with your physician.

Many men occasionally ejaculate prematurely, but when it occurs regularly, it may be diagnosed as premature ejaculation. The Diagnostic Statistical Manual of Mental Disorders (DSM IV) defines premature ejaculation as a recurrent ejaculation with minimal sexual stimulation before, on or shortly after penetration.

“Rapid or premature ejaculation is a condition where men ejaculate much sooner than they wish,” says Dr. Stacy Elliott, Chair of the Canadian Male Sexual Health Council and a Sexual Medicine Physician active in The Men’s Health Initiative of BC. “It’s defined by three things: one is that the time it takes to ejaculate is very short, probably under a minute. The second thing is that there isn’t a sense of control, and the third thing is it causes distress to either a man or his partner.”

There are both psychological and biological factors that can contribute to premature ejaculation, including:

  • Anxiety or stress
  • Feelings of guilt or shame around sexual intercourse
  • Abnormal hormone levels or brain chemicals
  • Prostate inflammation or infection

“The prevalence of premature ejaculation is about 30% across the board, across the ages,” says Dr. Elliott. “I look at it as a sort of very hyperactive reflex, and it’s normal. That’s the way that men are made, and how they’re defined as men: that you should ejaculate fast, so it’s not an abnormality. The problem is that it doesn’t work in your relationship, and you want to extend that time.”

There are a number of techniques a man and his partner can use to delay ejaculation during intercourse. Other treatments include topical anesthetic creams that contain lidocaine or prilocaine to dull the sensation on the penis, psychotherapy, and medication.
Patients need to understand that there is no “magic pill” to cure premature ejaculation. “No pill is going to get rid of this,” says Dr. Elliott. “You need to really spend the time to learn how to slow down that reflex through behavioural methods.”

What causes rapid ejaculation?

There are lots of theories trying to explain what causes rapid ejaculation. After all, sex is a complicated process – there are physical, mental and social factors all working simultaneously. Like many men’s sexual health issues, guys didn’t used to talk about rapid ejaculation with their doctors or partners; today, new research is shedding light onto the physiology of ejaculation.

The pelvic nerves and the muscles of the pelvic floor interact in a complicated way when men ejaculate. Recently, studies have shown hypersensitivity of the penile sensory receptors, hyperactivity of the ejaculatory reflex, and lower thresholds to unblock the normal neural inhibition of ejaculation. This neuro-muscular complex responds to a mix of neurotransmitters like adrenalin, serotonin, nitric oxide, and the latest discovery, carbon monoxide.

You think that’s complicated? Try this: a guy’s neurotransmitter levels at any given moment will also vary in accordance with his hormone level, not to mention his stress level, or his level of caffeine, alcohol, and who knows what else.

A recent report also identified a hereditary component to rapid ejaculation. That’s right. Your Dad, your Grandfather, your great Grandfather – you may have inherited more than you bargained for from the (ahem) family tree.

How do we know all this? It’s simple: guys have started to talk about rapid ejaculation as a part of living healthy — and sexually fulfilling – lives.

What are the types of rapid ejaculation?

Primary: 

This is most common type. It starts early in life, often with first sexual experiences. It’s only a problem if it persists.

Secondary: 

This is when rapid ejaculations begin later in their life. Secondary RE has been associated with some underlying medical conditions, like prostate problems, so it’s wise to see a doctor for a medical evaluation. Stress or relationship issues may also contribute.

The other possible cause of Secondary RE is erectile dysfunction (ED). This too should prompt a visit to a physician so that any underlying medical conditions like diabetes or vascular disease (to name just a few) can be uncovered if present, or ruled out. When rapid ejaculation develops as a result of ED, it is generally accepted that the best plan is to treat the erectile dysfunction and the RE will probably clear up on its own.

How do you treat rapid ejaculation?

First, forget about the shame and blame. Turn off that nagging voice in your head, and get smart about rapid ejaculation. It’s a medical condition, and it’s treatable.

Secondly, talk to your partner. If you’re intimate enough to be having sex, you’re intimate enough to talk about it before and afterwards. Talk, listen and ask questions… you’re on the same team.

Click here for treatment options for rapid ejaculation.

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