Dear Readers,
D.C. is a 24-year-old man from Manchester. He sends greetings to Lifeline and asks for help with his problem. He suffers with the fairly common male sexual condition, Premature Ejaculation, which affects about 40 per cent of males.
Premature ejaculation can cause significant problems in the male/female relationship. The fact is that without learned behaviour to prolong sexual intercourse, most men achieve orgasm in less than five minutes and will ejaculate. Women, on the other hand, on average require at least 12 minutes to experience orgasm and many women need even more prolonged genital stimulation. It is this functional and physiological gap in performance between the sexes that repeatedly causes problems.
When a man experiences a change in his sexual function with his partner there can be several causes which can be looked at.
1) Psychological factors;
2) Psychiatric factors;
3) Organic factors.
Psychological problems including problems with relationships, low self-esteem and adverse life situations can alter a man's sexual performance, while psychiatric conditions such as depression and alcoholism also alter sexual function.
Organic factors such as prostatitis (inflammation of the prostate gland) prostatectomy (surgical removal of the prostate gland) cardiovascular events such as a heart attack, spinal cord nerve damage, diabetes and even arthritis can affect a man's sexual prowess. The use of certain medications can also alter sexual function. The reason for the problem, premature ejaculation, will need to be ascertained before treatment can be determined. The man will therefore need to be physically examined as well as have his mental state assessed by a doctor.
When the man has always operated on a "short fuse," he may have to expand his sexual technique in order to satisfy his partner.
Prolonged foreplay is always a significant factor in arousing a female and bringing her near orgasm.
The decision to include or exclude oral sex as a part of sexual activity is a personal one for all couples; it is however, a useful method of arousing a woman or even having her achieve orgasms prior to intromission (penetration).
A man can also use "double" (two) condoms at a time, which cuts down on the stimulation received during sexual intercourse which will allow him to prolong the act.
There are also some medically prescribed, topical applications such as Retardin cream which acts as an anaesthetic and decreases the sensitivity of the penile head when applied. This also tends to prolong sexual activity.
Male premature ejaculation can also be treated by the "pause" and "squeeze" procedures developed by Semans, Masters and Johnson. These techniques are usually taught by a sex therapist, (there are sex therapists in Jamaica!)
The medication, sildenafil citrate, or viagra, when used by a man seems to improve his sexual functional globally (in all parameters). It is the only pill available that can improve a man's natural response to sexual stimulation.
Note: Men who use nitrate medication for treatment of heart disease should not take Viagra.
Other effective treatment options include:`
Counselling
Vacuum devices
Medicines inserted into the urethra
Self-injection drugs
Surgical implants
Regitina (another oral alter- native to viagra)
All of these methods work to provide a man with a sustained erection with which to get the job done.
By Dr. A.J. MORGAN
