Premature ejaculation is the most common form of sexual dysfunction among men.

One of the problems with the diagnosis and treatment of PE is that until recently there has not been agreement on what constitutes premature ejaculation. Many men believe they orgasm more quickly than they should only to discover that their time to orgasm is well within the average range. Other men might orgasm in 2 minutes but find it is neither a cause for concern for them nor for their partner.

1. According to the International Society of Sexual Medicine (ISSM) premature ejaculation is a male sexual dysfunction characterized by the following: Ejaculation that always or nearly always occurs prior to or within about 1 minute of vaginal penetration from the first sexual experience—Lifelong Premature Ejaculation (LPE), OR a clinically significant reduction in latency time (time it takes to reach orgasm after engaging in sex), often to about 3 minutes or less–Acquired Premature Ejaculation (APE);
2. The inability to delay ejaculation on all or nearly all vaginal penetrations; and
3. Negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy.

All three elements must be included for PE to be diagnosed. Men with PE generally fall into two groups: those who have it from their first sexual experience and those who develop it later. The good thing is that many of the interventions work for both groups.

Another definition of PE that has been suggested by the World Health Organization (WHO) is “persistent or recurrent ejaculation with minimal stimulation before, on, or shortly after penetration and before the person wishes it, over which the sufferer has little or no voluntary control which causes the sufferer and/or his partner bother or distress.” This second definition is more flexible. It is also inclusive of gay men and their partners, which is a welcome addition to the definition.

Although no single treatment works for everyone, most men can be treated successfully. Just be sure to stay in touch with your physician. There are multiple medications that can be tried, different topical therapies, and varied techniques that can be used alone or in unique combinations. Some people see immediate results. Others will find they need to try a few different methods before finding the right solution. If things don’t go as planned or if you experience an adverse side effect, don’t give up. You have options and we are here to help you find the best solution.

In addition to behavioral tips, there are several medication options that your doctor may recommend, depending on your unique health situation.These include the most effective treatments recommended by the American Urological Association.

The simplest effective treatment is usually the best choice, so your provider will try to prescribe the medication that is most likely to work well for you. Based on your feedback, however, your management may change over time by switching to another medication choice or using a combination of agents. Some men use an oral medication and apply a topical anesthetic that they then cover with a condom. They get the sensations they want, experience the prolonged pleasure of an extended sexual experience, and orgasm at a time both they and a partner find satisfying. For other men, such a combination is overkill. That is why your personal experience is so important.

The FDA requires that drugs go through a clinical testing process to establish that they’re safe and effective to treat a particular condition. Healthcare providers generally may prescribe the drug for an unapproved use when they judge that it is medically appropriate for their patient. This type of prescribing is called “off-label” prescribing. Off-label prescribing practices are sometimes validated by clinical experience and research and may be a widely recognized clinical practice. Roman-affiliated providers have the discretion to prescribe certain drugs off-label based a patient’s unique medical history, symptoms, and preferences.