Premature Ejaculation

The 35th President of the United States, John F. Kennedy once said: “History is a relentless master. It has no present, only the past rushing the future. Try to hold fast is to be swept aside.”

Indeed “the past is rushing the future”, and in the blink of an eye, the festivities of the Christmas, New Year and the Lunar Chinese New Year have ended. We are all ushered into 2016 and will face the challenges that have been predicted for this Year of the Monkey.

Many of us are embracing ourselves with the possibilities of higher costs of living and potential economic downturns, perhaps by tightening the purse-strings and being cautious in expenditure. However, others may face the hardship that is not so predictable, such as in the alteration of the state of health, with advancing age.

The American comedian, dancer and singer, Eddie Cantor, once said: “Slow down and enjoy life. It is not only the scenery you miss by going too fast- you also miss the sense of where you are going and why.”

This week we tackle the challenges of a reader facing the problems of “inability to slow down” in sex with advancing age.

Dear Dr G,  

My name is Albert and I am 54 years old.

I face a rather strange problem in the bedroom in the last three years, and really hope you can help me.  

My wife and I have been married for 25 years and we have a “normal” sex life.  

Sadly, I started having the problems of inability to hold back my ejaculation.

I read up in the Internet and wonder if this is the condition called premature ejaculation. 

I often thought it is a young man’s disease, and I am rather curious why this is happening to me at this age.  

Am I am getting this problem because I am too active or inactive in my sex life? 

The early ejaculation is really bothering my wife and I. Is there any treatment available? Are there risks involved?  

Are there any other reasons why I get premature ejaculation at this age?  

Am I not too old to be too fast?

Looking forward to your answers.  

Regards,

Albert  

According to the International Society of Sexual Medicine (ISSM), premature ejaculation (PE) is a medical condition characterised by a man having the inability to control his ejaculation, resulting in short latency time of intercourse (around one minute) and causing significant bothersome or impairment of the quality of life.

Many clinicians and sexual health physicians argue Premature Ejaculation is the commonest form of sexual dysfunction, compared to other conditions such as erectile dysfunction (ED).

The prevalence studies conducted in many countries, including Asian nations revealed that PE affects up to one in three men. Studies in the past indicate PE affects men from the incidence of their first sexual encounter and persists throughout their lives.

Such condition is believed to be due to the deficiency in the neurotransmitters in the brain, such as serotonin. Hence, this may explain why men get life-long PE or primary premature ejaculation.

In recent years, clinicians and scientists begin to investigate another group of sufferers who face the problems of early ejaculation in the advancing age, typically in the 50s. So, there is no such thing as too old to be too fast.

Researchers in the field of sexual health belief the etiology of such acquired PE (or secondary PE) is very different from the life-long PE.

Recent data had revealed the association of men with acquired PE with the possibility of prostate diseases, hormonal changes or even erectile dysfunctions. Many men may feel guilty about over indulgence (or even under-utilisation) in sex as the cause of sexual dysfunction. There is no real evidence to support the hypothesis.

The link between the onset of the inflammation of the prostate resulted in PE has been scrutinised in recent years. Although the exact mechanism of the conditions is largely unknown, many speculate that the local irritation of the pelvic organ may trigger the onset of early ejaculation. Other areas of research in this field include the association of men with hyperthyroidism and acquired PE. Again, the causative or effect of such link is hotly debated, and this has opened up further research avenues for better understanding of many sexual dysfunctional conditions.

Although the etiology and causative factors of the acquired PE remains a subject of scientific scrutiny, the treatment of both primary and secondary premature remains essentially the same.

Occasionally, the treatment of the underlying problems such as prostatitis or hyperthyroidism may resolve the issues. Otherwise, the pharmaceutical intervention to enhance the levels of serotonin in the brain also plays a vital role in the treatment of men with early ejaculations in the advancing years.

Patients who are treated with medications such as Depoxetine can benefit from better control and prolonged ejaculatory latency interval during sexual intimacy. Of course, with such improvement, the quality of life of the couples will enhance accordingly.

The American poet, playwright and social activist, Langston Hughes once said: “Hold fast to dreams, for it dreams die, life is a broken-winged bird that cannot fly.”

Dr G’s advice is, “Old bird that flies fast may not necessary be a good thing. Hold fast to treatment when faced with problems, as life should be like a carefree bird flying high and slow!”