Dear Dr G,

I email you with alarming concerns about my sexual performance.

I have been suffering from premature ejaculation in recent months.

It all started with an episode of blood in my ejaculation following a period of dehydration.

I went to the doctors, and was informed I may have suffered from prostatitis.

Thankfully, following a course of antibiotics, the bleeding in my semen was resolved.

At first, I thought my ordeal was over – until I started having issues with the timing of my ejaculation.

I was completely fine before the prostatitis and was able to have sexual intercourse with a duration of around 10 minutes.

In the last few months, I started noticing the duration of sex is getting shorter.

Don’t get me wrong, I am completely fine with maintaining an erection, it is just that I seem to climax too fast, sometimes in even less than a minute.

I am also uncertain whether I’m starting to face the problems of diminishing libido.

The urologists reckon I now suffer from chronic prostatitis and this is also related to premature ejaculation.

What perplexes me is how an infection of the prostate can end up with shortening the timing of sexual climax?

I would like to put Dr G on the spot for some clarification.

Exactly what is prostatitis and what causes the inflammation?

What are the symptoms of prostatitis?

How can prostate inflammation result in premature ejaculation?

I am really troubled by the quickie sexual performance and my wilting manhood, and hope you can help.

Yours truly,

Quickie Quittance

Chronic prostatitis is a relatively common condition that affects thousands of men worldwide. The inflammatory changes of the prostate resulting in prostatitis tends to affect men of all ages. It has been estimated 10-15% of men experience prostatitis symptoms at some point in their lives. Although the statistics may seem high, many specialists consider the figure may even be higher as many may not seek medical attention for various reasons. There is an undeniable connection between the prostate gland and sexual function, and therefore prostatitis is known to have an impact on physical and sexual health.

Prostatitis can be broadly divided into four different categories. Acute Bacterial Prostatitis (ABP), is usually caused by a bacterial infection resulting in severe symptoms of pain in the lower abdomen, fever, and difficulty urinating. On the other hand, Chronic Bacterial Prostatitis (CBP) is a persistent low grade bacterial infection that lasts for several months or even years. Other types of prostatitis is Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS). The condition is not caused by bacterial infection, but mostly associated with unidentifiable aetiology. Lastly, asymptomatic Inflammatory Prostatitis (AIP) can also be discovered incidentally during medical examinations.

The symptoms of chronic prostatitis can vary from person to person, but commonly include frequency and difficulties in urination, discomfort in the lower abdomen or bleeding during ejaculation. Chronic prostatitis can also result in sexual dysfunction including erectile dysfunction, premature ejaculation and generalised fatigue, malaise and diminishing libido.

Although prostatitis is well recognised to affect sexual function in men, the exact aetiology and pathogenesis are largely unknown. Chronic prostatitis is well documented to be associated with premature ejaculation. The discomfort and pain experienced in the prostate and surrounding areas are thought to result in heightened sensitivity and anxiety during sexual activity. This in turn leads to difficulties in controlling ejaculation resulting in premature ejaculation. Treating underlying chronic prostatitis symptoms can improve sexual function and alleviate premature ejaculation in these cases.

Prostatitis can also contribute to weakened erection and reduced libido. The inflammation is thought to result in swelling and disruption of blood flow, making achieving and maintaining an erection a bit more. On the other hand, painful and bloody ejaculation is also well-recognised to have adverse psychological impact in men, resulting in erectile dysfunction. Prostatitis can also dampen your desire for intimacy. The constant discomfort and associated pain can definitely make it difficult for men to get in the mood. Although it’s essential to remember that not every individual with prostatitis experiences a decrease in libido, research also demonstrated men with prostatitis may have lower levels of testosterone as compared to normal men.

The treatment option for prostatitis is mainly symptomatic, apart from bacterial induced ABP and CBP. Appropriate antibiotics are often prescribed for bacterial prostatitis, while pain relievers and anti-inflammatory are necessary to manage pain and discomfort. Other important medications such as alpha blockers, 5 alpha reductase inhibitors, NSAIDS and PDE5-I are often necessary to manage the symptoms. In addition, lifestyle changes such as regular physical exercise, stress reduction techniques, and avoiding triggers like alcohol and spicy foods may provide some relief. Other treatments such as pelvic floor exercises and relaxation techniques can help relieve muscle tension and pain.

Prostatic inflammation is known to form unwanted alliances with sexual dysfunction such as erectile dysfunction, ejaculatory derangement and dwindling libido. The association often generates uncertainty for both the suffering men and their treating physicians. Despite the sense of despair for the sufferer, a healthier and active lifestyle can potentially suppress the symptoms and progression of prostatitis in the long-term.

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