Premature Ejaculation: Breaking the Silence

WebMD Live Events Transcript

According to the American Urological Association, premature ejaculation (PE) may be the most common male sexual disorder and can affect one in four American men. But PE is often misunderstood and underdiagnosed because men are too embarrassed to discuss it with their doctor. Urologist Jon Lee Pryor, MD, joined us to answer your questions on May 24, 2005

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician. If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

MODERATOR:
Welcome to WebMD Live, Dr. Pryor. Thank you for joining us today.

PRYOR:
My pleasure.

MODERATOR:
We've read that premature ejaculation (PE) is the most common
sexual dysfunction among American men. How do you define PE?

PRYOR:
Premature ejaculation is when somebody ejaculates before he wants to on a consistent basis and it causes some distress or interpersonal difficulty. Let's say he ejaculates before he wants to and it's not causing a problem, then it's not premature ejaculation.

From a medical standpoint we say that it cannot be from certain medications. Example: If somebody is on an opioid and you withdraw it, then that can cause premature ejaculation, so not due to certain medications.

The bottom line is if you ejaculate too soon, before you want to, and it causes some distress -- that's the most important part of the definition.

MODERATOR:
What causes PE?

PRYOR:
We don't know for sure, but it has something to do with a chemical in the brain called serotonin. If you have low levels of serotonin you can ejaculate too soon and if you have higher levels, that helps prevent premature ejaculation. That's it from a simplistic standpoint, but there's so much we don't know about why people have premature ejaculation. We're kind of in our infancy in learning about it.

MODERATOR:
Who is likely to have PE? Are some men more likely to have PE than others?

PRYOR:
Just about any male can have premature ejaculation. As opposed to erectile dysfunction, which tends to affect elderly gentleman (it can affect younger people too, but tends to be more common in elderly males), premature ejaculation can affect somebody who is young or old. So it can affect people at any age, it can affect any ethnicity -- virtually anybody could have premature ejaculation.

MODERATOR:
What is the difference between PE and ED (erectile dysfunction)?

PRYOR:
Erectile dysfunction, or as it's often discussed in the public, impotency, is problems getting or keeping a firm erection. Premature ejaculation, again, is when you ejaculate too soon. So somebody could have both, they could have problems with erections and have premature ejaculation but usually they are separate entities.

They both fall under the rubric, the condition, of sexual dysfunction. You could have erectile dysfunction and that could be one sexual dysfunction and another type is premature ejaculation.

Interestingly, there are more people who are likely to have premature ejaculation than ED or impotency.

"Men want to feel like they are good in the bedroom and if they have premature ejaculation, it bothers them; it bothers their self-perception."

MODERATOR:
Why should PE be treated?

PRYOR:
Well, first of all, it causes distress often times for both the person and the partner. So, if you think of having sex or intercourse as being part of a quality of life and something to be enjoyed, we want to make it something that is less distressful, so that it's enjoyable and something that people can become intimate with. That's our goal; it's to make the sexual experience for these people who are often very distressed, a better experience.



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