Premature Ejaculation: Breaking the Silence (cont.)

Do doctors often check up on a man's sexual health during routine exams or physicals?

There are some doctors who do and some that don't. I think that when you go to your general practitioner, your family practice physician, he should ask about it. In general, people don't bring it up on their own. A patient may complain about a back pain or a headache, but does not tend not to say, "By the way, I've got premature ejaculation", or "I have erectile dysfunction."

I think that really good physicians should bring it up to their patients and make them feel comfortable. They should have comfort themselves with the topic and make sure the patient feels comfort so they can have an honest dialogue about this. Through a questionnaire or just talking, doctors should bring this topic up and try to find out if their patients have this problem.

Around 10% to 12% of all men have erectile dysfunction and 30% have premature ejaculation. These are common problems that really affect the quality of life.

What can a man's partner do to help, or maybe I should say what should they do, to not make things worse?

I think that the best way they can help is to communicate. A lot of times the man wants to be able to talk to somebody about it and it's nice to have somebody that says, "I understand, it's OK, we'll try to get help over this." Communication and understanding are great.

Obviously, the thing not to do, since distress is part of the whole process, is make the person feel guilty about it. Don't make him feel like if he has premature ejaculation that he's a bad person or that he's not the sexual partner that you are looking for. This will cause additional distress.

Women tend, and I'm saying this kind of generally, they tend to be the health care providers or encouragers for their family, including their husbands and they tend to be much more health conscious. In my opinion as an educator in medicine, men need to be more responsible for their own health.

To answer the question, I think that if a woman whose partner has premature ejaculation she should encourage the man to go seek help. Men need to be responsible, but they probably need some encouragement.

"Because ED has been out there on television and passed around in the media, people now feel more comfortable talking about erectile dysfunction."

I ejaculate after four to five strokes into intercourse. I am 28 years old and have been married for five months. It didn't happen much before, but in the last five months it's happening all the time. What is the solution?

If it didn't happen before but it's happening now, I probably would put you in the acquired category. It also sounds like it's really affecting you.

I would have you go see a urologist and try some treatments. Again, sadly, there's nothing that's specific for premature ejaculation, but there's no harm in trying to get some treatment now to see if you can make it better. The alternative is to wait until something does come out that is specific for premature ejaculation, which again, hopefully will be soon.

The stigma and embarrassment that men feel -- could you speak a little more about this?

I know that it's a very personal thing for people. The fact that it's not talked about very much gives it even more of a stigma than having erectile dysfunction.

Because ED has been out there on television and passed around in the media, people now feel more comfortable talking about erectile dysfunction. They are not as stigmatized about it knowing that people like Bob Dole and others have it, so they feel better about it. But there's no one out there that has gotten up to say, "I have premature ejaculation" so there's a lot of embarrassment. They are thinking that they are the only ones with this problem because they are not hearing that anybody else has it, so I can see why there would be a lot of embarrassment and stigma attached to it.

I'm sorry that people feel this way, and I think the best thing we can do is let them know that it's not just them, that they can seek help and that in the future we will have even better help for them.

You mentioned a questionnaire at the doctor's office. What questions would a doctor ask?

Questionnaires are great for physicians. For one thing, every one is time conscious -- not just with the physician's time but more importantly the patient's time. A questionnaire is also efficient -- you don't miss asking any questions. But, a questionnaire would not replace dialogue.

This questionnaire could be as simple as one question: Do you have premature ejaculation? If the man answers yes, then the physician can follow it up with questions such as:

  • Does this bother you?
  • Does it bother your partner?
  • Has it been lifelong or recent?

The doctor can then follow up with more questions. It can be just as simple as that.

How many men do you think are suffering in silence, too afraid to seek help?

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