Premature Ejaculation: Breaking the Silence (cont.)

PRYOR:
I think that virtually everyone with premature ejaculation is suffering in silence. We see, by far, the minority of patients with this problem. If you think about it, 30% of the male population has PE -- that's a lot of men, that's millions and millions of men. There is not good therapy out there and the problem is not known by most people. Sadly, these men are suffering in silence -- a great majority of them.

MEMBER QUESTION:
Is there any evidence that porn watching or masturbation increase the likelihood of PE or any other sexual dysfunction?

PRYOR:
There's no evidence that I'm aware of that watching pornographic television or looking at pornographic magazines contributes to this, I don't think masturbation does either. There's nothing that I'm familiar with that says that that's the case.

MEMBER QUESTION:
I always wake up in the middle of the night not fresh and the whole day I stay dizzy, without concentration and very easily irritated. I have been living like this for more than 10 years but lately it is worse. Because of this, whenever I have sex, I immediately ejaculate -- in just a few seconds. I have visited my doctor who gave some sleeping pills and he's not taking my situation seriously. I relate the issue of my sleep problem with my ejaculation situation. Your thoughts?

PRYOR:
Again, way don't know all the different causes of premature ejaculation. I'm not sure if the sleep problem is causing the premature ejaculation or not, although it is possible that it could be.

I suggest that you get some help from a sleep specialist. This is a very common problem now and we're learning more and more about sleep disorders. Sleep disorders can affect you throughout the whole day and affect your overall health. There are specialty centers that look at this. Perhaps you have sleep apnea or something else going on. The first thing I would strongly suggest is that you seek help from a sleep specialist.

MODERATOR:
You mentioned the woman's role in the family health care; should we wives go in with our husbands' and talk to the doctor about problems like these?

PRYOR:
I tend to be very fair about this. Sure, as long as the husband is willing to come in with the wife when they go to the physician. Maybe that's a little bit too glib. Often times, with sexual dysfunction, we do encourage the partner to come in, so I do think it's a two-way street.

On the one hand, I want the male to be responsible for his own health care. I think that's really important. Everyone needs to be responsible for their own health care and not necessarily rely on other people. On the other hand, sexual dysfunction, in virtually every case, is something that involves both people, therefore it's nice to have both people there. It certainly helps us in the arena of erectile dysfunction, and I know it does in premature ejaculation as well.

The most important thing is for the man to be responsible for his own health care, for the man to go in there and talk to his physician about it. If the woman can go -- great, all the better.

"There are probably some physical causes -- things like prostatitis can cause PE. In most cases it's probably more of a biochemical problem, or a neurological problem."

MODERATOR:
We hear oftentimes that PE is just all in a man's head. Could you talk to us a little about that?

PRYOR:
In most conditions, especially sexual dysfunctions that we don't know much about, that's how we label it -- we say it's in his head.

When I was a medical student, there was a Masters and Johnson text that said that 80% of erectile dysfunction was in a man's head. Now that we understand erectile dysfunction better, we realize that in 90% or more cases, it's truly due to a biological or physical problem.

I think it's the same thing with premature ejaculation; it's easy to say it's up in his head. We say that only because we don't understand the true biological nature of it. I can assure you, there's a lot of evidence out there that in the majority of cases it truly is a biological or biochemical problem.

So to finish this, I think, based on my expertise, I would say in a rare occasion is it truly just a psychological issue.

MODERATOR:
Tell us about physical "causes". And what about medications or stress?

PRYOR:
Certainly stress can contribute to premature ejaculation. We know that there are some medications, for instance, as I said in the beginning, opioids. If you withdraw these drugs it can cause premature ejaculation.

There are probably some physical causes -- things like prostatitis can cause PE. In most cases it's probably more of a biochemical problem, or a neurological problem. These are things that are hard to measure and there are numerous causes for premature ejaculation. If you had a hundred people with premature ejaculation they all wouldn't have the same cause.

MEMBER QUESTION:
How does the ED medication (Viagra, etc.) affect PE?



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