Premature Ejaculation: Breaking the Silence (cont.)

The ED medications, in virtually every case don't affect premature ejaculation, if the man only has premature ejaculation. In other words, if the guy has good erections and has premature ejaculation, the erectile medications like Viagra will generally do nothing unless it has a placebo effect.

If somebody has erectile dysfunction and also premature ejaculation, it's possible that curing the erectile dysfunction could help in the premature ejaculation, but this is rare. Usually people with premature ejaculation don't have problems with erections, it's just that they ejaculate quickly and then the erection goes away. But, you expect that -- after you ejaculate, your erection does go away.

I know some meds can inhibit sexual activity, from libido to ability to get an erection, but do some actually cause or contribute to PE?

We don't know all the different medications that can cause premature ejaculation but there certainly are some that can. I think the biggest ones are, again, the opioids. I'm not familiar with other ones but I'm sure that there are some out there that can contribute to premature ejaculation, but I think that's rare.

In most cases, we don't know why a person has premature ejaculation. In theory, people who take medications that stimulate the sympathetic system, such as Sudafed, could contribute to PE, but we haven't found that to be the case. I don't think there are many medications that we can identify today that we can say are to cause premature ejaculation.

I also don't think that people should be overly hung up about this because in most cases if you're on a medication, you should take it. Again, we think it's from some neurological or biochemical cause that we don't know about at this point.

Do men talk with other men about these topics?

Men definitely do not talk to other men about these issues. It wasn't until just recently that men started talking to other men about erectile dysfunction. Even when Viagra came out, for years the communication was mostly between the male and his partner, then hopefully, he would bring it up with the physician. Even now, after everything in the media about ED, men are still often times embarrassed to bring it up.

Men tend not to take care of themselves very well; they don't go to the physician as often as they should, often times it's the woman that's dragging them in to the physician.

It's just going to take some time for this to get out there, for people to understand it and to start talking about it. I think it's going to be a long, long time before men talk about it amongst themselves. They will talk about backaches and how their golf swing is not good and how they have plantar fascitis or something, but they do not talk about this issue.

"Certainly if PE is bothering you, I encourage you to see your physician."

Women talk with each other all the time about health related issues.

I think it's really important that men talk about it, and it would be nice if they talk about it with other men. You can talk about it with your partner, and I'm sure your partner would be sympathetic, understanding and encouraging you to get help.

I think that we need to start educating men more about taking care of themselves and men's health issues. Not just when you hit 40, but this education really needs to start early on in life.

Age 40 or 50 seems to be the "magic number" for the age of when people get concerned and want to become more educated about their health.

I think you should start being educated on just health in general from the third or fourth grade. I have actually written a book on men's health and one reason why I wrote it was because men tend to be so ignorant of some very basic things. It's amazing to me. Talk about a man's health should start in third grade. The girls learn about menstruation and the boys are excused to go to the playground and swing.

Much of what we do is based on habit. For many reasons girls and young women, very early in their lives, will go and see the physician on a routine basis, at least once a year. So women get in the habit of going to the physician and taking care of themselves. Men don't do that - they go to the physician when they need to for a sports physical, and that's it. Then it's not until they have a significant problem like a broken arm or crushing chest pain that they finally go again. By that point you have had all the bad habits instilled in you.

From the very beginning, in junior high, actually in grade school, I think we should start teaching some basic things about taking care of yourself. I know that's not about premature ejaculation, but as a health educator, I feel strongly about it.

Dr. Pryor, we are almost out of time. Before we wrap things up for today, do you have any final words for us?

I think the important thing is for people to, again, realize that this is a very common problem and that they don't need to think of it as just affecting themselves. I want them to know that there's some treatments out there but currently it's all off-label. Sometimes these work for people and sometimes they don't and sometimes they have side effects associated with them. Certainly if PE is bothering you, I encourage you to see your physician.


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