Premature Ejaculation (PE): Causes, Symptoms, Treatment & Best Products in Pakistan

1. Introduction

Premature ejaculation (PE) is one of the most common male sexual dysfunctions, affecting millions of men worldwide. It occurs when a man ejaculates sooner than he or his partner desires, typically within 1–3 minutes of penetration. While occasional early climax can be normal, consistent and uncontrollable early ejaculation can cause personal distress and affect relationships. In Pakistan, cultural stigma often prevents open discussion, leading to frustration and anxiety.

PE is not a sign of weakness or poor self-control; it can result from psychological, physical, or medical factors. Recognizing the condition and seeking treatment is crucial, as most men experience improvement with the right combination of therapies and products.The best opportunity is that FDA approved medications like Everlong tablet 60mg treat premature ejaculation.

2. What is Premature Ejaculation?

Premature ejaculation (PE) is clinically defined as the inability to delay ejaculation long enough for mutual sexual satisfaction. It is divided into two types:

• Primary / Lifelong PE: Present since a man’s first sexual experiences, often linked to genetic or neurochemical factors.

• Secondary / Acquired PE: Develops later due to stress, relationship issues, hormonal imbalance, or medical conditions.

Men with PE frequently report embarrassment, decreased self-esteem, and avoidance of intimacy, which can strain marital relationships. With proper guidance and treatment, PE is highly manageable.

3. Symptoms of PE

The main symptom is inability to delay ejaculation beyond 1–3 minutes after penetration. It can also occur during masturbation or other sexual activities.

• Lifelong PE: Early ejaculation occurs in almost every sexual encounter.

• Acquired PE: Develops after a period of normal sexual performance.

Other signs include frustration, emotional distress, and avoidance of sexual activity, which can lead to low self-confidence and relationship strain. Persistent symptoms require evaluation by a healthcare professional.

4. Understanding the Ejaculation Process

Ejaculation involves the brain, spinal cord, and nerves, occurring in two phases:

• Emission: Sperm and seminal fluid move into the urethra.

• Ejection: Rhythmic contractions push semen out of the penis.

Serotonin regulates ejaculation timing. High serotonin delays climax, while low serotonin can cause PE. Psychological stress, nerve hypersensitivity, or hormonal imbalance can disrupt this natural timing.

5. Causes of Premature Ejaculation

PE is caused by psychological, biological, and relational factors.

A. Psychological Causes

• Performance anxiety and fear of failure
• Depression or chronic stress
• Low self-esteem and guilt
• Relationship conflicts or poor communication
• Unrealistic sexual expectations

B. Biological / Medical Causes

• Hormonal imbalances (testosterone, thyroid issues)
• Low serotonin or nerve hypersensitivity
• Prostate or urethral infections
• Chronic illnesses like diabetes or hypertension
• Erectile Dysfunction (ED)
• Alcohol or substance use

C. Relationship & Age Factors

• Emotional frustration or lack of intimacy
• Older men may experience faster climax due to sensitivity changes

6. Diagnosis of PE

Diagnosis is based on sexual history, symptoms, and emotional impact, rather than routine lab tests.

Doctors evaluate:

• Duration and frequency of early ejaculation
• Occurrence with all partners or specific partners
• Presence of ED
• Emotional and relational impact

Lab tests may be conducted to check hormones, prostate health, or neurological conditions if necessary. Accurate diagnosis determines whether PE is primary or secondary and guides treatment.

7. Risk Factors

Several factors increase the likelihood of PE:

• Erectile Dysfunction (ED) causing rushed climax
• Psychological stress and anxiety
• Relationship problems and poor communication
• Limited sexual experience or confidence
• Hormonal or neurochemical imbalance

Recognizing these risk factors is the first step toward effective management.

8. Treatment Options

Treatment combines behavioral techniques, medications, topical therapies, and counseling.

A. Behavioral Techniques

• Delaying penetration
• Focusing on foreplay
• Masturbating before intercourse to reduce arousal

B. Pelvic Floor Exercises (Kegels)

Strengthen muscles controlling ejaculation:

1. Identify muscles used to stop urination.
2. Squeeze and hold 3–5 seconds, then relax.
3. Repeat 3 sets of 10 reps daily.

C. Pause-Squeeze & Stop-Start Methods

• Pause-Squeeze: Stimulate penis until near climax, then gently squeeze to delay ejaculation.
• Stop-Start: Pause before climax, wait for arousal to decrease, then resume.

D. Condoms & Numbing Agents

• Thick or climax-control condoms reduce sensitivity.

• Creams/sprays like Knight Rider Spray, Largo Delay Cream, Super Viga Spray applied 10–15 minutes before intercourse. Wash off excess before penetration to protect the partner.

E. Prescription Medications

• SSRIs: Dapoxetine (EverLong) delays ejaculation.
• PDE5 inhibitors: Sildenafil, Tadalafil, Vardenafil (for PE with ED).
• Tramadol: Off-label, under medical supervision.

F. Counseling & Psychological Therapy

• Manage performance anxiety
• Improve relationship communication
• Boost confidence and reduce guilt

G. Future Treatments

Modafinil, Silodosin, Botox injections (research stage)

9. Which Product to Use & When

Product Type	Best For	How It Works	Ideal Situation
Delay Sprays	Mild/moderate PE	Fast-acting numbing	Occasional use, quick control
Delay Creams	Mild/moderate PE	Gradual desensitization	Regular sexual activity
Tablets	Moderate/severe PE	Systemic stamina & delay	Persistent or lifelong PE

 قبل از وقت انزال اور پروڈکٹس کا مکمل رہنمائی

 وہ حالت ہے جہاں مرد جماع کے دوران ضرورت سے پہلے انزال کر دیتا ہے۔ یہ اعتماد، ازدواجی تعلقات، اور ذہنی سکون کو متاثر کر سکتا ہے۔ PE

اسپرے (Sprays): فوری اثر کے لیے بہترین۔ اگر کبھی کبھار انزال جلدی ہو رہا ہو، تو جماع سے 10–15 منٹ پہلے اسپرے لگائیں اور کنڈوم استعمال کریں۔

کریمز (Creams): آہستہ اثر دیتی ہیں، باقاعدہ استعمال سے بہتر کنٹرول حاصل ہوتا ہے۔ جماع سے 10–15 منٹ پہلے لگائیں اور اضافی مقدار صاف کریں تاکہ شریک حیات پر اثر نہ پڑے۔

ٹیبلیٹس (EverLong / Dapoxetine): شدید یا مستقل PE میں مددگار۔ systemic اثر کے ذریعے ejaculation کو delayed کرتی ہیں۔ ڈاکٹر کی ہدایت کے مطابق جماع سے 1–3 گھنٹے پہلے استعمال کریں۔

:اہم نکات

اسپرے یا کریمز استعمال کرتے وقت شریک حیات کی جلد کی حفاظت کریں

ٹیبلٹس ڈاکٹر کی ہدایت کے بغیر نہ استعمال کریں

صحت مند طرز زندگی، کم تناؤ، اور کگل مشقیں نتائج بہتر بناتے ہیں

11. Frequently Asked Questions (FAQs)

Q1: Can PE be cured?

A: Yes, with behavioral methods, medications, creams/sprays, and counseling.

Q2: How fast do PE products work?

A: Sprays & creams act within minutes; tablets work systemically within 1–3 hours.

Q3: Does EverLong (Dapoxetine) really work?

A: Yes, clinically approved and highly effective when used properly.

Q4: Does PE cause infertility?

A: Not directly, but untreated PE may reduce conception chances.

Q5: Difference between ED & PE?

A: ED = inability to maintain erection; PE = early ejaculation despite erection. Both can coexist.

Q6: Can masturbation habits affect PE?

A: Rushed or excessive stimulation may condition early ejaculation; controlled techniques improve endurance.

12. Conclusion

Premature ejaculation is a treatable sexual health condition. With the right combination of behavioral techniques, topical products, medications, and counseling, most men can regain control, confidence, and satisfaction. Early intervention, professional guidance, and proper product use are essential.