This podcast is for you, the Modern Man. I'm Dr Anne Truong,

your host. I'm an intimate health medical doctor and best

selling author of the book, Erectile Dysfunction Fix. I'll

do a deep dive into sexual health and performance and how

it affects men of all ages and backgrounds. So let's get

started, and be sure to visit my website at

sexualhealthformenpodcast.com for more information and

resources from the show. See you on the inside.

In today's episode, let's talk about an uncomfortable subject,

premature ejaculation or PE. I'm Dr Anne Truong. I've treated

over 7000 men with ED.

PE, premature ejaculation is a common male sexual dysfunction

that is characterized by ejaculation that is consistently

occurs sooner than desired, often within about one to three

minutes of penetration, that lead to personal and

relationship distress. And I stress that because if it is

distressful to you and in your relationship, then it's a

problem. If it's not, it may not be a problem. So different

society define PE as either one minute or three minute. The

consensus is probably around one minute after penetration. So it

doesn't involve foreplay or anything like that. And so PE

refers to the inability to delay ejaculation during sexual

activity, and it happens in around one to three minutes

after penetration. It affects up to 30% of men, and making it the

most common male sexual disorder at this time in younger men.

Occasionally, if it happened, it's not a problem, but if it

happened consistently, that is distressful over a period of six

months, then it is a problem.

Now there are two types of PE, lifelong PE, which presents as

the first sexual experience, and acquired PE, which develop over

a period of normal sexual function. Now the causes

sometimes are unclear. I stress that unclear, because several

psychological and physical factors may play a role. The

psychological causes can be anxiety, depression, early

sexual conditioning, stress, relationship problem, or even

traumatic sexual experiences. Physical causes, such as issues

with serotonin level, prostate or thyroid problem, increased

penile sensitivity, some medication side effects or even

a genetic predisposition.

Now, the key symptoms include persistent inability to delay

ejaculation or inability to control ejaculation. And again,

I stress with emotional distress both partners and usually it's

the timing issues at this point. But I want to stress that PE is

a treatable condition to a combination of method. First

behavioral techniques such as like start and stop and squeeze

method, which then help retain ejaculatory control, we'll dive

into that a little bit later. And another part is medication

such as selective serotonin reuptake inhibitors or topical

anesthetic to increase latency time. And then the third is

counseling for psychological factors and relationship issues.

And the fourth is using thick condom.

So let's discuss about the treatment. First is behavioral

techniques such as start and stop. What that means is that

sexual activity is paused just right before ejaculation, until

the urge passes and then you resume again. This retrain the

body response to sexual stimulation. What's the squeeze

technique? The squeeze technique is when you squeeze the head of

your penis or the glans. It is squeezed for about 10 to 20

seconds before ejaculation, reducing the urge. This can be

practiced alone or with a partner, and may require several

session to really get this right. Another tip is

masturbation before, and of course, masturbating a few hours

before sexual activity can help delay ejaculation during

intercourse. Another tip is a thick condom. Using a thicker

condom decrease penile sensation, helping prolong

sexual activity. Also using penis pump before sexual

activity will also help prolong your ejaculation as well. Now,

partner positioning, having the partner on top, sometimes allow

for quick disengagement when the urge arises as well. Now, the

one of the main thing that is a treatment for PE that's

neglected is pelvic floor muscle exercises or Kegel exercises,

which help in gaining better control over ejaculation,

because this muscle in the pelvic area what controls

ejaculation. So oftentimes, exercises involving tightening

and releasing the pelvic muscle, or Kegel, should be done

multiple times during the day, and it will help with

ejaculation control. Now there are several medication

treatments. They're called selective serotonin reuptake

inhibitor or SSRI. They're antidepressant. They're known as

paroxetine, sertraline, escitalopram, and they help by

increasing ejaculation latency. Now there is a short acting SSRI

called the dapoxetine, and it's specifically approved for PE and

can be taken as on demand because it has a fast acting

half life. However, some of the side effects of these

medications, headache, nausea, dizziness, sweating. And from my

experience giving it to some of my patients, it hasn't been as

helpful as it is touted to be. I often find that some lot of my

patients just stop using that. Now, you can also put topical

anesthetic like a lidocaine cream and spray or prilocaine,

which numb the head of the penis in reducing sensation and

prolonging time before you climax. However, you should wash

yourself before penetration of sexual activity to avoid

transferring it to your partner.

Now, taking medications such as Viagra sometimes can help with

PE because they could do decrease sensation, and it may

even help with prolonging erection. Now, combination

therapy, such as using medication, such as the SSRI and

then behavioral technique can be combined, such as the start and

stop technique and the squeeze technique can together, can

help. Now you can consider sex therapy, a psych counseling and

even hypnotherapy. So there are definitely options, and it is

treatable. You don't have to live with this. Okay. Now I

talked about masturbation before sexual activity can help with

prolonging ejaculation and also perhaps even reducing anxiety

and even improving outcomes.

So I hope you find this useful. Let me know what you think about

So just know that there are strategies for PE I get this

question a lot on videos. I wanted to produce a quick video

on what it is and some of the things you can do. Vut just know

sometimes it just occurred. It's unknown, and it's not your

fault, but at least now you have some strategies and tips that

you can try first before taking a medication. I like the aspect

of a thicker condom, a squeeze technique, start and stop

technique, and also a topical numbing medicine that you can

buy actually over the counter, like topical lidocaine, and then

maybe wear a thicker condom. Try that first, and then combining

that with start and stop technique and the squeeze

technique that you can do pretty quickly. Practice this before

this episode, because this is such a common problem and it's

you try taking medication. In my experience, we have not seen the

medication being that much helpful compared to behavior and

just self help technique at this point.

just a thing that you don't want to talk about, but I want to

bring it to the forefront and tell you it is treatable. You

don't have to suffer in silence. And so let me know what your

thoughts are. It will mean the world to me if you subscribe and

get notified and share them with someone you think can benefit

from this at this point. And just know to check out our

Modern Man Club at noedman.com it's a safe space where we

gather together to work through getting out of ED or even PE to

sexual restoration again, because there are alternative

beside medication and surgery at this point. And check out our

course, too, down below. Having said that, Modern Man, know that

there are options. You do not have to suffer in silence, and I

will see you in the next episode.

Okay, Modern Man, you are not alone and you don't have to

suffer anymore. ED can feel isolating, frustrating, and even

defeating. The endless guessing, the quiet shame, the weight of

not feeling like yourself is exhausting. But here's the

truth, you are not broken. You are not alone. You don't have to

figure this out alone anymore. The Get Wood Now Boost Program

is your step by step, path to sexual confidence and

restoration. No more suffering in silence, no more trial and

error, just real solution, real result and the confidence you

deserve. It's time to take back your power on your term. Let's

get this journey started together. Check out the course

at getwoodnow.com. I'll see you there.

Thanks for listening to the Sexual Health for Men Podcast.

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next time.