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Can premature ejaculation effect pregnancy ? | Overview of Premature ejaculation and infertility

While there's a lot of information available on erectile dysfunction (ED, aka impotence), what many people do not realize that the commonest male sexual problem actually lies at the opposite end of the spectrum.

Premature ejaculation (PE), as the name suggests, occurs when a man ejaculates sooner during sexual intercourse than they ( or their partner ) would like. If it happens infrequently, you don't need to worry. However, if you find that you ejaculate sooner than you wish on a regular basis - such as before intercourse begins or shortly afterward, then you need to find help. Often self-help can work, but if it doesn't, then you need medical assistance. Though PE is a non-life-threatening condition, like ED, it has a serious impact on the quality of life.

Common Complaint

Premature ejaculation is a common sexual complaint. Estimates vary, but as many as 1 out of 3 men may be affected by this problem at some time. Both psychological and biological factors can play a role in premature ejaculation.

Although many men feel embarrassed to talk about it, premature ejaculation is a common and treatable condition. A combination of medications, psychological counseling, and sexual techniques that delay ejaculation can improve sex for you. The good news is that even if all these fail, you can still have a baby!

The Distress Factor

Medically, premature ejaculation is defined as ejaculation that always or nearly always occurs within one minute of vaginal penetration. While this can cause a lot of distress, this will not affect your fertility, as long as the semen is being deposited in the vagina.

How quickly it is deposited after penetration does not affect your fertility - and even if you feel you are not able to satisfy your partner sexually because of your premature ejaculation, this will not affect your chances of achieving a pregnancy.

Guilt and Embarrassment

However, some men ejaculate so prematurely that they cannot achieve intravaginal penetration. They ejaculate even before entry, as a result of which the marriage remains unconsummated. This causes them a lot of embarrassment, and they refuse to talk about this issue.

Even worse, it causes a major guilt complex, because they cannot get their wife pregnant. This becomes the "elephant in the room", which neither partner discusses because it's such a touchy and sensitive issue! It causes a lot of frustration and resentment, and can even lead to the marriage breaking up.

It's normal to feel embarrassed when talking about sexual problems, but you can trust that your doctor has had similar conversations with many other men. Premature ejaculation is a very common - and treatable - condition. In the meantime, enjoy the many other ways in which you and your partner bring each other pleasure.

Treatment options for premature ejaculation include sexual therapy, medications, and psychotherapy. For many men, a combination of these treatments works best.


Read more-Premature ejaculation, sexual self-esteem, and infertility


Sexual therapy

In some cases, sexual therapy may involve simple steps, such as masturbating an hour or two before intercourse so that you're able to delay ejaculation during sex. Your doctor may also recommend avoiding intercourse for a period of time and focusing on other types of sexual play so that pressure is removed from your sexual encounters.

The squeeze technique

Your doctor may instruct you and your partner in the use of a method called the squeeze technique. This method works as follows:

  • Step 1. Begin sexual activity as usual, including stimulation of the penis, until you feel almost ready to ejaculate.
  • Step 2. Have your partner squeeze the end of your penis, at the point where the head (glans) joins the shaft, and maintain the squeeze for several seconds, until the urge to ejaculate passes.
  • Step 3. After the squeeze is released, wait for about 30 seconds, then go back to foreplay. You may notice that squeezing the penis causes it to become less erect, but when sexual stimulation is resumed, it soon regains full erection.
  • Step 4. If you again feel you're about to ejaculate, have your partner repeat the squeeze process.

By repeating this as many times as necessary, you can reach the point of entering your partner without ejaculating. After a few practice sessions, the feeling of knowing how to delay ejaculation may become a habit that no longer requires the squeeze technique.

Medications

Certain antidepressants and topical anesthetic creams are used to treat premature ejaculation. You may need to try different medications or doses before you and your doctor finds a treatment that works for you.

Antidepressants

A side effect of certain antidepressants is delayed orgasm. Your doctor may suggest that you take an antidepressant to benefit from this specific side effect. Other side effects of these antidepressants can include nausea, dry mouth, drowsiness, and decreased libido.

It is believed that serotonin ( 5HT) plays a central role in modulating ejaculation. Low levels of serotonin in specific areas in the brain could cause premature ejaculation. This is how selective serotonin reuptake inhibitors (SSRIs), which increase serotonin levels in the synapse, in treating Premature Ejaculation.

Your doctor may prescribe one of several selective serotonin reuptake inhibitors (SSRIs), such as sertraline (Zoloft), paroxetine (Paxil) or fluoxetine (Prozac), to help delay ejaculation. It may take up to 10 days for these drugs to take effect. Dapoxetine (Priligy) is a short-acting selective serotonin reuptake inhibitor (SSRI) marketed for the treatment of premature ejaculation. Dapoxetine is the only drug with regulatory approval for such an indication.

Topical anesthetic creams

Topical anesthetic creams containing lidocaine or prilocaine dull the sensation on the penis to help delay ejaculation. Applied a short time before intercourse, these creams are wiped off when your penis has lost enough sensation to help you delay ejaculation. A lidocaine-prilocaine spray is currently being studied. Some men using topical anesthetic creams report reduced sexual pleasure because of lessened sensitivity.

Vasodilator drugs

One more method makes use of the vasodilator drugs which are used for treating premature ejaculation, such as sildenafil ( Viagra), tadalafil ( Cialis), and vardenafil ( Levitra). An even more aggressive variant of this technique uses intracavernous pharmacotherapy.

This is a method of injecting a drug known as a vasodilator directly into the penis to help men maintain their erection so that even if they do ejaculate prematurely, they can still achieve penetration and intravaginal ejaculation.While the truth is that treating premature ejaculation can take time, if your primary focus is having a baby, this can be easy to achieve, if your sperm count is normal.


Read more-Why is premature ejaculation so common?


Authored by : Dr Aniruddha Malpani, MD and reviewed by Dr Anjali Malpani.