Premature Ejaculation

Treatment of Premature Ejaculation

If you are experiencing premature ejaculation, you are not alone. Premature ejaculation (PE), the most common sexual dysfunction in men worldwide, can arise for many different reasons. Sometimes it occurs temporarily due to stress; at other times it becomes a chronic sexual dysfunction that affects couples' lives. What's more, this dysfunction, which causes so much stress, lowers self-confidence, creates communication problems in relationships and can even become a reason for divorce, can be managed! However, myths about it are so widespread that taking the right step becomes difficult. So what exactly is this sexual dysfunction we call "premature ejaculation"? Is ejaculating early after a busy, stressful day a condition that requires treatment? Let's look at the details together…

What Is Premature Ejaculation?

Before explaining "what is premature ejaculation?", I would like to share some brief information about "what is ejaculation and how does it happen?". When a man is sexually aroused, signals from the brain are carried to the genital area by nerves in the spinal cord. These signals cause the pelvic muscles to contract rhythmically. With the onset of rhythmic contractions, sperm travel from the testicles toward the main sperm-transport channel called the vas deferens. During this journey, to protect the sperm, they combine with fluids secreted by the seminal vesicles and the prostate gland to form the fluid we call semen. The release of semen from the body after reaching sexual climax is called "ejaculation".
Ejaculation that occurs uncontrollably and repeatedly, against the man's wishes, before intercourse takes place or immediately after intercourse begins is defined as "premature ejaculation". The definition of this sexual dysfunction, also referred to medically as premature ejaculation, includes some subjective and some objective criteria. For example, the phrase "immediately after intercourse begins" creates a vague perception of time. However, when we approach the subject scientifically, we can say that this time has been set at approximately 1 minute.
The main purpose of sexual intimacy is a satisfying experience for both the woman and the man. Therefore, it would not be quite right to associate premature ejaculation solely with intercourse lasting less than 1 minute. The partner also needs to achieve sexual satisfaction. This requirement makes the man ejaculating before his sexual partner reaches satisfaction part of the criteria for premature ejaculation as well. In some men, premature ejaculation is present from the time they reach sexual maturity, but more often it develops later, during the sexually active years. This difference results in premature ejaculation being divided into two separate types.

What Are the Types of Premature Ejaculation?

Premature ejaculation is mainly examined in two main categories: "primary", that is, present from the start, and "secondary", that is, acquired later.
Primary (Lifelong) Premature Ejaculation
This is the type of premature ejaculation observed from the first sexual activity after reaching sexual maturity and continuing throughout life. It is less common than the acquired type of this sexual dysfunction. It is usually observed as a result of hormonal problems.

Secondary (Acquired) Premature Ejaculation

In the secondary type of premature ejaculation, sexual function problems appear later in life. Men who have had no sexual function problems may experience premature ejaculation due to psychological and/or physiological causes. This is the most common type.
At the heart of the difference between the types of premature ejaculation lies the variety of factors that lead to it. So now, let's look at the causes…

What Causes Premature Ejaculation?

In the past, it was widely believed that the causes of premature ejaculation were only psychological. Today, however, it is known that physical, chemical and psychological factors can lead to ejaculation problems.
The presence of an underlying erection problem,
Imbalances of oxytocin, luteinizing hormone, prolactin and thyroid-stimulating hormone,
Inflammation of the prostate and urinary tract,
Sexually transmitted diseases,
Low levels of serotonin, dopamine and chemicals in the brain that increase sexual desire,
A hypersensitive penis,
Faulty circumcision surgery,
Performance anxiety, excessive excitement, the meaning attached to sexuality, bad sexual experiences,
Problems in relationships,
Depression and similar causes can lead to premature ejaculation in men.
Although premature ejaculation is common both in our society and worldwide, it may not always require treatment, and the experience may not even be considered a sexual dysfunction. For example, ejaculating quickly during intimacy after a busy, stressful day or after a long period without intercourse is considered quite normal. Variables such as how often premature ejaculation occurs, how long it has been experienced and under what conditions it happens can shape the diagnosis of sexual dysfunction in a man. This brings us to the symptoms of premature ejaculation.

What Are the Symptoms of Premature Ejaculation?

For male sexual problems to be defined as "premature ejaculation", three criteria must be present.
If the person, almost every time, ejaculates before sexual penetration or within the first minute after it,
in a way that cannot be delayed or prevented, and has begun to avoid sexual intercourse because of the chronic sense of failure he experiences, the presence of premature ejaculation symptoms comes into question.
Psychological symptoms such as reduced trust in the relationship with the partner, communication difficulties, anxiety, depression and embarrassment can appear in both the man and the woman. Although it is classified among male sexual dysfunctions, premature ejaculation does not affect only the man; it can harm the couple's relationship and communication. It is important for couples with similar complaints to seek treatment options with a constructive approach.
Premature ejaculation is not something to be ashamed of or a problem that cannot be treated; on the contrary, when treated it can be controlled and the duration of intercourse can be extended. If treatment is not started, it can have negative effects on sexual and family life. Accurate diagnosis is critically important for planning the right treatment.

How Is Premature Ejaculation Diagnosed?

Men who frequently experience premature ejaculation over a period of about 6 months and, as a result, begin to have both personal and relationship-related concerns should be examined by urology and andrology specialists. Doctors take a history of how long this problem has been present, under what conditions and how often it occurs. At this point, patients need to answer all questions fully and clearly for an accurate diagnosis and proper planning. During the examination, information is also obtained about the patient's general health, any medications or supplements he uses and his lifestyle habits. If a medical condition is suspected as the cause of premature ejaculation, laboratory tests may also be used.

Can Premature Ejaculation Be Prevented?

Unfortunately, it is not possible to give a definitive answer to this question. The causes and course of sexual dysfunction may not be the same for every patient. Trying temporary measures such as masturbating before intercourse, using thick condoms to reduce sensitivity of the head of the penis, or trying a different position during intercourse will not be sustainable. The fact that sexual dysfunctions, including premature ejaculation, may appear as a reflection of other health problems should not be overlooked, and treatment options should always be sought.

How Is Premature Ejaculation Treated?

Premature ejaculation is a sexual dysfunction that can be treated according to its causes, with treatment aiming to prolong the time to ejaculation and revitalize the couple's relationship. Within individually planned premature ejaculation treatment processes, both medical and psychological support can be obtained. In this sense, premature ejaculation treatment methods vary.
Premature ejaculation can be treated with methods such as monitoring, medication, exercises and changing ejaculation habits. Today, glans (penile head) filler has come to the fore in the treatment of premature ejaculation because it can deliver quick results and show a long-lasting effect.
At our clinic, premature ejaculation treatment is performed with glans filler. Thanks to dermal fillers applied to the head of the penis, the area with the highest nerve density, our patients can feel the effect in as little as 1 week and can enjoy a sex life free of the problems caused by premature ejaculation for about 1 year.

Glans Filler (Penile Head Filler)

Premature ejaculation is one of the most common sexual dysfunctions in men.
This procedure, performed with special fillers, reduces nerve sensitivity and strengthens ejaculatory control.
The filler effect lasts an average of 9–18 months; if necessary, the procedure can be repeated.
Glans filler is one of the modern, minimally invasive options that can be considered for treating premature ejaculation in suitable patients. However, the most appropriate treatment approach should be planned after identifying the underlying causes and an individual evaluation.

Contact us for more detailed information and to book an appointment.

Selective Dorsal Cryoablation (SDC)

It is a non-surgical method used to treat premature ejaculation.
It is a method of controlled freezing of nerve endings to reduce sensitivity.
With appropriate patient selection, the success rate is 70%, and when combined with glans filler, success of up to 80% can be achieved in suitable patients.

Contact us for more detailed information and to book an appointment.

Surgical Treatment of Premature Ejaculation

Selective Dorsal Neurectomy (SDN)

In men with premature ejaculation
who have not benefited from the main treatments, this surgical treatment is performed with a high chance of success.
By selectively cutting the sensory nerves running along the penis, the aim is long-lasting control of premature ejaculation.

Contact us for more detailed information and to book an appointment.