Premature Ejaculation Singapore: Causes, Diagnosis & Treatment

Men’s Health Clinic (Caring & Treating Since 2005)

There are 2 main reasons why you cannot last long in bed.

• You have difficulty getting or sustaining an erection. This problem is called erectile dysfunction or ED.
• You have no problems getting hard or sustaining your erection, but the moment you begin penetration you ejaculate soon after. This is Premature Ejaculation

Premature ejaculation is often influenced by a combination of psychological and biological factors.

Psychological Causes
These are among the most common contributors and may include:

• Anxiety
• Poor body image
• Early sexual experiences
• Relationship problems
• Depression

Biological Causes
In some cases, physical factors may play a role, such as:

• Abnormal hormone levels
• Abnormal levels of brain chemicals involved in sexual response
• Inflammation and infection of prostate or urethra
• Increased penile sensitivity

Other Contributing Factors

• Erectile dysfunction (leading to rushing intercourse)
• Certain medications or substance use
• Fatigue or poor overall health

In many men, premature ejaculation is multifactorial, meaning more than one cause may be involved.

Premature ejaculation can be classified into different types based on how and when it occurs. 

1. Lifelong (Primary) Premature Ejaculation
   This type occurs from a man’s first sexual experiences and continues throughout life. Ejaculation tends to happen very quickly, often within one minute of penetration, and consistently across most situations.
2. Acquired (Secondary) Premature Ejaculation
   This develops later in life after a period of normal sexual function. It may be linked to psychological stress, relationship issues, or underlying medical conditions.
3. Generalised Premature Ejaculation
   This occurs in all sexual situations, regardless of partner or setting.
4. Situational Premature Ejaculation
   This happens only in specific circumstances, such as with a particular partner or during certain situations. Psychological factors are often a contributing cause.

Diagnosing premature ejaculation typically involves a detailed discussion rather than complex testing.

1. Medical and Sexual History
   Your doctor will ask about your symptoms, including how long the issue has been present, how often it occurs, and whether it happens in specific situations or all the time.
2. Assessment of Ejaculation Timing and Control
   You may be asked about how quickly ejaculation occurs after penetration and whether you are able to delay it. This helps determine the severity and type of PE.
3. Evaluation of Psychological Factors
   Stress, anxiety, and relationship concerns may be explored, as these commonly contribute to PE.
4. Screening for Underlying Conditions
   Your doctor may assess for related issues such as erectile dysfunction, hormonal imbalance or prostate conditions.

As mentioned above, Premature Ejaculation is usually due to a psychological cause.

It is advised for you to speak to your doctor and work closely with him in order to help you overcome your problem.

With time, effort and persistence, you can overcome PE and you can look forward to a healthier sex life with your partner.

Premature Ejaculation is very common and in some men, it only happens occasionally but not all the time. So that is normally not a cause for concern.

However, if you have any or all of the following, you are advised to see a doctor.

• Frequently or always ejaculate within one minute of penetration
• Almost always unable to prolong ejaculation during intercourse
• One or both of you feeling distressed about this issue affecting sexual intimacy

Treatment options for premature ejaculation include behavioral techniques, topical creams and oral medications.

Treating Premature Ejaculation may take time so you have to be patient and find the treatment that works best for you. It is recommended that you combine behavioural techniques and medication for best results.

The following techniques may help delay ejaculation:

• Masturbate 1-2 hours before intercourse
• Focus on other forms of sexual play other than intercourse or penetration. You may learn to achieve sexual satisfaction without penetration. This may also relieve pressure of performing during intercourse.
• Learn to delay ejaculation during masturbation by prolonging the duration each time.

This is also another technique that may help you and your partner.

1. Start your sexual activity, stimulate the penis until you feel almost ready to ejaculate.
2. Then have you or your partner squeeze the head of your penis, at the point where the head joins the shaft, and maintain the pressure for a few seconds, until the urge to ejaculate is gone.
3. You can repeat this process as long as you like.

When you repeat this exercise a few times, you start to train yourself to be able to control and delay ejaculation

The other technique is called withdrawal. It basically means withdraw before ejaculating. Wait till the sensation to ejaculate passes before you continue penetration.

Using condoms help to reduce penis sensitivity, which can help delay ejaculation.

You may choose thicker condoms as it reduces sensation more than normal or thinner condoms.

The strategies listed above may be effective to help with PE but they take time and effort in order to help you overcome PE. While you are working on delaying your ejaculation, you can take some medications to help make it easier for you to overcome Premature Ejaculation.

1. Topical Creams

One way of delaying ejaculation is by applying numbing or anaesthetic creams on your penis. By numbing the area it helps to reduce sensitivity and delay ejaculation. However, it can be messy and it may numb you and your partner to the point that you don’t get sexual satisfaction. One way to overcome this is by applying the creams on your penis and then putting a condom over it.

2. Oral Medication

At the moment there is only one medicine that is officially available for the treatment of Premature Ejaculation. On top of that, doctors also add on medicine for erectile dysfunction. Studies have shown that when both are taken together, they are extremely effective for treating premature ejaculation even if you don’t have erectile dysfunction. Doctors can also add on painkillers which can have the effect of delaying ejaculation.

The tablets prescribed are usually to be taken only when necessary, before intercourse.

While premature ejaculation cannot always be fully prevented, especially when linked to long-standing patterns, there are steps that may help reduce the likelihood or severity over time.

1. Manage Stress and Anxiety
   Psychological factors play a significant role in PE. Managing stress through relaxation techniques, exercise, or speaking to a professional may help improve control during intercourse.
2. Build Better Sexual Awareness
   Understanding your body’s arousal levels can help you recognise the point just before ejaculation. With practice, this awareness may allow you to better control timing.
3. Strengthen Pelvic Floor Muscles
   Pelvic floor (Kegel) exercises can help improve control over ejaculation by strengthening the muscles involved in sexual function.
4. Maintain Open Communication with Your Partner
   Discussing concerns with your partner can reduce performance pressure and improve overall sexual confidence, which may help prevent PE from worsening.
5. Address Erectile Dysfunction Early
   If you experience difficulty maintaining an erection, you may rush intercourse, which can contribute to PE. Early management of erectile issues may help prevent this cycle.
6. Maintain Overall Health
   Regular exercise, adequate sleep, and a balanced diet support hormone levels and overall sexual health.
7. Avoid Relying on Quick Fixes Alone
   While temporary solutions may help in the short term, focusing on long-term behavioural and psychological strategies is key to sustainable improvement.

DTAP @Clarke Quay, DTAP Men’s Health Centre.

Premature Ejaculation Treatment is available in all our clinics.

If you are interested in this service and wish to find out more, please call or visit our clinics or drop us an email at hello@dtapclinic.com.sg

1. Is premature ejaculation normal?
Yes, it is relatively common. Many men experience premature ejaculation at some point, especially during periods of stress or new sexual experiences. Occasional episodes are usually not a cause for concern.

2. Is premature ejaculation curable?
In many cases, premature ejaculation can be effectively managed and improved with the right combination of behavioural techniques and medical treatment.

3. Is there medicine for premature ejaculation?
Yes, medications are available and may be prescribed by a doctor. These can include oral medications or topical treatments that help delay ejaculation. The choice depends on individual needs and suitability.

4. What are the risks or complications of premature ejaculation?
While not physically harmful, premature ejaculation can affect self-confidence, relationships, and overall sexual satisfaction. It may also lead to stress or anxiety if left unaddressed.

5. Can premature ejaculation be cured permanently?
Some men achieve long-term improvement, especially when psychological or behavioural factors are addressed. However, results vary, and some individuals may require ongoing strategies to maintain control.