An interesting sexual dysfunction question was posted by a young man under
the age of 20. He was experiencing sexual relations for the first time. During the first sexual encounter, he did not last longer than two minutes before having an orgasm. This introduces a condition called "premature ejaculation" or "rapid ejaculation." This differs from erectile dysfunction. The two can co-exist, however, in some patients. More commonly, the man will have normal erections, but he will not have the ability to hold off his orgasm and ejaculation. There are several options for a person experiencing this problem. It is always necessary to discuss this with an urologist or your family doctor first, as it may require medical treatment.
Attempts can be made at decreasing the sensitivity of the penis by wearing a condom during sexual activity. Topical creams or gels that contain a numbing medication similar to Novocaine use by dentists can be used as well. The medication is usually applied prior to intercourse to allow it to absorb and hopefully not affect the partner. This is one of the complications with the use of this medication--the partner may get numbed as well
In some cases, oral medications can also be used. Zoloft, a medication used for depression, has been shown to delay ejaculation. This was originally a side effect, but it was found to be useful in another area of medicine, namely the treatment of premature ejaculation. This medicine must only be taken under the direction of a physician.
Other medications in this family can also be used. They are often used on an "as needed" basis or by a daily low dose. Viagra or other phosphodiesterase inhibiting medications have been described as well to work in this condition. This family of medications will not postpone the ejaculation, but it will often allow the patient to remain erect after the orgasm occurs. Therefore, intercourse can continue.
Other considerations may be counseling about the relationship and the security of the couple with each other. All medications and treatments will have some associated side effects; therefore, as a first line, the topic must be approached by the couple together as to educate both partners. This may avoid the embarrassment that can be associated with the problem.
Overall, most patients have reasonably good outcomes with the above listed treatments, and others may even successfully overcome the problem after treatments for a period of time.