Premature Ejaculation in Singapore

What Is Premature Ejaculation?

Premature ejaculation (PE) is characterised by the release of semen shortly after or even before sexual penetration. Despite being a common sexual health issue, the hesitation to talk about it openly means that men and their partners may struggle in silence. Feelings of embarrassment, frustration, or fear of judgement can prevent men from seeking the support they need.

Our clinic offers various treatment options individualised to the patient’s condition and lifestyle. Dr Tan Kok Kuan is a highly experienced men’s health and sexual health doctor with over 20 years of clinical practice. He has helped numerous men in Singapore overcome PE through a combination of advanced medical therapies, personalised treatment plans and evidence-based approaches.

The Classifications of Premature Ejaculation

There are two classifications of premature ejaculation based on its onset and underlying causes:

• Primary Premature Ejaculation (Lifelong) – This type of PE has been present since the man has been sexually active. Men with lifelong PE consistently experience rapid ejaculation, typically within a minute of penetration, and find themselves unable to control or delay it.
• Secondary Premature Ejaculation (Acquired) – This form is new and has not occurred before in the individual’s sexual history. Men with acquired PE notice a significant and often sudden change in their ability to control ejaculation. This change can cause distress, especially when compared to previous sexual experiences.

What Are the Possible Causes of Premature Ejaculation?

There are many possible causes of premature ejaculation, including:

• Over-sensitive Glans Penis

  - Increased sensitivity at the tip of the penis (glans) can lead to rapid arousal and premature ejaculation.

• Erectile Dysfunction

  - Men who have trouble achieving or maintaining an erection may develop a pattern of rushing through sexual encounters to avoid losing their erection, which can lead to PE.

• Hormonal Imbalances

  - Irregular levels of hormones, such as low testosterone, can disrupt sexual function and contribute to PE.

• Alcohol Consumption and Tobacco Use

  - Long-term heavy alcohol use or smoking may impair nerve and blood vessel function, affecting ejaculatory control.

• Thyroid Problems

  - Both overactive (hyperthyroidism) and underactive (hypothyroidism) thyroid conditions may interfere with the body’s regulatory systems, including sexual function.

• Swelling and Infection

  - Inflammation of the prostate (prostatitis) can cause discomfort and contribute to rapid ejaculation.

• Side Effects of Medication

  - Certain medications, particularly some antidepressants and blood pressure medications, may influence sexual function and ejaculation.

• Conditioning From Young

  - Early sexual experiences, where one may have rushed to ejaculate for various reasons, can establish a pattern that is difficult to break later in life.

• Worrying About Sexual Performance

  - Anxiety about ejaculating too early can heighten arousal and lead to PE.

• Sexual Abuse

  - A history of trauma, including sexual abuse, can lead to complex psychological issues that affect sexual intimacy and control.

• Depression

  - Low mood or mental health challenges can reduce control over ejaculation and diminish sexual confidence.

• Stress

  - Life stress or relationship conflicts can worsen performance anxiety and contribute to PE.

How Is Premature Ejaculation Diagnosed?

The diagnosis of premature ejaculation involves a thorough evaluation of the patient's medical, physical and sexual history. The doctor will typically:

• Evaluate Sexual History – The patient will be asked about the onset, frequency and duration of PE, as well as explore relationship dynamics, stress levels and any psychological factors that may contribute to the condition.
• Review Medical History – This includes assessing any underlying conditions, such as diabetes, thyroid disorders or prostate issues, which may contribute to PE.
• Conduct a Physical Examination – This involves examining the genital area for signs of infection, prostate abnormalities or nerve sensitivity that can affect ejaculatory control. Blood tests may also be recommended to check hormone levels, particularly testosterone, and to rule out other medical conditions.

What Are the Treatment Options for Premature Ejaculation?

Treating premature ejaculation usually involves a combination of medical treatments, counselling and behavioural techniques. The best approach depends on the underlying cause of the condition and the individual's circumstances. Some specific treatments include:

• Medications

  - Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), can help delay ejaculation. Topical anaesthetic creams and sprays can also be used to reduce penile sensitivity.

• Extracorporeal Shockwave Therapy (ESWT)

  - This is a non-invasive procedure that employs low-intensity sound waves to help improve blood flow and nerve function in the genital area. While primarily used for erectile dysfunction, ESWT may benefit some men with PE by addressing underlying physical factors.

• Circumcision

  In cases where an over-sensitive glans penis contributes to PE, circumcision may be considered. This procedure removes the foreskin to reduce sensitivity and improve ejaculatory control.

• Frenulectomy

  - If a tight or short frenulum (the tissue band beneath the glans) is causing sensitivity issues, a frenulectomy procedure may be recommended. This minor surgical procedure removes or modifies the frenulum to reduce discomfort or sensitivity during sexual activity.

FAQs About Premature Ejaculation