Today, Dr. Natalya Lopushnyan is joining us for a topic that not many people like to talk about (or admit to): premature ejaculation.
As with all content on our blog, the following is educational, not medical advice. Always consult your medical provider regarding your unique healthcare needs.
Without further ado, here's Dr. L., as her patients call her, in her own words.
Let's talk about premature ejaculation . . .
Hello, friends, partners, and anyone who's ever said, "Wait, that was it?" Welcome to the blog where we talk about the things you wish came with a manual—like your body. I'm Dr. L, your friendly neighborhood urologist, and today we're tackling a topic that's quick in more ways than one: Premature ejaculation (PE).
Let's rip off the awkward Band-Aid: PE is when a guy finishes (you know what I mean) sooner than he or his partner would like. It is very common, affecting up to 1 in 3 men at some point in their lives. And yes, while some only experience it occasionally, for others, it's a lifelong issue that can be detrimental to their relationships, sexual experience, and self-esteem.
What even is "premature"?
There's no stopwatch involved here (unless that's your thing), but generally:
- If it happens within about a minute of penetration, and
- You feel like you have zero control, and
- Most importantly, it is causing you distress or trouble in the bedroom.
If those three things exist, then yes, we call that PE. And no, you're not broken. You're not weird. You're not alone. You're just… faster than average. Or a cheetah. So, let's find your inner snail.
So, why does premature ejaculation happen?
There are a multitude of factors that can be the cause, or it may be a bit of all of them:
- Psychological factors like anxiety, stress, depression, or relationship issues, a new partner, or not having intercourse for a while.
- Biological factors, including low serotonin levels (a brain chemical that affects timing and mood), hormone imbalances, or even an overly sensitive little soldier.
- Inexperience or a rush to the finish line (sometimes conditioned by years of trying to avoid getting caught as a teenager—thanks, Mom).
What can you do about premature ejaculation (besides apologize)?
Great news! PE is super treatable. And no, we're not talking about chanting mantras or thinking about baseball (although, go ahead if it helps). Here are the real, science-backed options:
- Condoms. They're not just for birth control and STIs. They can also decrease sensitivity, which helps some men last longer. Bonus: There are thicker or desensitizing condoms designed explicitly for this purpose.
- Desensitizing sprays and creams. Think of these like numbing agents for your penis. Sounds dramatic, but they can take the edge off just enough to delay the Big Finale. Just don't go overboard. You want a slow dance, not a full-body nap.
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- Pro tip: Let it soak in for a few minutes before action and wipe off excess to avoid numbing your partner, too.
- Medications
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- SSRIs (like paroxetine or sertraline) are usually prescribed as antidepressants, but a lovely side effect is delayed ejaculation.
- Topical anesthetics in prescription strength are also an option.
- There's even a fast-acting oral med (dapoxetine) used in some countries specifically for PE (not yet FDA-approved in the U.S., but stay tuned).
- Behavioral techniques
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- The "Start-Stop" Method: You (or your partner) stimulate until you feel the point of no return—then pause, breathe, repeat.
- The "Squeeze" Technique: Just before the finish line, gently squeeze the tip of the penis. It's not romantic, but hey, neither is ending things 37 seconds in.
- Pelvic Floor Exercises. Yes, Kegels aren't just for ladies. Strengthening your pelvic floor can help you gain more control over your timing. Google "how to find your pelvic floor muscles" or ask your urologist (we've heard it all).
- Therapy. If anxiety, guilt, or relationship stress is a factor, seeing a sex therapist can be life-changing. It's not weird—it's wise.
Bottom Line: Premature ejaculation might be fast, but fixing it is a marathon, not a sprint.
And the good news? You don't have to deal with this alone. There are effective and safe treatments, and the first step is talking about it—ideally with someone like me1, not just your group chat.
So, if you're tired of the "wham" without the "thank you, ma'am," make an appointment with a urologist. Let's help you go the distance—and enjoy the journey.
1Dr. Natalya Lopushnyan is a urologist, confidence coach, and accidental stand-up comedian. Disclaimer: No egos were harmed in the writing of this post. PE is common, treatable, and nothing to be ashamed of. Unless you ignore it—then it's just plain annoying.