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Urology

Telemedicine for Premature Ejaculation: A Quick Solution for a Quick Release

Dr. Joe Pazona

An accidental boner at work, farting during yoga and meeting a new client with food on your teeth are all less embarrassing to a man than premature ejaculation. In fact, I’m not certain there’s another medical condition that causes more stress to a man. Unfortunately, premature ejaculation is not widely talked about except by mean girls on Instagram.

Well here at VirtuCare we say “NO MORE!” We are here to help. As experts in all things penis (medically that is), our urologists are here to comfort and guide you towards improving your premature ejaculation. Allow us to show you how telemedicine for premature ejaculation is the best solution for being a little too quick under pressure.

There’s no need to feel embarrassed. We are here to help. Unlike the other telemedicine options for premature ejaculation, VirtuCare is not trying to push you towards pills. That being said, if you need medication, then we can certainly prescribe anything you need.

In fact, if reading isn’t your thing, and you know you need some medication, then click here jump to the front of the line and schedule a telemedicine consult with VirtuCare urologist now and get the care you deserve ASAP.

Otherwise, let’s get started with understanding more about why some men have a “quick release on the trigger.”

What is ejaculation?

Before you schedule a telemedicine visit for premature ejaculation, let’s make certain we are talking about the same thing. There are three distinct things that happen during sexual activity that men sometimes mix up.

An erection (aka boner, hard-on, chub, pitching a tent . . . you get the point) is when your penis gets firm. Seems obvious but you’d be surprised how many patients have seen us with erectile problems but say they have premature ejaculation.

Ejaculation is the process of “shooting” out semen (aka cum, jizz). Most often ejaculation is occurring simultaneously with an orgasm (the pleasurable contractions of the pelvic muscles associated with your “O” face). But sometimes you can jizz with no orgasm (sad face) and other times you can have a dry orgasm (feels good without the mess). Weird I know.

 

What is premature ejaculation?

There are several definitions for premature ejaculation.

The International Society for Sexual Medicine defines premature ejaculation as any of the following:

  • “Ejaculation that always or nearly always occurs prior to or within 1 minute of vaginal penetration from the 1st sexual episode.”
  • “Bothersome reduction in ejaculation usually to < 3 minutes.”
  • “Negative consequences such as distress, bother or frustration and/or avoidance of sexual intimacy.”

 

Bottom line is if it is a bother to you, and occurs in under 1-3 minutes, then it’s premature ejaculation. If you and/or your partner are unsatisfied because of how quick you “came”, then it’s premature ejaculation.

Now unfortunately many of these “expert” societies have not caught up to 2022. You can have premature ejaculation with anal or oral intercourse as well. We believe that regardless of sexual preferences, orientation or gender identification, you should receive the care you deserve. At VirtuCare we offer telemedicine for premature ejaculation to help improve the sexual performance between any consenting adults.

Here’s another frustrating thing with these definitions. Who has a stopwatch by their bed? I don’t know about you, but I’ve never timed a sexual encounter. I don’t think any man has any accurate idea of his “average” sexual encounter. But if it’s coming from a man, you can count on a little exaggeration.

I hate to tell you guys, but in a study of over 500 couples, from several countries, the researchers showed that the average time from penetration to ejaculation was just over 5 minutes. Disappointing I know.

There’s also something called foreplay. If you’ve been petting, kissing and rubbing a bit before penetration you may not last very long. Especially with a new or very exciting partner.

Lastly, there’s another variable that affects how quickly you pull the trigger. When’s the last time you ejaculated? If it was a month ago, expect to be quick on the trigger. On the other hand if you’re going for round two, 10 minutes after your first encounter, then you may last a while. The latency period, or time between ejaculations, impacts how quickly you will ejaculate.

 

What causes premature ejaculation?

The cause of premature ejaculation is poorly understood. First and foremost, there’s nothing wrong with you. Let’s practice a little self love. Some men orgasm quickly and others can’t orgasm at all (that’s no fun either). It doesn’t mean you’re “bad” nor that the other guy is a stud.

That being said, there are certainly some potential factors which can play a role. Past traumatic sexual experiences are probably the most common contributors to premature ejaculation. All it takes is one sarcastic look, or comment from a partner after a quick ejaculation  to scar you in the bedroom.

Other psychological factors that are possibly associated with premature ejaculation include:

 

These things can all go hand-in-hand. If you didn’t date much at a younger age, or due to whatever reason decided to save your virginity until marriage, then there’s a good chance you’ve been anticipating sex for a LONG TIME. Since sex feels pretty darn good for most men, the first time it probably blew your mind and blew your . . . well you know . . . pretty quickly.

Erectile dysfunction (ED) and premature ejaculation are often seen together as well. Whether it’s a quick release before you get firm, or too much excitement once the Viagra kicks in, men with ED often experience premature ejaculation as well. Kicking a man while he’s down . . . literally.

Telemedicine for premature ejaculation can start the process of uncovering some of these causes. More importantly, a telemedicine visit with a VirtuCare men’s health expert allows a private place to listen to your concerns and build up not only your confidence, but your bedroom stamina.

Are there natural treatments for premature ejaculation besides medications?

YES! It seems like every “digital health clinic” or doctor’s office wants to throw pills at medical issues. Don’t get us wrong, medications have their place. However there are various natural treatments for premature ejaculation as well.

Remember, there is no one magic bullet to delay release of your bullets. But, here are some things you should consider.

Sexual therapy

Therapy has a bad connotation in our society and that’s a shame. IMHO everyone should be in therapy. We all have issues from our past, good or bad, that influence our current beliefs and behaviors. These include their psychological influences in the bedroom.

It’s beyond our expertise to provide therapy advice so instead, check out some of these telemedicine sexual therapy options:

 

A urology telemedicine visit for premature ejaculation is not going to uncover all of your sexual experiences, beliefs and traumas. A therapist is trained to uncover what the root cause of your premature ejaculation might be. Sexual therapy for premature ejaculation may not be a quick fix, but if you put in the work, then you may see some dramatic results.

Pelvic physical therapy (PT)

A man’s junk is surrounded by the pelvic floor muscles.

When a man ejaculates, the muscles of the pelvic floor contract to “shoot out” the semen. Therefore, it makes sense that better control of the pelvic floor muscles would improve premature ejaculation.

So how do you gain better control of your pelvic floor muscles? You can work with a pelvic physical therapist. They are experts in teaching people how to contract, relax and strengthen the pelvic floor muscles.

There are several studies showing the benefit of pelvic physical therapy for premature ejaculation including this one from 2018. Of the men who completed the 12-week therapy program, they demonstrated over a 2 minute delay in orgasm. Two minutes may not seem long, but it may be the difference between a happy vs. a frustrated partner in the bedroom.

If you need some guidance, a telemedicine consultation with a VirtuCare specialist can help you find a pelvic physical therapist in your area.

Sexual techniques

If you want to get stronger in the gym, then you should probably work out. Getting stronger in the bedroom is no different. Practicing sexual stimulation without ejaculation can absolutely help premature ejaculation.

One simple technique to treat premature ejaculation is to masturbate before sexual intercourse. Don’t disappoint your partner with a quick round one when you can last a bit longer with round two. All men have a latency period where achieving a second erection after orgasm can take some time. This may be 5 minutes or 5 hours. Play around with the timing to see what best helps your premature ejaculation.

Next is the stop-start technique. It’s pretty self-explanatory. Simulate your penis until right before the point of no return, then stop. This is best performed with your partner via oral or manual stimulation. The idea is to get your penis and brain used to the idea that someone else is playing with your junk. You want to enjoy the feeling without exploding too quickly. With time, you’ll build some stamina.

Another commonly described technique is the “squeeze” technique. Again this is best with manual stimulation by a partner. It involves squeezing your penis as you approach orgasm to prevent blowing your load. Although I’m sure it could work, it doesn’t sound fun either (we’re trying to be thorough).

Condom usage

There’s nothing like a piece of latex or sheep’s skin to decrease the sensitivity of your penis. My guess is you may have tried this one already. If not, slipping on a condom not only prevents sexually transmitted infections, it can also prevent a quick release.

Premature ejaculation treatments: pills, wipes, and sprays

Assuming none of the above conservative treatments for premature ejaculation have helped yet, then you may need medication. VirtuCare telemedicine visits for premature ejaculation can involve prescribing some of the following medications:

Selective serotonin uptake inhibitors (SSRIs)

When fluoxetine (Prozac) hit the market in the 1980’s, patients began reporting a bothersome side effect. They couldn’t orgasm. Frustrating for many, but an opportunity for others. The urology community quickly noted, “Hey, I know who that can help!” And thus was born a medication to treat premature ejaculation.

Since then, a number of SSRIs have been released such as sertraline (Zoloft) and paroxetine (Paxil). They have been used by urologists as an off-label medication for premature ejaculation. Off-label means that the medication was not originally intended nor FDA-approved to treat a particular condition. Regardless it’s use in this setting is generally accepted by the medical community.

Which SSRI is best? There is some evidence to support that paroxetine (Paxil) is better tolerated with good results. There are a handful of small head-to-head studies with different SSRIs, but nothing is definitive. The best SSRI is the one that your body responds to most effectively.

Although on-demand usage has been reported, taking a SSRI every day seems to work better. It may take 1-2 weeks to take effect so be patient. The most common side effects are GI upset, changes in energy or mood. If you have any side effects please stop the medication immediately and contact your primary care doctor.

 

Tramadol (Ultram)

Commonly used as a pain medication, tramadol has also been shown to help treat premature ejaculation. The main concern with tramadol is that it is a narcotic. Controlled substances are typically not prescribed via telemedicine for premature ejaculation because of legal concerns. However, VirtuCare specialists can determine if tramadol is appropriate so you can request a prescription from your primary care doctor.

Phosphodiesterase type 5 inhibitors (PDE5 inhibitors)

Better known as sildenafil (Viagra) and tadalafil (Cialis), PDE5 inhibitors are usually used to treat erectile dysfunction. Since ED and premature ejaculation often occur together, it makes sense that using PDE5 inhibitors may improve premature ejaculation.

A collection of 15 studies demonstrated that sildenafil (Viagra) delays ejaculation as well as SSRIs. You can even use sildenafil in combination with an SSRI to last even longer in the sack. PDE5 inhibitors are typically well tolerated. They can cause headaches, facial flushing, and blurry vision to name a few of the more common side effects.

Topical anesthetics

One reason you may have premature ejaculation is that your one-eyed pant monster is a little sensitive. To decrease this sensitivity, a numbing spray, wipe or cream can be prescribed via telemedicine. Lidocaine, benzocaine and prilocaine are some of the more common “numbing” medications used to treat premature ejaculation.

EMLA cream (lidocaine-prilocaine) 5% is commonly used in telemedicine for premature ejaculation. EMLA cream is best applied for about 20 minutes before cleaning it off. Longer usage can lead to ED which kind of defeats the purpose. When used in this setting, ejaculation can be delayed for up to 7 minutes.

A similar combination of anesthetics is available as a spray. The spray is less messy and can work within 15 minutes. Results from one study showed that men lasted on average for 11 minutes compared to under 2 minutes at their baseline.

One of the “male digital health clinics” sells benzocaine 4% wipes to patients. The quoted study shows an improvement in time to ejaculation from <2 minutes to 5.5 minutes. Not quite as good as the spray but better than nothing.

How does telemedicine for premature ejaculation work?

Now you know the definition and treatments for premature, what’s next? How about a visit with the men’s health expert, a board-certified urologist?

Listen if all you want is a pill pusher then go see the other “digital health” clinics. They make money from prescribing you pills via their prescription services. That’s their goal. Plain and simple.

But if you’re interested in speaking with an expert to make sure there’s nothing else wrong and to answer your questions, then VirtuCare may be the right fit. With telemedicine, our experts can prescribe premature ejaculation medications and send them to your local pharmacy at no added cost.

Your best buddy below the belt needs some help. Don’t just dial up any telemedicine service for premature ejaculation. Call in the specialists with VirtuCare. We are the “junk experts”. And your buddy deserves the best.

 

Click here for a telemedicine for premature ejaculation consultation today.

ABOUT THE AUTHOR

Dr. Joe Pazona

Dr. Joseph Pazona is the founder and President of VirtuCare, a telemedicine solution for connecting patients with physician experts. He can be reached at joe@myvirtucare.com.
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At VirtuCare, we believe that patients deserve direct access to the experts. There should be no gatekeeper standing between you and a healthcare specialist. VirtuCare puts you in control.

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