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We’ll discuss this further in the treatment section.

Currently, my approach to premature ejaculation consists of a history and a physical examination specifically geared to determine the amount of sensitivity of the penis and detect any neurological problem.

One common side effect of SSRIs is delayed ejaculation or even inability to ejaculate.

Since serotonin in he brain is one of the molecules involved in ejaculation, this led to the idea that low serotonin levels might cause premature ejaculation.

The drug may be taken daily or about four hour before intercourse, although daily use is more effective.

It takes one to two weeks for the daily dosing to become effective, and many men find that they can then stop the daily dose and just take the medication when they’re expecting to have intercourse.

There is also a biochemical explanation for premature ejaculation that is showing a great deal of promise.

The first hints of this came with the release of several anti-depressive medications called selective serotonin reuptake inhibitors (SSRIs), the best known of these being Prozac.

It is important to recognize, however, that premature ejaculation is a subjective diagnosis and totally depends on the satisfaction of the partners.

Being so concerned about performance they didn't pay attention to their own sensations Guilt about enjoying sex or pleasure of any kind Worrying about maintaining erections Unresolved relationship issues General life stress Causes Through the years, many physical causes have been linked to premature ejaculation.

However, there are very few medical reasons that have been documented as causing premature ejaculation.

Even at the minimum dose, it has been found to double time to ejaculation, and stronger doses bring longer delays.

Initial trials also indicate that dapoxetine produces minimal side effects and doesn’t interact in bad ways with other medications or alcohol.

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