Dear doctor;

I used to have sex without any problem two years ago, but nowadays I cannot even last 5 minutes. Am I growing old or there is some other problem with me?

Frank 28

Dear Frank,

Premature ejaculation is worrisome for men as they think it has impaired their performance in some way. The term is usually applied when one is unable to hold for more than 2 minutes. It can occur due to a single factor, but is mostly due to a combination of psychological, mental and physical factors.

The most common cause of premature ejaculation among young adults is mental stress. Stress at work, anxiety about a new situation or anxiety to perform well before an intercourse can lead to premature ejaculation. Sometimes a man may be normal but high expectations on the part of the partner may lead him to believe that he has premature ejaculation.

Alcohol, diabetes, diseases of the thyroid, long standing high blood pressure, prostate problems and anti depressant drugs can also cause premature ejaculation. Sometimes it can be due to hypersensitivity of nerves around the penis. Diseases of the spinal cord may cause sexual impotence or premature ejaculation. But they would be associated with other predominant symptoms such as burning pain and or weakness, urinary problems, etc.

First you need to analyse if there is something causing stress. Learn to relax completely both physically as well as mentally. Avoid alcohol. Some foreplay between partners helps one to avoid premature ejaculation and increases chances of satisfaction of both. To clear further doubts, it is better to get tested for diabetes and thyroid functions. If any problem is found, it can be treated.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital