Dear Dr. G,

I am a twenty-six-year-old man who is troubled by my shortcoming between the sheets. I am hoping you can help.

Since I started having sex, I have been suffering from early ejaculation.

I am troubled by an overly-sensitive penis – especially at its bottom – and this results in ejaculation in less than one minute.

This has cost me multiple relationships and has put a dent in my confidence.

Lately, my girlfriend has asked me to seek help from specialists, but I understand the treatment is mainly controlling the timing and not solving the issue in the long-term.

Aside from this, I have also read some publications that say that an excessive amount of foreskin can be the cause for a sensitive penis resulting in fast ejaculation.

Therefore, it would seem that circumcision is potentially a cure for men with premature ejaculation.

I dare to put Dr. G on the spot for clarification on this matter.

Firstly, can you tell me the causes of premature ejaculation?

How common is it? And what are the treatment for the sexual dysfunction? Secondly, how common is circumcision?

Have you come across publications that demonstrate that circumcision can potentially help with premature ejaculation?

If so, do you think having the cut is my shortcut to overcome my shortcomings?

Finally, do circumcised men make better lovers?

Yours truly,

Shortcoming Samuel

Premature Ejaculation (PE) has been reported in medical literature for more than a century; however there is still no uniform consensus of the cut-off defining the timing and with no clear-cut diagnosis, many men are left confused with their shortcoming.

The “typical” man has an ejaculatory latency of approximately 4 to 8 minutes and the International Society for Sexual Medicine (ISSM) has endorsed a definition of intercourse lasting around one minute as the definition of PE.

The exact causes of PE are unknown. Some specialists suggest PE is the result of excessive friction of the foreskin causing oversensitivity. Others highlight the link of PE with performance anxiety or a short supply of neurotransmitters in the brain and research has identified that a certain part of the brain is responsible for the physiological control of ejaculation, including serotonin neurotransmitter involvement.

Other evidence supports a genetic predisposition, elevated penile sensitivity and nerve conduction defectiveness in men suffering from PE. Hence, various medical developments evolve around such understanding.

The moist glans penis is recognized to be full of sensitive nerves meant to enhance sexual pleasure, especially the frenulum. On the other hand, the role of the foreskin complementing sexual pleasure is less well understood.

Therefore, the issues surrounding the differences in sexual pleasure and the true impact of circumcision on sexual pleasure is not so clear-cut.

Circumcision itself is not known to interfere with libido, erectile or ejaculatory functions. However, many clinicians believe the moist glans of the penis is its natural state, and a critical feature in sexual intercourse, which is different from the dried, keratinized head and shaft of circumcision that creates friction and a loss of natural lubrication.

Scientific evidence has demonstrated some loss of fine touch neuro-receptors that are highly responsive to light touches and on this, one study that investigated patients suffering from premature ejaculation reported 59% of participants have an excessive amount of foreskin. This is defined as foreskin exceeded the tip of the penile glans by more than 1 cm.

The men with such a condition were offered circumcision as a potential definitive treatment for the premature ejaculation and six months following the cut, 96% of the participants who had the circumcision reported improvement in their intravaginal latency time (IELT).

However, the study only involved a small number of participants with the specific pre-treatment condition of excessive foreskin and a short follow-up.

On circumcision, an estimated one-third of men in the world are circumcised, with most of the surgery being done for religious reasons. Elective non-religious circumcisions are also commonly performed in countries like the United States and parts of Southeast Asia.

However, the removal of the foreskin is still controversial and hotly-debated although it is a simple centuries-old practice. operation. One study from Denmark showed women are twice as likely to report dissatisfaction in the bedroom with a circumcised partner, and yet other studies reported the opposite.

Ultimately, PE is a complex sexual dysfunction which requires understanding of a person’s past sexual, psychological, and cultural upbringing. Although the medical and surgical treatments have been successful for some, the condition still requires open communication between couples for a better long-term outcome. The decision to undergo elective circumcision is often a dilemma for parents, and worse for adults for non-medical purposes. Despite weighing the risks and benefits of a life without foreskin, the decision is still difficult as it impinges on preconceived ideas and its long-term impacts on sex life.

The American actor Gary Busey once warned that “if you take shortcuts, you get cut short!” When contemplating the shortcut overcoming shortcomings between the sheets Dr. G cuts to the chase and says that “if you take short cuts, your foreskin will definitely be cut short and you may still end up with the shortcomings!”

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