Dear Dr. G,

My late wife and I were married for twenty years and had a normal sex life until she passed away from cancer three years ago.

I’m now 60 and my children have encouraged me to start seeing someone again for companionship.

I am lucky to now have a relationship with a woman in her 40s.

Although the relationship is going well, I feel a bit compromised as I now have an inability to hold back my ejaculation.

I often thought premature ejaculation is a young man’s disease and rather curious why this is happening to me at this age.

What exactly is premature ejaculation and what causes it? Are there any other reasons why I may get premature ejaculation at this age?

Am I getting this problem because I am too active or inactive in my sex life in the past few years?

This is really bothering my partner and I hope there is some treatment available. Are there risks involved?


Flash Frank

According to the International Society of Sexual Medicine (ISSM), premature ejaculation (PE) is a medical condition characterised by a man having the inability to control his ejaculation, resulting in short latency time of intercourse (around one minute) and causing significant impairment of the quality of life for both the sufferer and partner.

Many clinicians and sexual health physicians believe PE is the commonest form of sexual dysfunction, as compared to erectile dysfunction (ED). The prevalence studies conducted in many countries, namely premature ejaculation prevalence and attitude, revealed PE affects up to one in three men. The study revealed PE can affect men from their first sexual encounter and persists throughout their lives. PE is believed to stem from deficiency in the neurotransmitters in the brain, such as serotonin. Hence, this may explain why men get lifelong PE.

In recent years, clinicians and scientists have begun to investigate another group of sufferers who face the problems of PE in advancing age, typically post 50. Researchers believe the aetiology of acquired PE, or secondary PE, is very different from lifelong PE, as data showed association of acquired PE with the possibility of prostate diseases and hormonal changes. Although many men may feel guilty about over indulgence (or even under-utilisation) in sex may be the cause of the sexual dysfunction. There is no real evidence to support the association of PE with past frequency of ejaculation.

The link between the onset of the prostate inflammation resulting in PE has been scrutinised in recent years. Although the exact mechanism is largely unknown, many speculate the local irritation of the pelvic organ triggers the onset of early ejaculation. Other areas of research in this field include the association of men with hyperthyroidism and acquired PE. Again, the causative or effect of such a link is hotly debated, which has pathed further research avenues for better understanding of many sexual dysfunctional conditions.

The aetiology and causative factors of the acquired PE remains a subject of scientific scrutiny, however the treatment of both primary and secondary premature essentially remains the same. The treatment of underlying problems such as prostatitis or hyperthyroidism may resolve the issues. Otherwise, the pharmaceutical intervention to enhance the levels of serotonin in the brain also plays a vital role in the treatment of men with early ejaculation in advancing years. Patients who are treated with selective serotonin reuptake inhibitors (SSRI) medications such as Depoxetine can benefit from better control and prolonged ejaculatory latency interval during sexual intimacy. Of course, with such improvement, the quality of life of the couples will enhance accordingly. Although the medication is effective, the potential side effects of SSRI may be nausea and vomiting.

Although acquired PE can be associated with medical conditions such as prostatitis and hyperthyroidism, the real causative factors may not be established.

To older men with secondary PE wondering if they are too old to develop it, Dr G’s on the spot answer is that treatment can potentially slow you down and let you enjoy life. Otherwise, the climax in a flash will leave you in limbo in coming or going!

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