A study done in Somalia and published in the BMC Urology Journal found that "polygamous men have a lower incidence of premature ejaculation and higher sexual satisfaction than monogamous men," with a complex bidirectional relationship between PE and erectile dysfunction.
Then there was another male patient with premature ejaculation which prevented him from approaching the prospective girlfriends he was eyeing. At almost 40, pressure from the family to settle down was piling and horrible past sexual encounters were not encouraging.
"When he came, we started working on his problem," says Prof Osur. "But he disappeared for almost a year but came back to the clinic married and expecting a baby!"
Dr Carol Nthiwa, a urologist at Karen Hospital in Nairobi, says men with PE experience reduced time to ejaculate, lack of control over ejaculation and associated distress from the dysfunction.
"It remains underdiagnosed because of the shame associated with the condition," she says. "Doctors should have a high index of suspicion, especially in those young men visiting urology clinics."
Treatment of PE depends on the type. The commonest is where a man is born with the problem (Primary PE), only to find out during the first sexual encounter. Secondary PE, on the other hand, is acquired later on due to underlying biopsychosocial causes.
PE can be mild, moderate or severe-like in cases where the slightest touch of a woman can cause the man to discharge without warning!
"There are others who will try engaging and within a minute or less, they are ejaculating leaving their spouses or partners hanging which is the moderate type. Others ejaculate within one to three minutes, which is a mild form," explains Prof Osur.
Due to men's poor health-seeking behaviour and inability to explain themselves, most suffer in silence. Distressed, others opt to steer clear of serious relationships or have multiple partners to cover up the underlying problem of not rising to the occasion.
Societal expectations do not make it easy for men. A single man at 40 or 50 is eyed suspiciously. Is he gay or just irresponsible? Nosy relatives offer all manner of solutions including interdenominational prayers, herbs and sometimes witchdoctors are contracted to find the poor soul a permanent bed-mate.
"I have met men who have gone into depression because the family cannot understand," says Prof Osur. "They try a relationship and it is shameful, they are left embarrassed." Men, he says don't know what to do, and "for sexual problems, people don't think they should go to hospital and that's the problem we have."
Some, he says mistrust sexual medicine specialists like him, wondering whether they are actual medical doctors or herbalists they have unsuccessfully tried before.
Because of the psychological element associated with PE, psycho-social therapy involves one's partner offering support in treatment. Catherine Holden, a psychologist specialising in addiction, sexuality and relationships says a man can also experience anxiety which is distracting and makes ejaculatory control even harder.
"Understanding our bodies is essential for pleasurable mutual sexual experiences as we need to be conscious over the sensations we are feeling that lead to such a reflex; the same as what we have for urination or defecation," she says.
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She works with the couples to learn what works for them including some techniques to manage anxiety and stress in healthier ways; focusing on understanding their own inner fears and the psychological conflict that can arise from this.
"As a therapist, I provide a safe and non-judgmental space for men struggling with premature ejaculation to share their experiences," she says. "With their partners, I encourage them to support the men in their life by being understanding and moving away from putting pressure on them being able to 'perform'."
The experts advise men suffering in silence to reach out to certified sex therapists since PE is "also easy to treat with sex therapy treatment protocols, in most cases."