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Dear Eve,

I am 25 years old and recently married but I have been having problems during sex. I ejaculate so fast and now I have been forced to use Viagra which has been going on for for some months now... please advise me.

James

Dear James,

Let me start by congratulating you on your recent marriage; I wish you both many years of happiness.

I would like to address two main things in your current problem. The first is the premature ejaculation itself. Premature ejaculation can generally be described as a condition in which a man is unable to maintain an erection for sexual encounters including masturbation.

There are two main types: lifelong – also known as primary – and acquired – also known as secondary. For men suffering from lifelong premature ejaculation, they will have trouble maintaining their erection during all or most of their sexual encounters, including their first sexual encounter.

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On the other hand, men with acquired premature ejaculation are those who have a history of successful sexual encounters. One of the things to keep in mind is that a typical sexual encounter lasts for about five minutes, meaning that while some studies show more and others show less, the average sexual encounter will last about five minutes.

In your letter, you don't say much about how or when this problem started and whether you could be having primary or secondary premature ejaculation. What you do say is that you have been self-medicating with Viagra for a few months. This brings me to a critical point in this discussion: you self-diagnosed and then self-medicated on something that may or may not be a medical condition. In other words, your assumption that you do have premature ejaculation may or may not be accurate.

Even if it is, your chosen treatment may not be the most appropriate in effectiveness or safety. To put a fine point on it, do yourself a favor and get off Viagra until and unless it is prescribed by a medical doctor trained to assess and advise on its use, efficacy and safety precautions.

There is another reason not to medicate yourself with Viagra and similar drugs: side effects. These can include the typical most-commonly reported side effects such as headaches, upset stomach, abnormal vision, dizziness, muscle pains, stuffy nose and back pain, just to name a few.

They can also include more severe side effects such as priapism i.e. an erection that will not go away and lasts for more than four hours (requiring medical intervention) or even sudden loss of vision or hearing. Viagra can also interfere with the efficacy of certain drugs. I hope you can see that self-medication could actually be making you physically ill and ironically, further interfering with your sexual performance.

Now, supposing you do have premature ejaculation, what could be causing it and what can you do about it without self-medicating? The causes of PE do vary and would require a proper assessment by a doctor or therapist, especially if you have no known medical conditions. However, the most common causes include mood disorders such as depression or anxiety, physical conditions such as high cholesterol, heart conditions, diabetes, low blood sugar (hypoglycemia) or low/high blood pressure just to name a few. It can also be caused by injuries e.g. as a result of a fall or hit to the head or some kind of physical, emotional or sexual trauma. Major life events – whether positive or negative – can also increase stress thus interfering with sexual enjoyment and performance. Other common but sometimes overlooked causes of PE could be being over/under weight and stress from areas such as work, marriage, or family. As I hope you can see, there are many possible reasons for developing PE, whether primary or secondary, and therefore an assessment would be important.

What are some things you can do?

In no particular order, here are a few suggestions of things that you can do to help improve your sexual performance.

Watch what you eat: A diet that is high in fat, sugar or processed foods drags your body's energy, not to mention that it clogs your arteries and interferes with your blood flow and the general function of your body. None of this is helpful to your sex life. Remember, a stronger erection is about blood being able to flow into your penis therefore allowing the engorgement you need to enjoy penetrative sex.

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Cut out excesses: Anything in excess is likely to interfere with your sex life. Drinking too much (an erection and sexual intercourse requires energy, which is the opposite of what happens with you're drunk), watching too much TV (makes you lazy and unexcited so your body becomes unaccustomed to excitement including sex), masturbating too much (it detaches your mind/body from its ability to enjoy the softness of a sexual partner), etc. Please note: I didn't say don't do these things; I said don't do them in *excess*.

Stop harmful habits: If you smoke/ingest cigarettes or other drugs, please stop. These substances do not do you any favors when it comes to your sex life.

See a doctor: If you're concerned that you may have a medical condition, please see your doctor. They will assess your health and determine the appropriate course of treatment for you, should you need it.

I hope that you have better insight and clarity into your concerns of premature ejaculation, and I hope that these tips can help you have a happy, healthy, satisfying sex life.

Maggie Gitu is a marriage, family and sex therapist. Reach her on: [email protected] or via her Facebook page: Maggie Gitu