You’d be surprised how many men whisper this question in the clinic, almost embarrassed to make eye contact. And honestly — it’s far more common than most think.

Every week at Mind & Mood Clinic, Nagpur, I meet men who look perfectly confident on the outside but carry deep anxiety about their sexual performance inside.
Some say, “Doctor, before I even start, it’s over.”
Others confess, “It happens too fast, and then I feel ashamed.”

Let’s talk about Premature Ejaculation (PE) — openly, honestly, and with empathy.

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🔍 What Exactly Is Premature Ejaculation?

Premature Ejaculation means ejaculating sooner than you or your partner would like during sexual activity.
It’s not about an exact number of minutes, but more about loss of control — and the distress it causes.

In clinical terms, PE can be defined as:

Ejaculation that happens within one minute of penetration (in lifelong cases) or a significant reduction in latency time (in acquired cases), accompanied by emotional distress.

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⚠️ Common Symptoms of Premature Ejaculation

You might be dealing with PE if you notice any of the following:

• Ejaculation within a minute or two of penetration (or even before).
• Feeling unable to control when you ejaculate.
• Avoiding sex due to anxiety or embarrassment.
• Emotional distress — guilt, frustration, or fear of disappointing your partner.
• In some men, even reduced sexual satisfaction or low self-esteem.

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🧬 Epidemiology – How Common Is It?

You’re definitely not alone.

• Around 30–40% of men experience PE at some point in their lives.
• In India, estimates suggest nearly 1 in 3 men may experience premature ejaculation at least once in their sexual lifetime.
• It’s seen across all age groups but more common in younger men and those with anxiety or relationship stress.

Interestingly, most men delay seeking help for years, thinking “it’ll fix itself” — but early treatment works best.

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🧠 Etiology – Why Does It Happen?

There isn’t one single reason. PE is often a mix of biological, psychological, and relationship factors.

🧠 1. Psychological Causes

• Performance anxiety – “What if I can’t last long enough?”
• Guilt or fear of intimacy.
• Depression or stress – mental fatigue can reduce sexual control.
• Conditioned response – rushing masturbation during teenage years can train the brain to finish quickly.

⚙️ 2. Biological Causes

• Neurotransmitter imbalance, especially low serotonin levels, may reduce ejaculatory control.
• Hypersensitive penis or increased penile nerve excitability.
• Thyroid dysfunction or prostate inflammation.
• Rarely, genetic factors affecting serotonin transporters.

💑 3. Relationship Factors

• Poor emotional intimacy.
• Partner dissatisfaction leading to performance pressure.
• Communication gaps about sexual preferences or foreplay.

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🧩 Pathogenesis – What’s Actually Happening in the Brain?

The science behind PE is fascinating.
When a man gets sexually aroused, signals travel through the spinal cord to the brainstem, coordinating muscular contractions leading to ejaculation.

In men with PE:

• The serotonergic (5-HT) inhibitory pathway doesn’t function optimally.
• There’s reduced serotonin receptor activity (especially 5-HT1A and 5-HT2C).
• This causes rapid firing of ejaculatory reflexes.

In short — the “control brakes” in the brain aren’t working as efficiently.

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📜 History Taking – What We Usually Ask in Clinic

When a man visits me for PE, the conversation is gentle and confidential.
I typically ask:

• When did this start — since the first intercourse or later in life?
• How long do you last during intercourse?
• Any associated anxiety, guilt, or relationship tension?
• How’s your erection quality?
• Any medical conditions or medications you’re on?

A good history helps differentiate between lifelong PE (biological) and acquired PE (often psychological or relationship-based).

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💊 Treatment – What Actually Helps

The good news? Premature Ejaculation is treatable.

At Mind & Mood Clinic, Nagpur, treatment is tailored for each individual:

1. Psychological Therapy

• Sex therapy and behavioral techniques (like “stop-start” and “squeeze technique”).
• Cognitive Behavioral Therapy (CBT) for anxiety and performance fears.
• Couple counseling to improve intimacy and communication.

2. Medications (When Needed)

• SSRIs such as Paroxetine, Sertraline, or Dapoxetine (on prescription).
• Topical anesthetic sprays to delay sensitivity.
• Combination therapy often yields the best results.

3. Lifestyle Modifications

• Avoid alcohol and smoking.
• Regular exercise to improve serotonin and testosterone balance.
• Mindfulness and relaxation to enhance control.

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🧍‍♂️ Real Clinic Experience (Anecdote)

I remember a young man, around 28, who came to my clinic and said,
“Doctor, I can’t satisfy my partner — I’m losing confidence.”

After evaluation, we found he was suffering from severe performance anxiety and had trained himself to rush during early masturbation.
With a mix of therapy and mild medication, he regained control within 6 weeks.
His relationship improved dramatically.
He later said, “Doctor, it wasn’t just about lasting longer — it was about feeling in control again.”

That’s the real victory.

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📞 Call to Reach

If you or someone you know struggles with premature ejaculation, don’t let shame or fear delay treatment.
Confidential, professional help is available at:

Mind & Mood Clinic, Nagpur (India)
Dr. Rameez Shaikh, MD
(Psychiatrist & Sexologist)
📞 +91-8208823738

Every session is private, judgment-free, and focused on helping you regain control — not just in bed, but in life.

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⚠️ Disclaimer

This article is for educational purposes only. It is not a substitute for medical advice, diagnosis, or treatment. Always seek the advice of a qualified health professional with any questions regarding your sexual health.
Dr. Rameez Shaikh, MD – Psychiatrist & Sexologist, Mind & Mood Clinic, Nagpur.