Sex among the elderly: Does aging improve premature ejaculation?

Many men can function normally and without using medicines after three months of treatment for premature ejaculation, achieving a normal duration of sex. Some may develop recurrence after some months of being off treatment in which case repeat treatment is needed.

But there is another category of men, those who cannot function unless they are on treatment. James was such a man. Whenever he stopped taking drugs he would not function.

“I ejaculate before penetration,” he lamented. “I have lost relationships before and I was devastated, I do not want to lose my wife so I am on medication throughout.”

Premature ejaculation is characterised by three symptoms: accelerated rate of stimulation resulting in quick ejaculation, helplessness or inability to delay the ejaculation, and frustration and distress by the man, the woman or both parties because of inability to achieve satisfying sex.

Accelerated rate of stimulation is not just genital stimulation, all body systems are tuned to react fast to a sexual situation. The rapid stimulation can be classified into three – ejaculation before penetration, ejaculation within two minutes of penetration or ejaculation between two and five minutes of ejaculation. These are described as severe, moderate, and mild forms of premature ejaculation.

There are premature ejaculators who know no other way of experiencing sex. From the time they first attempted sex, they ejaculated quickly. They are said to have primary premature ejaculation. Those who develop premature ejaculation later in life are said to have secondary premature ejaculation. They normally have another problem causing premature ejaculation unlike in the primary type which is an inherent abnormal response to sex.

“Mine is primary and severe,” James said during one of our discussions, “I have never experienced normal sex unless while on medicines.”

The fact that James could not function without taking medicines stressed him.

“Will I be on medicines forever?” he asked rhetorically, “I am doomed, why did this have to happen to me?”

Scientific studies have shown that primary premature ejaculation is a result of an easily excitable sexual system. It is important that the whole body is engaged during sex so it is really a whole-body reaction coordinated by the brain. More than normal impulses are sent from the penis to the brain which similarly reacts faster than normal, stimulating all body systems to move to climax leading to an uncontrollable point of no return where the man is helpless and unable to control the ejaculation. This slippery slope is frustrating, leaving the man with low self-confidence and a crushed ego.

The woman is similarly left annoyed and may throw in a nasty word further throwing the man off balance.

“All that is well known to me doctor,” James said. “All I am asking is if I will use medicines for the rest of my life.”

The question of whether premature ejaculation improves with age has been researched severally. Initially, results were mixed, some researchers finding that as people aged their premature ejaculation improved while others found the exact opposite.

More recent studies have however clarified the confusion. The answer lies in disaggregating the premature ejaculation into either primary or secondary types. It is known that as one ages, the sensitivity of the sexual system goes down. In other words, the genitals get numb, fewer impulses reach the brain and the brain response is also slower. The outcome is a delay in stimulation even in people who previously considered themselves normal.

What aging does to primary premature ejaculation, therefore, is to slow down things. The one with severe premature ejaculation may slide to moderate and later to mild and finally to normal ejaculatory time as they age. The only challenge is that this response is individual specific so it is not easy to predict the ages at which these improvements may occur.

Further, this situation only applies to the primary type of premature ejaculation. Those who have developed premature ejaculation later in life may exhibit the opposite effect where age worsens their situation. For them the cause of the problem needs to be treated, be it hormone disorders, psychological, or relationship problems, or any other causes identified after a thorough medical evaluation.

It is also important to note that the person with primary premature ejaculation can develop other problems that come with age and which cause secondary premature ejaculation. This may cancel out the improvements expected from aging.

“I give up,” James said in frustration. “What you are saying is that I may improve as I age and again that I may develop secondary premature ejaculation as I age so I will always be a loser!”

Not really. Premature ejaculation does not mean one is a loser. It is treatable. The discussion here is whether one can go off treatment at some point or not.