It was 9am when Jane walked into the consultation room at the Sexology Clinic. Elegantly dressed with long hair braids that hang freely below her shoulders, she wore a black striped suit, a white shirt and high-heeled shoes that brought out a sense of power and authority in her appearance.
I found myself standing from my seat as she marched majestically towards me, her expensive perfume filling the air. She extended her hand and I obliged for what turned out to be a strong, bold handshake.
“So doctor I am here to seek your professional advice before I proceed with an important decision I have been toying with,” she said as she settled on her seat, “I am tired of quickies and I have decided to divorce my husband.”
She was a 39-year-old marketing executive in an international pharma company. She had been married for five years and had two children. Her husband was a doctor and head of a county hospital.
“So, what do you mean you are tired of quickies,” I asked.
“My husband does the chicken business in bed, you know the way a cock runs after a hen, jumps on it, and before you realise what is going on the game is over?” She asked confidently, looking at me in the face. She was describing premature ejaculation. You see, when a man ejaculates before, during or within three minutes of penetration during sex that is what is called premature ejaculation. Jane called it a quickie and a chicken business.
The problem with premature ejaculation is that it not only distresses the man but also his partner. Most women of affected men rarely get orgasm. They are known to be totally dissatisfied with sex. A number end up divorcing and in fact a quarter of all divorces in many countries are attributed to premature ejaculation.
“So, you understand my predicament boss,” Jane interjected.
But that does not have to be the way to manage this common problem. For one, most of the affected men suffer low self-esteem. Their self-confidence is diminished. Anxiety hits them hard when faced with intimate situations. While a normal man would be excited to face a woman she loves in a private place, a man with premature ejaculation feels scared and threatened. Most develop a phobia for intimacy and even become averse to it. In fact many men in this situation contemplate suicide.
There are two types of premature ejaculation or PE: Primary, and acquired PE. Primary PE is when one has premature ejaculation right from the time they start having sex and this does not resolve for the rest of their lives. Acquired PE is when a person who has previously had normal sex develops PE, and suddenly they start ejaculating before, during or immediately after penetration.
Primary PE is mostly inborn, kind of a variant of sexual response in which one is unable to hold and things move to a point of no return without their liking. Occasionally, the cause may be a rushed first sexual experience which is quite common in young people; such as when young people rush sex so that they are not caught and hasten to arrive at ejaculation. If this happens frequently, it can turn into a lifelong trend.
Acquired PE is commonly a complication of erectile dysfunction (ED). Men with ED tend to rush sex with the hope that they reach ejaculation before erection goes. The result is a complex situation of ED and PE.
Other causes of acquired PE include hormonal problems, especially high prolactin levels and abnormal thyroid hormone levels. Diseases of the prostate can also lead to PE. Enlarged prostate or cancer of the prostate or even the treatment of these diseases are known to cause PE.
Depending on the type and cause of PE, treatment can be prescribed, some with good outcomes and others with unpredictable results. Suffice it to say there are medical ways of managing PE and its consequences.
“I must say that I am now confused, should I divorce this man or what is your advice?” Jane asked. She was obviously bored with the load of information I had given her and did not know how to make use of it.
But truly that is the nature of medical problems, including PE. There are never simple and straight forward answers. I advised Jane to bring her husband to the clinic for full assessment and treatment.
Jane remained quiet for a minute, staring into the distance and holding her chin in her left palm. She was in deep thought. She then stood up and extended her hand for a handshake.
“Let me go and synthesise this information and get back to you,” she said and hurried out of the consultation room. It has been two years since our meeting and Jane has never come back. Possibly she went ahead and had a divorce. It appears that PE could possibly be the worst sexual problem a man can face.
