JOKES. That's what you usually get when
you talk about premature ejaculation with anyone. Even my colleagues,
when they found
out that
I was working on this story, quipped: "You can write from
experience, eh?" "We've all heard the jokes before," said
Assoc Prof Dr George Lee, consultant urological surgeon at Universiti
Malaya. "When I told my
friends I was going to South Korea to give a talk on premature
ejaculation, they told me, "You better get there quick before it's over!" "
Certainly in our Asian culture, where men often pride
themselves on their virility and the number of children they father,
premature
ejaculation (PE) is naturally a scary and humiliating subject deemed to
affect the manhood of those who suffer from it. The social stigma and
jokes only worsen the sufferers' perception that they are the
odd ones out. So, they suffer in silence rather than seek help.
But how many of us know that 30% of the male population
suffer from PE?
That's right, that's one in every three men aged 19 to 80.
The percentage in South-East Asia differs little from that in the
West, which is
28%. With this in mind, PE doesn't seem that uncommon a condition
anymore.
"However, the number of men who come forward (to report the
condition) is miniscule," says Lee. "Nobody wants to. People who come to
see me talk about something else, about their prostate or
something like that. You can see that they are undecided on whether they want to
tell you. And when they're about to walk out the
door, they come back and want to say it. They need time. Embarrassment is a big issue."
Lack of awareness also contributes to their hesitation, as
there are still those who do not know the difference between premature ejaculation
and erectile dysfunction (ED). Unsure of whether their
predicament is pathological or physiological, the men might avoid intimacy altogether.
Lee says the International Society of Sexual Medicine defines
PE as "ejaculating shortly after penetration" or "ejaculating before
one desires
to". All studies of PE have shown that ejaculation happens within
a minute or less. When it affects the relationship between partners, then it
becomes a problem.
But things are about to change, says Lee.
"We are gradually moving towards recognising PE as a medical
condition. Before this, PE was thought to be psychological, that the person
may be too anxious during intercourse. All sorts of methods were
then recommended, such as certain physical manipulations and even
anaesthetic creams and sprays, which were largely ineffective.
Now, opinion has shifted to recognising the cause as a neuro-biological one.
"We increasingly understand that there are people who suffer
from primary PE," says Lee. "They are born that way and it's because of their
central nervous system. There are certain components in there
that lower the threshold of climax. And the whole system is controlled by the
seratonin system, which controls our mood, appetite,
anger, pain and sexual pleasure."
This is where therapeutic intervention comes into the
picture, where seratonin inhibitors can be manipulated so that the
threshold can be
elevated. Anti-depressants are usually used, but there are actually
no anti-depressants licensed for PE.
"Prozac, probably the most common anti-depressant, is used
for this," Lee explains. "But a majority of them are long-acting. So, technically
that is not a suitable medication to treat PE. You want to
treat PE during sexual intercourse, but not beyond that especially if the person
suffers from side-effects."
But now there is a new medication that is short-acting. It
has already been tested, and is being marketed in seven countries.
"I'm predicting that it should be released (in Malaysia) by
next year," says Lee. "It is a prescription drug because it carries
the side-effects of
nausea, headache and vomiting, so it needs to be handled
with care."
Even though treatment is within reach, the biggest obstacle
is still to get men to come forward for help.
"I guess there will always be jokes about the condition,"
says Lee. "But if you notice, impotency jokes are no longer around.
But there are a
lot of jokes about Viagra now. So the jokes are no longer on
the men but on the success of the treatment. That's the key to it - do not
humiliate the men who suffer from this. It's already
bad enough that they suffer in silence, so there's no need to humiliate them. Cultural
change takes time."
With more education and awareness about PE. and in
recognising PE as a medical condition, hopefully embarrassment will
diminish and
more men will come forward to talk about it.
Lee adds that PE is not solely a man's problem; it is also a
condition from which women suffer, as they might not find satisfaction
in their
sexual relationship. Communication is important, as usually the man recognises that he has a problem and tells his wife. Then she would
suggest that they see a doctor about it.
Lee draws a parallel between what is happening now in the
treatment of PE and the advent of Viagra which he says was "the first sexual
revolution for men." Previously, ED was known as impotence, which
was very demeaning. But now it is recognised as a medical condition
and is treated with medical respect, says Lee.
"If you look at the pre-Viagra era, the jokes were always
about impotent men," he says. "At the time, before there was a
treatment, men
were suffering in silence. Now, 10 years on, it has helped millions,
about 233 million men. Every second, six tablets are consumed. That has
improved men's sexual experiences, and also improved
the relationship between many husbands and wives.
"Hopefully, (with the treatment for PE) we will have a second
sexual revolution that will change many men's relationships with their wives."
The Star/Asia News Network
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