Premature Ejaculation and Pregnancy

Pregnancy is indeed a blessing but certain conditions should be met to ensure a healthy and successful conception. This includes, optimal vaginal insertion, presence of a healthy egg in the fallopian tubes and availability of functional sperms after ejaculation. Needless to say that any alteration in these functional events can affect the fertility and chances of conception.Premature ejaculation is a common issue faced by approximately 30% males globally (1). For some males, it is a transient phase while others develop it for a brief period of time after physical or psychological trauma. Although, premature ejaculation usually resolves with lifestyle modification and non-pharmacological remedies, you should look for medical advice if you are planning a family.

What is Premature Ejaculation?

Premature ejaculation (also abbreviated as PE) refers to “an early orgasm followed by release of male juices”. Although there is no definite time or definition that could help in diagnosing PE, but clinically an average male lasts for about 7.3 minutes or even more. It is imperative to keep in mind that the time to ejaculate vary among different males (or even in the same male at different points of life), yet clinical diagnosis of PE is usually made if average time to ejaculate is less than 1.8 minutes.Premature ejaculation is more common around the extremes of age (very young males) or elderly. Most common physiological causes are:

• Over-excitement: This is more common in young pubertal boys
• Anxiety: This phenomenon is seen in males who are very conscious about their performance or impression on the partner
• Hypersensitivity (some males are more sensitive than other males) to sexual stimulation
• Physiological aging
• Chronic health issues (especially diabetes)

Premature ejaculation can also present in certain organic health issues such as:

• Prostate hypertrophy or hyperplasia
• Severe depression
• Adverse effect of certain prescription and cold medications

Is There an Association Between Premature Ejaculation and Infertility?

Although, time to ejaculate doesn't really matter as long as the vaginal penetration is sufficient; yet in some cases, it may compromise fertility. Here is how:

• Early ejaculation can lead to frustration, anger and agitation between the partners and may compromise the quality of relationship, affecting fertility indirectly.
• Most males get anxious and even more conscious that usually worsens the problem. Consequently male partners tend to avoid engaging in the act of intercourse to avoid the embarrassment. However, early ejaculation does not usually affect chances of conception if all other conditions are met (intercourse at the time of ovulation and release of male secretions in the vaginal canal).
• In extreme cases of premature ejaculation, the male partner may release before even entering the vaginal canal. For obvious reasons, in all these extreme cases, chances of getting pregnant are minimal.

What Can You do to Improve Your Chances of Conception With Premature Ejaculation?

Most males tend to overlook premature ejaculation as a problem, while others tend to hide it or cover it due to embarrassment. In either case, premature ejaculation is not a disease and can respond significantly to medical treatment. It is highly recommended to see a professional in order to assess the actual cause of premature ejaculation and infertility.If PE is due to anxiety or nervousness, simple tips can help a lot; such as:

• Speaking to a psychotherapist or counselor to share and discuss your concerns. Ideally, if you include your partner as well, results can be achieved much quickly.
• If PE is due to nervousness or performance anxiety, a small glass of wine can help in calming your nerves.
• Retraining yourself with stop-start technique also helps a lot of males to get over premature ejaculation issue.
• There are a number of over-the counter products that can also help in managing this issue. For example, local anesthetic creams that reduces the sensation during the act of intercourse and delays ejaculation. However, this technique may affect sensations in the female partner as well; thereby affecting the quality of intercourse (2).
• Antidepressants (such as clomipramine, sertraline and fluoxetine) are often prescribed by healthcare providers to address this issue (3).
• If the cause of infertility or difficulty in conception is a more organic issue, other options like assisted reproductive techniques should be sought.

Premature ejaculation usually has a negative impact on fertility and pregnancy especially if there are hidden causes behind it. One should talk to the doctor about his sexual life and his desire to conceive and both should work together to find a solution or treatment of the problem.References:

1. Carson, C., & Wyllie, M. (2010). Improved Ejaculatory Latency, Control and Sexual Satisfaction When PSD502 is Applied Topically in Men with Premature Ejaculation: Results of a Phase III, Double‐Blind, Placebo‐Controlled Study. The journal of sexual medicine, 7(9), 3179-3189.
2. Buvat, J. (2013). Clinical Trial Designs for Premature Ejaculation: Observational, Intervention and Intervention Preference Studies. In Premature Ejaculation (pp. 349-358). Springer Milan.
3. Waldinger, M. D. (2013). Treatment of Premature Ejaculation with Selective Serotonin Re-Uptake Inhibitors. In Premature Ejaculation (pp. 229-240). Springer Milan.