KUALA LUMPUR (feb 28, 2010): Premature ejaculation (PE) remains a taboo subject in conservative Asia, despite the fact that about a third of all men suffer from it. But the release of the Asia Pacific Premature Ejaculation Prevalence and Attitude Study (AP PEPA) last December may be a first step towards creating greater awareness of this medical condition.
Consultant urologist at Universiti Malaya and clinical associate professor at Monash University Dr George Lee Eng Geap was directly involved in the study which involved about 5,000 men aged 18 to 65 from 10 countries in the region.
"Up to 30% of men suffer from it," Lee said. "However, few men are willing to admit they have a condition and even fewer seek help."
At a media briefing on Thursday aimed at creating public awareness on the subject, Lee and Dr Zulkifli Zainuddin, secretary-general of the Malaysian Urological Association, spoke at length about the public misconceptions and lack of understanding about PE.
Zulkifli, who is also an associate professor at Universiti Kebangsaan Malaysia (UKM), also elaborated on the condition.
"The International Society for Sexual Medicine defines it as a male sexual dysfunction characterised by ejaculation nearly always occurring prior to or within about one minute of vaginal penetration," he said.
It is distinct from erectile dysfunction (ED), which is defined as ‘the consistent or recurrent inability to attain or maintain penile erection sufficient for sexual intimacy‘.
The condition may not be life threatening and is therefore under-publicised, but that does not mean it does not have a devastating impact on those that suffer from it.
What’s more, it is not just men who are affected by it. Studies have revealed how it often leads to the break down of existing relationships.
During his career, Zulkifli, said he had seen cases resulting in divorce after just two weeks, whilst the longest it took for a marriage to break down was six years.
The condition also has more subtle impacts. "Surveys have shown most men think it will affect their ability to enter into long term relationships," said Lee.
Unfortunately, male sufferers very rarely seek help due to stigma, embarrassment and a reluctance to discuss the problem with their doctor or partner.
Most men don’t even admit it is part of a medical problem. "Help is often sought from non medical sources such as bomoh or roadside products like gambir Sarawak," said Zulkifli.
Unfortunately, such topical alternative therapies can have nasty side effects including uncomfortable genital inflammation.
As advocates of men’s health issues, Lee and Zulkifli said the primary way of helping those with PE was to tackle the taboo status of the subject. They said there were three actions for men who think they may suffer from PE.
"Firstly, acknowledge the condition," said Lee. "Secondly, talk to your partner. And thirdly, seek advice from your doctor who can advise you if there really is a problem and if necessary make a specialist referral."
There are a number of ways to deal with the problem, the most important of which is to improve communication between men and their partners.
"Partners play a wider role in awareness and treatment seeking behaviour," said Lee, illustrating the importance of step two.
"It is much better to seek help with the cooperation of the partner, then the doctor will get a clearer picture of the problem."
In terms of treatment, there are three main methods. For instance, psychosocial education can improve intimacy between couples.
"This includes cognitive strategies which involve the redirection of thinking to delay orgasm," said Zulkifli.
Then there are the behavioural strategies which include physical exercises men can practise alone or with the cooperation of their partner.
Most commonly, a variety of topical anesthetics in the form of creams and sprays can be used to decrease sensation of the penis and delay ejaculation. However, drawbacks to this include numbness in both the man and his partner and possible skin rashes on the areas applied to.
