When you're 'short-fused' between the sheets


Dear Dr G,

I really hope you can solve this sexual predicament that has been bothering me for years.

I am a healthy man in my mid 30s. My wife and I have been married for nearly a decade and we have a very healthy sexual relationship. We had twins last year, and I happily showed off my pride and joys during the recent Chinese New Year festivities.

Although it appears I have a healthy love life, one that produced two beautiful children, I am in reality "short-fused" between the sheets – and I'm not talking about my temper!

Since I have known my wife – and during previous sexual relationships – I have only been able to sustain less than one minute of sex. I can say my love life is only good for procreation and not recreation.

I gathered from your previous articles that I suffer from premature ejaculation.

Your previous responses show that you are an advocate of using medication to prolong sex. However, my wife and I are not keen on this.

I have looked up information on the Internet and discovered that certain numbing agents can help to prolong the sex act.

I would like to put Dr G on the spot and find out more about these "numbing" creams.

What are they? How do they work and how are they applied? Would they be harmful to me or my partner?

I am hoping your answers can help me to prolong my fuse!

Regards,

Short-Fused

Premature ejaculation (PE) is arguably the most common sexual dysfunction suffered by men. The recent Asia Pacific Premature Ejaculation Prevalence Analysis (Pepa) revealed the condition affects nearly one in three men in the region.

The study evaluated men using a self-applied questionnaire that focused on the key elements used to diagnose PE.

The premature ejaculation diagnostic tool (PEDT), helps men to self-evaluate different facets of this sexual dysfunction. These include the ability to control, the degree it bothers them and the shortness interval of sex. The total score from the questionnaire helps to determine the probability of PE.

While the exact pathophysiology of PE is unknown, two neurological domains are known to determine the physiological control of ejaculation: Peripheral tactile stimulation of the penis can trigger the ejaculatory reflex via the spinal cord and erotic thoughts can stimulate the brain's central nervous system to reach a physiological climax.

As the physiological basis of the central and peripheral nervous systems differ significantly, the use of medications to dampen either of these systems can help prolong the interval of sex in men suffering from PE.

Medications such as SSRIs (selective serotonin reuptake inhibitors) have proven effective in increasing neurotransmitters in the brain, helping men to prolong sex. Similarly, the use of anaesthetic agents (such as lidocaine and lignocaine), in the form of a spray or cream, can numb peripheral nerve endings, helping to create "lasting" moments between the sheets.

According to a study, the use of a numbing aerosol spray on the penis 15 minutes before sex can help men last 2.4 times longer during sex. The study, which was published in the British Journal Of Urology, involved 54 heterosexual men who ejaculated, on average, one minute after penetration; they received either the medicated spray or a placebo. The men (or their partners) used a stopwatch to evaluate the time from penetration to ejaculation.

The result in those who used the spray demonstrated an increase in the sec act to two minutes or more in 55% of the men and three minutes or more for 40%. However, four of the 20 men receiving the medicated spray reported complete numbness of the penis, to the extent of suffering erectile dysfunction. A similar number of partners also experienced numbness and some even reported a burning sensation during sex.

The curse of PE in the bedroom cannot be underestimated. The inability of a man to sustain intercourse for a rewarding sex life often results in avoidance of sex and a "numbness" in the relationship.

Behavioural therapy, penile anaesthesia and medical interventions are available to help couples to overcome the condition.

When Dr G is put on the spot for his opinion on the benefit of numbing agents for the treatment of PE, he paraphrases Canadian novelist and artist Douglas Coupland and says: "When using the numbing cream to defuse the short-fuse between the sheets, although time passes less quickly, the world is definitely not a better place when numbing the lovemaking!"

(Coupland said: "There's much to be said for feeling numb. Time passes more quickly. And the world's probably a better place.")

Dr George Lee

Dr George Lee

Dr George Lee is a consultant Urologist and Clinical Associate Professor whose professional interest is in men’s health. The column “Putting Dr G on the spot” is a forum to help men debunk the myths and taboos on men’s issues that may be too “hard” to mention. You can send him questions at askdrg@thestar.com.my