Premature Ejaculation Problems in Men

by Dr. Alex Shteynshlyuger, a board-certified urologist, and specialist in the treatment of penile problems in men


If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-5747


Why Do Men Come Too Fast and Experience PE (Premature Ejaculation)?

Premature Ejaculation

Premature ejaculation is a fairly common condition that affects many men at some point in their life.  For most men, premature ejaculation is an occasional concern.  Some men have severe and persistent premature ejaculation that has been present their entire life.

In studies, premature ejaculation is measured as intravaginal ejaculatory latency time (IELT), the time from penetration to ejaculation.  For some men, premature ejaculation may be so severe that they ejaculate even before they are able to penetrate as soon as they get excited and often within 30-60 seconds of getting an erection or vaginal penetration.  Premature ejaculation can have a severe effect on relationships both from guilt felt by the man and lack of satisfaction by partners. It can also cause depression and performance anxiety.

Two types of premature ejaculation are commonly seen in men. 

Lifelong premature ejaculation is present since the onset of sexual activity and typically occurs every time a man ejaculates.  Lifelong premature ejaculation tends to be more severe in nature, with time to ejaculation anywhere from 15-30 seconds to 2-3 minutes.

Men also can develop acquired premature ejaculation that often occurs as men get older or may occur occasionally.  Acquired premature ejaculation has many causes including UTI, prostatitis, STDs, erectile dysfunction, neuropathy and diabetes, and many other causes.  This tends to be less severe with men typically complaining of ejaculating within 2-5 minutes.

Causes of Premature Ejaculation

The exact cause of premature ejaculation is not clear but it is apparent that serotonin pathways in the brain affect premature ejaculation as SSRI (selective serotonin reuptake inhibitors) prolong ejaculatory time by increasing serotonin levels in the brain.

One hypothesis is that premature ejaculation is an evolutionary adaptation. Men who ejaculate faster may have an advantage in reproduction and survival. 

It appears that men with attention deficit hyperactivity disorder may be at increased risk for premature ejaculation as well.

There are some reports that some men with premature ejaculation who also have scrotal varicoceles benefit from varicocele repair.

Some men develop new-onset premature ejaculation that appears to be related to inflammation around the nerves that go to the penis.  Men with prostatitis, sexually transmitted diseases sometimes develop premature ejaculation along with urinary symptoms such as frequent urination, urethral pain during or after urination and perineal pain.

Treatment for Premature Ejaculation At New York Urology Specialists.

Premature ejaculation often coexists with erectile dysfunction.  Often, erectile dysfunction may be masked by a severe premature ejaculation.  Anxiety caused by premature ejaculation often leads to problems with obtaining and maintaining erections with a partner.

It is also important to differentiate erectile dysfunction from premature ejaculation. Men with premature ejaculation ejaculate too soon and then lose the erection.  Men with erectile dysfunction lose erection typically without ejaculation.

Guidelines from American Urological Association (AUA) and our practice at New York Urology Specialists is that patients with any degree of erectile dysfunction associated with premature ejaculation first get treated with the goal of correcting erectile dysfunction.  Treatment for erectile dysfunction often improves symptoms of premature ejaculation especially in men with acquired premature ejaculation. 

Exact treatment depends on the individual situation but medications such as sildenafil (Viagra) or daily Cialis (tadalafil) work well for most men.  In addition to treating erectile dysfunction, medication such as Viagra and Cialis appear to shorten the refractory period in men.  Medications such as Cialis and Viagra can also allow men to maintain an erection and satisfy their partner even after ejaculation.

Treatment for Premature Ejaculation

Treatment options for premature ejaculation include behavioral therapy, psychotherapy, and medications.   While psychotherapy may be helpful, it is often impractical.

Behavioral Therapy for Premature Ejaculation

Behavioral therapy involves a number of methods. One simple method is for men to stop thrusting to allow the sensation of impending orgasm to pass before resuming.  That can prolong ejaculatory time.  It tends to work for men with acquired premature ejaculation and does not work as well for men with severe PE.  Some men find that after masturbation when they get a second erection they are able to last longer. This is more common in men with acquired ejaculation.

SSRI: Effective Treatment Option for Premature Ejaculation

Most effective treatment option for premature ejaculation involves using SSRI, antidepressant medications that have a beneficial side effect of prolonging ejaculatory time.  These medications can be taken a few hours prior to intercourse if sex is planned.  More commonly we advise that men take medications daily to avoid last-minute worry about the timing of medication use.  

If SSRI medications do not help, certain medications that affect pain receptors can be tried.

Topical ‘numbing” creams, wipes, and sprays can be used for the treatment of premature ejaculation.  They are effective. Men often get frustrated because applying a bit too much causes numbness (not too good); not using enough does not help.  Finding the right balance can be a challenge.

Penile Injection Therapy with Alprostadil (Edex) or Trimix

Another effective treatment option that can overcome premature ejaculation is intracorporeal injection therapy with medications such as alprostadil or Trimix which produce a very strong erection.  These medications do not affect premature ejaculation but enable men to maintain erections for a prolonged period of time even after ejaculating which can allow them to satisfy their partner.  The dose of medications can be adjusted to produce an erection of adequate duration.  Typically the goal is to find a dose that will produce an erection that lasts less than 1 hour to avoid risks of priapism (an erection that lasts more than 2-3 hours).  Usually, penile injection therapy is the treatment of last resort as it is associated with risks of priapism and Peyronie’s disease (scar formation in the penis).  Unfortunately, there are some clinics that offer penile injections as the first therapy for PE without trying other less expensive and safer treatment options.

We advise that you see a board-certified urologist who specializes in the treatment of PE.

Other Treatment Options for PE

There is some evidence that suggests that pelvic floor muscle training may be helpful for men with PE.

Treatment of the underlying erectile dysfunction often improves or overcomes premature ejaculation

Testosterone replacement therapy in men with low testosterone may be useful for some men with PE.

Surgical Treatment of Premature Ejaculation

Circumcision does not help men with premature ejaculation.  

Why Choose New York Urology Specialists for Treatment of Premature Ejaculation Problems in Men?

  • All treatment is performed by a Board-certified urologist experienced in treating men with penile symptoms using medical therapy, minimally invasive therapies, lasers, and open surgery.
  • We are one of the few practices in the region to offer a full range of options for treatment of sexual and penile problems in men
  • We offer treatment options for balanitis, genital warts, phimosis, Peyronie’s disease, and penile cysts in our office which avoids the risks, costs, and recovery from general anesthesia.  
  • Extensive Experience: Hundreds of men and women have treated successfully using medical therapy and surgery.

Excellence-Urology_Care VasectomyWhen it comes to experience and innovation – New York Urology Specialists are a step ahead.  Better Science Means Better Care.  We specialize in minimally invasive highly effective treatment for symptoms of penile pain, urethral burning, foreskin inflammation, and penile cancer. Many treatment procedures are performed in the convenience and privacy of office settings under local anesthesia.

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-5747

Medicare and major insurances accepted. Urologist. We offer affordable rates and financing options.

Schedule an Appointment with Dr. Shteynshlyuger:

Call today: 646-663-5747 or make an appointment online

Dr. Alex Shteynshlyuger is a fellowship trained board-certified urologist with expertise in evaluation and treatment of penis problems in men.  He uses modern effective and proven treatment methods. He is highly recommended by doctors and patients alike.

He has successfully treated hundreds of men of all ages with penile problems including irritation and inflammation of the penis, bent penis, and weak erections. 

If you or someone you know has been experiencing urological symptoms, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice. Please feel free to Contact Us with any questions.

Patients Reviews

Overall Rating:

4

Total Ratings

4

Total Reviews

25

Ratings

Ease of Appointment: Bedside Manner:
Promptness: Spends Time with Me:
Courteous Staff: Follows Up After Visit:
Accurate Diagnosis:

Peronis Disease
by on Aug 04, 2019

Dr Alex was both knowledgeable and concise with his diagnosis and advice which was well received. Dr was her knowledgeable in the subject and provided good advice.

3P Removal
by on Jul 24, 2019

Went to get my penile papule remove. Got done same day, it was fast, great staff, and most importantly, pleased with the result.

Urology Visit
by on Jul 18, 2019

Staff were all very welcoming. Dr. Alex Shteynshlyuger was very knowledgeable and attentive during my time spent with him.

Recommendation
by on Jul 18, 2019

Therefore I would like to recommend you to anyone who need your services.

Outstanding
by on Jul 09, 2019

Went in for a procedure with Dr. Alex and he was very calm and thorough about the the operation and the recovery. From the front desk to his assistants, everyone was very courteous, professional and polite. I highly recommend NY Urologist Specialist. They are outstanding!!!

Care at NY Urology Specialists
by on Jul 06, 2019

I am a 54 year-old male who is extremely happy with my care at New York Urology Specialists. I came to see Dr. Alex out of near desperation after consulting with three other urologists. Literally over one night, I began experiencing severe penile pain and burning. None of the other urologists were able to help diagnose what my problem was and seemingly didn't take my problem very seriously. In fact, one of them specifically told me at it had nothing to do with my prostate. After 6 weeks of suffering, I saw Dr. Alex. He examined me and gave me some tests and lab work. He very quickly ascertained that my problem was due to an enlarged prostate. He proscribed medicine to deal with my pain in the short-term and keep my prostate size in check over the long-term. My problem quickly disappeared. Today, 5 years later, I feel great. Dr, Alex listens to you as a patient, takes your opinion and health concerns seriously and knows his field inside-and-out so that you can get proper treatment for your problem. I can't thank him enough for diagnosing and solving my malady - you sometimes can't appreciate a problem until you have it. Getting rid of it and getting back to normal is so important - I am so glad that I saw Dr. Alex for my problem.

Professional staff as well as the Doctor
by on Jun 18, 2019

Professional staff as well as the Doctor

First class Surgeon & staff
by on Sep 24, 2018

From the very appointment to the last follow-up visit, I felt I was at the right place and with the right people around me. Dr. Alex Stheynshlyuger and his staff made it easy and confortable. I would recommend them to every man.

Satisfied Patient
by on Sep 15, 2018

I am very please and satisfied with everything that has been offorded to me by New York Urology Specialist Office.....Dr Alex

Friendly , courteous, effiecient and professional
by on Sep 15, 2018

Wyts Wyts recommends New York Urology Specialists via Facebook. September 15, 2018 · Friendly , courteous, effiecient and professional staff members. This office i highly recommend for any and all Urology matters. Dr Alex Shteynshlyuger is very professional and knowledgable easy to communicate with. Thanks Dr Alex

Surgical Procedure
by on Sep 01, 2018

Dr Alex and his staff are through professionals in every sense of the word. From initial diagnosis to a period of evaluating and ruling out options, we decided upon a surgical solution, which appears for the most part to have corrected the issue. Thanks to Ana, and the staff, especially Dr. Alex for treating me so well. Best regards, Lee

Review
by on Aug 16, 2018

Outstanding service

A very good doctor
by on Aug 15, 2018

Dr. Alex Shteynshlyugerand is careful, patient, experienced. Uses innovative approaches, that actually yield results. He is indeed a good doctor, in every sense

urology services
by on Apr 11, 2018

I am very satisfied with the treatment I received at new york urology specialist and would recommend them to other patients.they are the very best.

My wife was elated
by on Jan 15, 2018

Well I put it to use last night and man, good job. My wife was elated. u made it much better somehow, so thank u for fixing my penis

Thankful
by on Dec 05, 2017

"Cannot express how thankful I am I found Dr. Shtetnshlyuger. After undergoing surgery to correct a penile torsion I couldn't be happier with the results. A great doctor who is clearly good at what he does. With something as important as your private area, It's nice to be able to rest easy and know you are in good hands.." via HealthGrades.com 12/5/2017

Review
by on Nov 19, 2017

I am writing to thank dr. Alex. He is thorough, professional, knowledgeable, helpful and friendly. I have seen him for ED and prostate issues, and he has explained all my options clearly, and found solutions that have been a great help. thank you! I highly recommend both Dr. Alex and his staff, which I find to be helpful, friendly, knowledgeable and very professional. They are a pleasure to deal with and all have been a great help.

Frenulectomy
by on Nov 18, 2017

The attention and care that I received were reassuring and superb. My uneasiness was quickly dispelled by the skill and efficiency they demonstrated during the brief procedure. As a result, my comfort and appearance has improved considerably, and I highly value both Dr. Alex and his staff.

Dr visit
by on Sep 14, 2017

I am very much thankful for meeting Dr Alex .I had a very serious medical problem I visited many doctors but none could not help me it was very difficult for me until I visited Dr Alex after a couple visits my medical problem is no more I feel very great also I felt almost 20 years younger Dr Alex is second to none fantastic doctor. Thanks again Dr Alex from my family.

Good Dr. who cares about his patients
by on Aug 18, 2017

Received circumcision from Dr. Shteynshlyuger. Dr. Shteynshlyuger is a very good specialist who cares for his patients. He was always concerned with my physical and mental comfort prior, during and post-operation. Dr. Alex is very thorough in his work to assess any problems and provide the necessary solution. Being that he has recently moved to a new location, this may afford for speedier appointments and easier flow of patients in and out. In addition, more personal space for waiting patients. If there was any con, it would be, the lack of space at his prior office and being able to see his patients at the appointed time, but a necessary sacrifice for good, careful work. I would recommend him as a very good doctor.

Excellent doctor
by on Jul 03, 2014

I am feeling better now after visiting clinic New York urology specialists. Excellent staff and appointment on time.

Thanks to you
by on May 16, 2013

Dear Dr. Alex -On behalf of John and myself – Our thanks to you for the care and concern of your help to Jack with his cancer problems. We will miss you & wish you only the best. Sincerely John & Pat Date: 2013

Thank you for excellent care
by on Jan 07, 2013

Dear Dr. Alex: We want to thank you for the excellent care you provided for George during his emergency operation and the follow up treatment. Your quiet, confident manner was reassuring to us during a very scary time for us. We will never forget you. George Sally R. Date: 2013

We appreciate all that you did to help my dad
by on Sep 17, 2012

Dear Dr. Alex – I just wanted to write you a note to thank you for all of the care you have gave to my father during his illness. We appreciate all that you did to help my dad through his illness. We wanted to be sure to let you know how much it meant to us. Sincerely Joanne R.

We love you!
by on Feb 16, 2012

Dr. Alex Shteynshlyuger and Staff – Thank you so much for taking care of my husband Bob. Dr. Alex: I thank God everyday for you. You were an answer to prayer.


If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-5747

We offer affordable, highest-quality urology care with or without insurance.   Find out our office hours or directions to our office. We offer weekday, weekend and evening office hours.



If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-5747

Dr. Alex Shteynshlyuger is a board-certified urologist in NYC who specializes in treating men with penis problems including lumps, pain in the penis, penile masses, erectile dysfunction, circumcision.


Top