The sexual dysfunction Singaporean men keep a secret

A urologist and men’s health expert tells us what he knows – and what we can do to help our partners out

PHOTO: Ingimage

Here in Asia, it’s not common to talk about what goes on behind closed (bed)room doors. But maybe we should. According to a new survey conducted on 3,500 men and women in nine Asian territories, over 50 per cent of couples are unhappy with their sex lives.  And among the many obstacles to sexual satisfaction, premature ejaculation (PE) stood out as one of the most prominent culprits.

For men in general – but especially for Singaporean men held back by “Asian reticence,” – PE is a shameful condition kept between themselves and their doctor. Some fortunate men manage to remedy their affliction before becoming sexually active. But what happens when you and your man discover the problem from experience? And even more importantly, how are we supposed to help them?

It’s not an easy topic to openly discuss, let alone broach with one’s partner. But clearly, it’s affecting relationships for the worst. Nearly one in three men suffers from the condition of PE. Among those who reported experiencing it, 30 per cent of men and 40 per cent of women said that it made them want to avoid having sex completely. And 15 per cent of men and 15 percent of women said that PE could even lead to a breakup or a divorce. Yikes.

So last week, we consulted men’s health expert Dr. Ng Kot Kit, a Senior Consultant in Changi General Hospital’s Department of Urology for advice on how couples struggling with PE should seek help.

“There’s an idea that a real man doesn’t want to talk about his problem, but this is actually changing,” Dr. Ng said. “There’s more exposure because the media is more forthcoming with talking about such issues and people are discovering information on the internet.”

Continue reading to learn more about PE and how you can keep it from harming your relationship.

Guys: you are not alone
Plenty of men afflicted with chronic PE feel alone in their struggle, especially when so many of their peers have already outgrown it. But there’s no reason to feel that way – Dr. Ng says he sees two to three PE sufferers in one clinic session, or about 10 a week. So guys, no matter how embarrassing it seems, it’s better to see a professional – he won’t laugh, as he’s probably seen about a hundred men who struggle with the same thing you do.

PE isn’t just about youth and sexual inexperience
One of the biggest misconceptions about PE is that it only affects young, sexually inexperienced men. But Dr. Ng sees patients of all ages, and with varying amounts of sexual experience. While previous studies have suggested that the affliction is psychogenic, newer research shows that the problem may have a biological basis. Like some mental illnesses, such as depression, chronic PE is linked with a lack of serotonin – the chemical popularly attributed to happiness, memory, and learning. But of course, anxiety and distress can compound this tendency, making it harder for you to remedy the situation than if you were relaxed.

What PE is NOT caused by
Anxiety, distress, inexperience, and a serotonin deficiency can all contribute to PE. So what doesn’t? According to Dr. Ng, masturbation and porn, which are two of the biggest culprits blamed on the internet for chronic PE.

How it affects relationships

In Dr. Ng’s experience, male patients often come to him alone and don’t enjoy talking about how sexual dysfunction affects their relationship.

“Men would rather talk about the ‘nuts and bolts’, what works and what doesn’t, and what switches the machine on,” Dr. Ng said. Most come alone because they find the situation embarrassing and would rather solve the problem themselves. In addition to feeling like less of a man, they have to deal with their partner’s gratification and the prospect of someday bearing children.

Surprisingly enough, men in Singapore often consult Dr. Ng before getting into a relationship, rather than finding out the hard way (no pun intended) that something’s amiss. Many of his patients are men who have chosen to abstain from sex before getting married, but who want to remedy the situation before making a lifetime commitment. Naturally, the man’s partner is often clueless about his personal struggle.

“I seldom see the sexual partner during consultations so it’s hard to gauge if they know what’s happening,” Dr. Ng said. “But it bodes well in the relationship if both partners can act as a team.”

In his opinion, it’s better if a man’s partner knows that he’s suffering from PE, so that she can manage her expectations of his performances while helping him work on techniques to get better. Which brings us to our next point….

How you can help your man with his PE
Before prescribing drugs, Dr. Ng likes to suggest conservative treatments that couples can try in the bedroom. We won’t go into graphic detail here, but some of these include the “stop and start” technique as well as the “squeeze” technique, which can be described in more meticulous detail by a physician. The man can also try pleasuring himself before intercourse, as masturbation can help a man sustain a longer erection once he goes for the real thing. However, Dr. Ng warns that couple techniques take patience, commitment, and a good deal of practice, as the timing can be hard to nail.

The other option: drug treatments
While health professionals like Dr. Ng can provide some counseling and tips for sexual technique, he also recommends drug treatments for men who either can’t figure out the couple techniques, or who would rather just fix the problem right away. One of the most popular options of Dapoxetine, which was specifically developed to treat PE in men 18-64 years old. This drug, which was initially created as an anti-depressant, is an SSRI (selective serotonin reuptake inhibitor) that can be absorbed and eliminated quickly – meaning that while it can’t treat depression, it can delay ejaculation if taken 1-3 hours before sex.

Dr. Ng recommends trying it for three months before evaluating how much of a difference it has made. During that time period, the guy might just develop the confidence and the technique to help him overcome the problem, thus allowing him to stop using the drug completely. PE might have a biological basis, but the right amount of confidence can help compensate for it.

For the guys: How do you inform your partner of your PE? 
As the old adage goes, honesty is the best policy. If they can’t solve the problem by themselves (or in time for the wedding), men who struggle with PE should tell their partners that they’re going to seek medical advice – and that the treatment may come in the form of sexual techniques. If the partner is willing to accept his condition (which is temporary!) and to help him out, then they can embark on that journey together.

Sure, it’s tempting to keep PE a secret. But it’s not always possible – and as a couple, it’s better to share the sufferer’s burden than to let him find excuses to avoid sex.

“If the woman knows that the male partner is actively trying to remedy the situation, then she may be more supportive of him,” Dr. Ng said. “And as a result, he might become less anxious about his condition.”

For the ladies: How to broach the topic in a sensitive way
So what happens when you’re a woman in a relationship with a man suffering from chronic PE? The key thing is to encourage him instead of shaming him. If you want to broach the topic in a sensitive matter, you can always say that you “read somewhere else” that there are medications and techniques available to improve his problem.

“Once a man knows that it’s treatable, he’s more likely to go forward,” Dr. Ng said. “As opposed to living in fear that he will be forever labeled with an ‘embarrassing disease.’”

“Once they see me, they’ve overcome the first step, so they can be pretty frank and forthcoming in their problem,” he added.

Treating your PE? Don’t give up
When we asked Dr. Ng if he’d consulted any men who couldn’t get past their PE, he said no. It might take a while, but the majority of guys will get over it.

“Long term doesn’t mean forever,” he said. “When the control becomes better, the anxiety becomes less. Or when the anxiety lessons, the control gets better. It is a virtuous cycle.”

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