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IMAGINE this scenario: A couple, newly married, has sex for the first time.
And it's over in under a minute.
The man feels he has let down his wife.
The wife, thinking she must have overly excited her husband, forgives him.
Fast forward a few years. The couple no longer look forward to love-making.
Instead, they have found other interests to occupy their time. Their level of intimacy has most likely suffered.
They may split up or the man may finally consult a doctor about his problem - premature ejaculation.
This is one scenario that presents itself regularly to Professor Peter Lim, senior consultant urologist at the Andrology, Urology and Continence Centre at Gleneagles Hospital.
"It (premature ejaculation) can have devastating effects on a man and a woman in a relationship as they may avoid sexual activity altogether," said Prof Lim, who sees about four such patients a week.
It is a problem that afflicts as many as one in three men here.
And they often don't seek help early.
Seeking help
It is an "underground" condition, said Prof Lim, something no one wants to talk about.
Couples seek help only when their inability to conceive a child hits them, he added. Most often, it is the man who seeks help by himself.
"His self-esteem is affected. He feels he cannot satisfy his partner. He also feels bad for his partner even if she does not complain," said Prof Lim.
The women don't usually complain, he said. "Especially if they already have children and can turn their attention on them. Also, such women tend to be financially dependent on their husbands and they do not want to hurt their husbands by bringing it up," he said.
More recently, however, he has met some women who are speaking up about premature ejaculation.
He has made up a profile of such women. "These are independent, go-getting women who know what they want," said Prof Lim.
Frustrated
Frustrated
They are financially independent, have their own careers, are well-educated and aware of their own needs.
One such woman is Susie (not her real name), a tutor in her 40s. She and her husband married late and do not have children.
She found out about his condition after they were married.
"I was frustrated, of course. I had waited so long to find the right man and then this!" she told The New Paper on Sunday.
"I tried to be understanding but after a while, I told him he had to get help."
Her husband, who is also in his 40s, has been seeing a doctor for more than five years, but the problem persists.
They tried a variety of methods, including the "stop-start" and "squeeze" technique which involves a series of exercises designed to increase the feeling of control over ejaculation.
The basic principle is to stimulate the penis alone or with a partner until just before the point of ejaculation, and then stop until arousal is lower.
But nothing really worked for her husband.
"Nowadays, we are more like brother and sister. It's okay, but I don't know how long we can last like this. It is not what I want," Susie said.
But they haven't got to a stage where he sleeps on the living room sofa.
Just a few days ago, a man went to Prof Lim's clinic for help because his wife had kicked him out of the bedroom.
"He was told not to return until he got help for his premature ejaculation," Prof Lim said.
1 in 3 men
1 in 3 S'pore men suffers from premature ejaculation
A SURVEY of Singapore men showed that as many as one in three suffers from premature ejaculation.
And they are concerned for their partners.
Most of the men diagnosed with premature ejaculation (92 per cent) worry that their condition leaves their partners sexually unfulfilled.
The questionnaire survey was carried out on 243 men, aged 18 to 55, in February and March.
Premature ejaculation is a lack of control on the man's part during sex.
It results in him having an ejaculation before or within a minute of sexual penetration, said Professor Ganesan Adaikan, a clinical sexologist with the department of obstetrics and gynaecology at the National University Hospital.
Common problem
At a media briefing of the survey findings on Wednesday, Prof Adaikan touched on the prevalence of and attitude towards premature ejaculation while Prof Lim highlighted the impact of premature ejaculation. Prof Adaikan said premature ejaculation is believed to be the most common male sexual health problem in Singapore.
It is twice as prevalent as erectile dysfunction in men aged between 18 and 59.
According to the survey, 20 per cent of Singapore men suffer from premature ejaculation while another 14 per cent probably suffer from it.
In all, almost 35 per cent of the men who responded to the survey felt that they had little ejaculatory control.
This resulted in high levels of distress, dissatisfaction and frustration in their relationships.
This is consistent with results of another study done last year on men in the Asia-Pacific region.
In the earlier study, about 30 per cent of 5,000 men from 10 countries surveyed suffered from it and it was found to be prevalent across all age groups.
Both studies were commissioned by pharmaceutical company Janssen-Cilag.
The cause can be genetic, passed down from generation to generation, or psychological, said Prof Adaikan.
Both professors declined to give a straightforward answer on what is considered the normal amount of time that men take to ejaculate.
Prof Adaikan said anything beyond two minutes can be considered "normal". But there are no studies to verify this.
He then reluctantly trotted out a number, which had been brought up before in the US, where an informal survey found the norm to be eight minutes.
"But there are no studies to verify this," he said. Treatment includes behavioural therapy, counselling and the use of creams.
Currently, there are no drugs approved for the treatment of premature ejaculation here.
But a drug treatment may be available soon. A drug, dapoxetine, is currently undergoing the registration process here.
It is already available in places such as Australia, New Zealand and many countries in Europe.
Do you suffer from PE?
Do you suffer from premature ejaculation? Take this quiz
1. How easy is it for you to delay ejaculation?
- Not at all difficult
- Somewhat difficult
- Moderately difficult
- Very difficult
- Extremely difficult
2. Do you ejaculate before you want to?
- Almost never or never
- Less than half the time
- About half the time
- More than half the time
- Almost always or always
3. Do you ejaculate with very little stimulation?
- Almost never or never
- Less than half the time
- About half the time
- More than half the time
- Almost always or always
4. Do you feel frustrated because of ejaculating before you want to?
- Not at all
- Slightly
- Moderately
- Very
- Extremely
5. How concerned are you that your time to ejaculation leaves your partner sexually unfulfilled?
- Not at all
- Slightly
- Moderately
- Very
- Extremely
If your answers are mostly moderately difficult to extremely difficult or more than half the time, chances are you need to see a doctor to get help.
If your answers are mostly not at all and less than half the time, chances are you're all right.
This article was first published in The New Paper.