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Urology/Penis Erection


I am 29 years, I doesn't experience early morning erections as I hear other of my friends discuss,  since I became conscious of my body system, I have had a protected sex 3 times since maturity though in each of those times, I came quick, that has affected my zeal for intercourse, please could this be a problem and is it the reason for my premature ejaculation? if it is, how can I get rid of it please. Thanks

Jungle Black, most men experience erections while sleeping and these are a normal occurrence.  They occur during the REM (rapid eye movement) stage of sleep, average about 3-5 per night and last for up to 30 minutes.  They are thought to be triggered by fantasy dreams, but during REM, most of the dream content remain amnestic to us. Therefore, most of these fantasies are not remembered on awakening. In my experience, they are more common if one does not ejaculate very often.  Although the majority of men (especially younger men) awaken with these erections, not all do.  Not having AM erections in itself is NOT an abnormality.

Premature ejaculation is a common condition.  It refers to men who ejaculate prior to intromission or within a minute or so after insertion.  It is more common in younger men and tends to spontaneously improve with age.  In general, it occurs more often in those men who ejaculate relatively infrequently.  I do not recommend coitus interruptus for this problem as this practice can lead to inflammation of the prostate gland, so called prostatitis. This in itself can lead to other sexual difficulties such as problems obtaining and maintaining erection. The commonly used treatments are:

1.  Masturbation within 24 hours of contemplated sexual intercourse may help prolong the period before ejaculating.

2.  Topical anesthetics can be used to numb the glans penis.  Durex performa condoms contain Benzocaine on the inside. It is reputed to work well.  Also available, is EMLA cream, a prescription drug that contains a potent relative of novocaine.  I have not had much success with it.  After application, one has to wait 20-60 minutes before its removal to allow sufficient time to work.  In addition, it has the potential to decrease penile sensation too much and, if not removed adequately, to also cause decreased vaginal sensation in one's partner. use in the future.  A new topical anesthetic agent being used successfully in Japan (PSD502) has an onset of action in 5 minutes and avoids many of the side effects of EMLA.  Although not yet available in the USA, it may be approved in the near future.

3.  Certain antidepressants in the class of serotonin uptake inhibitors (ie Prozac, Anafranil, Zoloft, Paxil, etc.) can be used successfully in delaying ejaculation.   However, they also have potentially harmful side effects. They are prescription drugs and should not be taken without medical supervision.   Daily therapy seems to work best for younger men but but carries a greater risk of side effects.  For older men or those who have just occasional sex, a single dose is recommended several hours before sex is contemplated.  A new drug in this class called "dapoxetine" (Priligy) has recently been approved in Europe.  It works in one hours and is then rapidly cleared from the system reducing the likelihood of side effects.  It is not yet available in the USA.

4.  The "squeeze technique" of behavioral modification is successful and safe. It is well described on the internet and in most books on sexual therapy and dysfunction. However, it requires frequent practice and a cooperative partner.

5.  The use of regular condoms decreases penile sensation and helps some individuals.

6.   Having sexual intercourse a second time in the same session usually produces a greater time to ejaculation. If one can't get aroused again, the use of PDE5 inhibitors (such as Viagra) may help. However, the drugs do not treat the  premature ejaculation per se. It is best to see a urologist skilled in the evaluation and treatment of sexual dysfunction for more information about the above options.

7.   I have heard that some intense meditation techniques  allow one to train their body to resist ejaculation. Personally, I am not familiar with these techniques but you could probably find more about them on the internet.

8.   Kegel exercises have been used in an attempt to strengthen the muscles of the perineum (pubo-coccygeal muscles) in the hope of providing more control over ejaculation.  The reports of success are largely anecdotal.  I have used these exercises mainly for therapy of urinary incontinence but have no personal clinical experience with them when used for premature ejaculation.

Good luck! 


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Arthur Goldstein, M.D.


Problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, etc. I no longer answer questions related to erection problems or male sexual dysfunction.


I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in endourology.

American Medical Association, American Urological Association, American College of Surgeons

College degree - BS Medical degree - MD Master of Science - MS

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