Firing Too Quickly – a new campaign designed to raise awareness of premature ejaculation, the most common male sexual

dysfunction² – launches today, announces A. Menarini Farmaceutica Internazionale SRL. In an innovative step for Pharma, nationwide cinema advertising is being undertaken, with information and support provided on the campaign website. Men (and their partners) are encouraged to visit their health care professional to discuss the various treatment options available.

International rugby players Danny Care (England), Sean Maitland (British Lions and Scotland) and Dan Biggar (Wales) have teamed up with Menarini to encourage sexual wellbeing amongst men and their partners. Results from a recent Sex of the Nations survey – investigating differences in sexual attitudes across the home nations – highlights that there is low awareness of how common sexual dysfunction is:

• Nearly a quarter (24%) of respondents thought that premature ejaculation only affected one in ten men,³ when in reality this figure is twice as high (up to one in five men are affected)¹

“We’re proud to support the Sex of the Nations and hope that it will encourage people to talk more openly about sex,” commented the rugby ambassadors. “Men in particular are often too embarrassed to talk about their health problems or visit their doctor. We hope that we can help overcome this and raise awareness of sexual wellbeing”.

As well as low awareness of how common premature ejaculation is, there is also uncertainty as to how long men should take to climax during sexual intercourse:

• More than one fifth (22%) of respondents thought that the average time was over ten minutes,³ whereas clinical studies indicate that in a ‘normal’ population (i.e. men not experiencing premature ejaculation) it is actually approx. five and a half minutes

Sex of the Nations data reveals that this unrealistic expectation of sex impacts perceptions of satisfaction:

• England is the least satisfied nation, with only 54% of respondents satisfied with their sexual performance (vs. approx. 60% in Wales and Scotland)³
• Across all nations, over one fifth (22%) of respondents wanted sex to last longer³

“Sexual wellbeing is central to health and happiness – there is a strong link between having a positive evaluation of your sexual life and your overall health and feelings of happiness,” explains Martin Tod, Chief Executive of the Men’s Health Forum. “Initiatives such as the Sex of the Nations and Firing Too Quickly are welcomed as they will help break the taboo associated with sexual dysfunction – help is available from your GP and there is no need to suffer in silence.”

Despite sexual dysfunction being relatively common, Sex of the Nations survey results indicate that only 13% have ever spoken to a GP about their (or their partner’s) sexual wellbeing, with England, Scotland and Wales being the least likely to discuss sex with their doctor.³

“We are delighted to launch Firing Too Quickly and hope to support men (and their partner’s) in the management of premature ejaculation – a high impact condition which can lead to feelings of frustration and disappointment, and may negatively impact men and their partner’s quality of life,” commented Marco Bernocchi, General Manager, A. Menarini Farmaceutica Internazionale SRL. “We are committed to providing healthcare solutions to enhance the lives of patients worldwide, and will continue to support healthcare professionals and patients in the field of men’s sexual health in the immediate future.”

For further information please visit www.firingtooquickly.co.uk

PatientTalk interviewed Dr Hilary Jones & Prof Geoff Hackett about the campaign.

PATIENTTALK  What is premature ejaculation and how does it differ from erectile dysfunction?

JONES Well it is something that is characterised by uncontrolled ejaculation with minimal sexual stimulation so for many people that would mean not being satisfied with the length of time that intercourse takes. Put very simply we can define the average length of time that a man will last during sex will be about five and a half minutes and anything below one to two minutes could be called premature ejaculation but what is really important is whether the individual or the couple having sex are distressed by the length of time of the intercourse. If it is too short and they are feeling that they would like it to last longer, then by definition that is premature ejaculation.

PATIENTTALK Are these common medical conditions? How prevalent are they? What proportions of the population suffer from this?

HACKETT Well premature ejaculation affects about 20% of the male population and the interesting thing about it is that it is spread equally across all the age groups whereas erectile dysfunction which is stated to be one in ten but it is actually more like 30% once you get above the age of fifty, is definitely age related and it is related to the medical conditions that men get as they age; things like diabetes, high blood pressure, high cholesterol which fur up the arteries and mean you can’t actually get enough blood into the area in order to get an erection.

PATIENTTALK How can it be treated? What sort of success rates are we looking at?

HACKETT With premature ejaculation you have got to divide the patient into either lifelong or acquired and the patients who have had the problem all their life from the very first sexual relationship – they can be very difficult to treat. Whereas those who have an acquired problem where everything was fine and then they’ve suddenly become much quicker in their ejaculation – they are much easier to treat and they can usually be helped with psycho-sexual therapies with various techniques such as stop-start and squeeze. Learning how to recognise the point at which ejaculation becomes inevitable and learn how to control and put off that point through practicing some exercises and working on it as a couple. In terms of the life long ones where often as Hilary said these men find it difficult to actually form relationships in the first place then often those need some form of medication as well as the sex therapy input.

PATIENTTALK  Would you say these are personal issues as oppose to medical ones?

JONES They are both. They certainly affect people’s private lives to a huge degree but they can be very distressing, very frustrating, they can cause ongoing anxiety sometimes depression. They can ruin relationships. So yes there is a very significant personal element to it and there is a medical explanation in most cases that can be addressed and treated effectively. There are sympathetic doctors, nurses, counsellors, neurologists, psycho-sexual counsellors out there who can help and we have medicines today which are more effective than they have ever been and various different approaches that we can tailor to the individual so it is important that people are aware that they’re not alone, that there is help and there is an extremely good initiative currently being put out there in the public arena called the Firing Too Quickly campaign. And on the website which is www.firingtooquickly.co.uk people can get all the information, advice and support about this particular issue – premature ejaculation – and I think they would be very reassured to know that there is help there.

PATIENTTALK And why do you think there is such stigma attached to sexual health issues?

JONES In our society where people talk about nothing else these days and everyone is lead to expect the most fabulous sex almost all of the time, of course people are often going to be disappointed that they’re not this Lothario who can make a personal best every single time. So I think that there are plenty of people who feel dissatisfied, who feel lacking in self-confidence and people still find it embarrassing to talk to their doctor about anything below the waist, particularly men. You can talk about something courageous and brave you do on the football pitch or a terrible war wound or injury but to talk about your manliness or virility, many men find difficult and that’s a shame because if only we could have the same mature grown up approach that women have had to their sexual health in recent years, men would be a lot happier.

PATIENTTALK Can you tell us a bit more about the survey in terms of the methodology and the results?

HACKETT Well the survey was an internet survey looking at men across all ages in the six countries involved in the Six Nations rugby tournament which is just about to start. And this was done as part of the campaign because what we have realised in terms of other initiatives in the past is that there is no point in leaving leaflets around in libraries or in doctors surgeries for men because those are places they just don’t go, you have to get into sporting events, pubs and clubs, places that the men actually go. So this survey contrasted the Six Nations and the most striking thing of course was what was we all knew that the Italians are the best performers and they have the highest expectations and seemingly, although it was self-reported, the highest achievement followed by the French. So this is a predictor about how the Six Nations is going – it’s going to be Italy and France going for the grand slam and the other four competing for the wooden spoon. But the other argument is that probably the Italians and the French will be worn out by the time they get on the rugby pitch and we might pick up the trophy. It has also shown some differences around the country that in certain parts of the country men are more likely to go and see a doctor and that men in the south might be a little bit more reserved than in the north where people just speak a lot more to each other for a start. But one of the things that really struck me is that where I am in the West Midlands and the Birmingham area, we have the part of the country where men were most likely to be satisfied with their sex lives so I was able to sit back and put my chest out that it might be all the result of what I am doing in my clinic.

PATIENTTALK What does the BSSM actually do?

HACKETT The BSSM is the British Society for Sexual Medicine and it is linked to the European Society and the International Societies, and basically it is a professional organisation for doctors with an interest in sexual medicine which is different from sexual health because sexual health in the UK is all about contraception, unplanned pregnancy and sexually transmitted infections whereas sexual medicine is about sexual disorders or dysfunction so it is about E.D, premature ejaculation, lack of sexual desire, orgasm problems. It is all about the medical conditions that are associated with these conditions.

PATIENTTALK Where should people go for advice and more information on sexual matters?

JONES Well if they’d like to go anonymously to the website at www.firingtooquickly.co.uk they will get a great deal of information and support and advice about where they can get treatment and what kind of treatments exist. They can also get details of this survey which we have both found very interesting, indeed fascinating. So that’s one source, but of course you can always go to your GP, you can go to a counsellor, you can be referred on to a specialist such as Geoff, you can go to a sexual health clinic. There are many sources of help and advice.

Premature ejaculation

The definition of premature ejaculation varies but the condition is characterised by uncontrolled ejaculation which occurs with minimal sexual stimulation. Premature ejaculation can be defined as ejaculating before or during sexual intercourse to the detriment of you or your partner and can have a significant impact on relationships.⁵

 

The condition can also be defined using the intra-vaginal ejaculation latency time (IELT), which measures the time taken to climax upon penetration; an IELT of less than one to two minutes characterises premature ejaculation.⁴ This compares to a median IELT of almost five and a half minutes in the ‘normal’ population (i.e. men not experiencing premature ejaculation).⁶

 

Premature ejaculation is the most common male sexual dysfunction,² with more than one in five men affected,¹ and is more common than erectile dysfunction.⁷ Premature ejaculation is not dependent on age and is consistent across all age groups.⁷

 

The exact cause of premature ejaculation is unknown. Like other physical conditions, there may be a psychological component.² Premature ejaculation also involves a physical component centred around neurotransmission and experts believe it is caused by a chemical imbalance of serotonin in the body.¹

 

In everyday clinical practice, using a self-estimated IELT is sufficient (rather than stopwatch measured as in clinical trials), although there are also several questionnaires that have been developed in order for healthcare professionals to assess premature ejaculation objectively. A physical examination is also part of the initial assessment of men with premature ejaculation in order to assess the vascular, endocrine and neurological systems to identify any underlying medical conditions that are associated with premature ejaculation or other sexual dysfunctions.⁴

 

Sex of the Nations survey

Menarini commissioned an online survey of 6,041 adults (mix of male and female) aged 18 years and over from England, Scotland, Wales, Ireland, France and Italy, to investigate differences in sexual attitudes across the home nations. The research was conducted by Opinion Matters, an independent market research company, between 15/11/2013 and 03/12/2013.

Menarini Group

Menarini is an international pharmaceutical company which, with a 2011 consolidated worldwide turnover of more than 3 billion Euro, ranks 17th in Europe and 34th world-wide.

 

References

1. Pryor, The Lancet 2006; 385: 929-937
2. Hellstrom, International Journal of Clinical Practice 2011; 65: 16-25
3. Sex of the Nations survey, December 2013,
4. Wespes, Guidelines on Male Sexual Dysfunction: Erectile Dysfunction and Premature Ejaculation. Update March 2009
5. Mohee, Therapeutic Advances Urology 2011; 3: 211-222
6. Waldinger, Journal of Sexual Medicine 2005; 2: 492-497
7. Hatzimouratidis, European Urology 2010; 57: 804-814