Of the 2 major normally reported cases of male sexual dysfunction, erectile dysfunction accounts for about 100% whereas premature ejaculation is reported to account for some eighty percent. Some statistics indicate that one in 3 men suffer from premature ejaculation indicating a prevalence rate of between 27 percent and thirty four percent in men of all ages.
According to The American psychiatric Association, premature ejaculation is defined as the “persistent or recurrent ejaculation with minimum sexual stimulation before, on or shortly after penetration and before the person wishes it…” simply stated, PE is a condition where a man frequently ejaculates earlier than he or his partner wishes to either before, on or shortly after copulating with his partner. Premature ejaculation is also known as rapid ejaculation.
Premature ejaculation causes marked distress or interpersonal difficulty for a man and his partner as it allows neither partner to enjoy the sexual act in a proper manner. The man feels discontent due to the inability to hold out the pleasurable sensations of sexual contact for an extended period of time whereas his partner is equally discontented for not being unable to reach her sexual peak.
It is also common for men that are experiencing premature ejaculation to question their masculinity and lose confidence in their sexual performance. They might feel misunderstood as to the extent of frustration and humiliation they regularly experience while a partner may suffer in silence for worry of upsetting their man more or become frustrated at their partner’s apparent unwillingness to mend the matter.
However, several men occasionally experience premature ejaculation throughout sexual intercourse, but as long as it does not happen frequently, there is no cause for the man to worry. The time period that qualifies for P.E has, however, become an extremely debatable topic thanks to the fact that men ejaculate at completely different times during different sexual encounters. Scientists and researchers currently define premature ejaculation as a condition in which the person achieves sexual climax in about a hundred and twenty seconds or two minutes after vaginal penetration. Others specify the number of penile thrusts, considering less than eight to fifteen thrusts before ejaculation to be premature. With that said, if this should occur on a more regular basis, then he could also be suffering from PE.
Causes of Premature Ejaculation (PE)
The causes of premature ejaculation are still unknown. There were earlier beliefs that premature ejaculation was as a result of psychological problems instead of biological causes. However, there are new indications that the causes of premature ejaculation are more sophisticated, and involve a complex interaction of both psychological and biological factors.
There are basically 2 types of PE that are the primary and secondary types. Primary premature ejaculation may be a condition where the person has been suffering from premature ejaculation throughout his entire sexual life. On the other hand, secondary premature ejaculation is where the man develops premature ejaculation later in life due to one or several possible causes. The majority of men affected by premature ejaculation fall under the secondary category.
Ejaculation is a reflex action that’s triggered when a certain level of stimulation is earned. Therefore the power to manage this reflex action depends totally on the capability of the person to recognise and regulate the amount of stimulation he’s receiving so that he doesn’t reach the point of triggering off his ejaculatory reflexes before he needs to.
Premature ejaculation will have both psychological and biological causes as hereinafter listed.
Some of the psychological causes of premature ejaculation include the following:
Early Sexual Experiences
Though PE is a drawback that occurs in men of all ages, younger men are more at risk of suffering from this disorder. A reason for this may be as a results of established patterns of events that occurred in their earlier sexual experiences. A lot of 1st experiences of sexual intercourse often involve excitement mixed anxiety and a demand to perform quickly to avoid being caught.
In such 1st experiences, performance – the need to “get it right”, is commonly the focus instead of the pleasurable and erotic aspect of the experience. As a result, a decent percentage of young men reach climax too quickly. This may be considered a problem by such young men, and next time there might be fear of a repeat which will increase the probabilities of a premature ejaculation happening and thus a pattern is formed. This would possibly continue well into adulthood if not treatment is undertaken.
Anxiety and Stress
Anxiety associated with a man’s sexual performance or caused by alternative problems can even be a cause for premature ejaculation. When sex is linked with performance instead of with pleasure, developing ejaculatory control would possibly become a tough proposition. It is therefore better for a person to concentrate on what will bring pleasure to him and his partner.
Erectile Dysfunction Fears
Men suffering from erectile dysfunction may also develop premature ejaculation as they will be anxious of obtaining and maintaining an erection throughout sexual intercourse and therefore rushing to ejaculate quickly. Once a pattern of speeding to ejaculate is formed, it may become tough changing it.
The biological factors which will contribute to premature ejaculation include the following: –
1. Abnormal hormone levels
2. Insufficient concentration of the neurotransmitter serotonin
3. Abnormal reflex activity of the ejaculatory system
4. Certain thyroid problems
5. Inflammation and infection of the prostate or urethra
6. Inherited traits
Treatment of premature ejaculation
Despite the very fact that premature ejaculation exists as a clinical diagnosis, it can’t be classified as a disease or an ill health.
Irrespectively of whether the cause is psychological or biological, treatments for premature ejaculation include behavioural therapy, psychological counselling, and medications. There may also be a mix of any of these methods of treatment.
Behavioural therapy helps about an hour to 90th of men with premature ejaculation. In general, practice and relaxation can help in addressing the matter. However it ought to be noted that premature ejaculation usually returns and additional behavioural therapy could also be required.
Below are some examples of behavioral therapy methods that can be used for the treatment of premature ejaculation.
The “Squeeze” Technique
This methodology was developed by Masters and Johnson some decades ago. If a person senses that he’s on the brink of ejaculate, he simply withdraws from his partner, then him or his partner squeezes the shaft of his penis between a thumb and two fingers. The squeeze ought to be lightweight and for about twenty seconds, then let go and resume sexual intercourse. The technique is repeated as often as necessary throughout intercourse. With practice, a man can gain good control over ejaculation without the squeeze.
The “Stop and Start” Method
This second method which was developed by Dr. Helen Kaplan helps men with premature ejaculation to recognize when they are about to climax and then to slow down or reduce stimulation in order to extend the time until ejaculation. By starting and stopping sexual stimulation you’ll be able to learn to prolong the sexual activity.
Abstaining from Intercourse
Couples could also be taught to avoid sexual relations for a period of time to assist reduce anxiety. This is beneficial as while avoiding intercourse they can spend time to specialise in different types of sexual plays that eliminate pressure from the sexual encounters. This can help the person to connect and re-establish a satisfying physical bond with his partner.
By engaging in more arousal, couples can help each other achieve a state of high arousal by stimulating each other through kissing, cuddling, hugging, petting, stimulating the breasts, genitals, and other erogenous zones before copulating. This way, ejaculation and sexual climax are often achieved almost at the same time by the couples.
In some cases, behavioural therapy may involve simple steps such as masturbating an hour or two before intercourse to help in the delay of ejaculation or stimulation of the partner to a state of arousal before copulating. Also since an ejaculation has already occurred, the man will now take a longer time to ejaculate when having sex with his partner.
Routine Kegel Exercises
Researchers have noted that some men who are suffering from premature ejaculation have a quicker neurological response within the pelvic muscles. Men with premature ejaculation caused by neurologic factors will undertake certain exercises like Kegel to assist them gain voluntary control over the pelvic muscle and thus offer them a lot of control over ejaculation. The added benefit of this is that it can also give men stronger erections and can therefore help to alleviate erectile dysfunction.
Counselling or Psychotherapy
This can help patients and their partners resolve conflicts and personal problems which may include anxiety, stress and resentment that can be contributing to premature ejaculation. In most cases this is often more effective when couples attend sessions together.
Current approaches to psychotherapy permits men amongst other things to learn techniques to control and/or delay ejaculation, increase confidence in sexual performance, reduce performance anxiety, modify rigid sexual patterns, overcome intimacy problems, resolve feelings and thoughts that interfere with sexual functions and to increase communication between him and his partner.
There are 2 categories of medicines that may be utilized in the treatment of premature ejaculation and these include the use of (a) certain antidepressants and (b) local anesthetic creams.
The 1990s ushered in a new era in the treatment of premature ejaculation as physicians discovered certain antidepressant medication that had a side effect of delaying ejaculation. This type of medication can be useful as they have a typical side effect of prolonging the time it takes to achieve sexual climax. However, antidepressants aren’t approved by the Food and Drug Administration (FDA) to treat premature ejaculation. Nonetheless, studies have shown that they’re safe and effective. These