Premature Ejaculation - An Overview

When a male is stimulated in a sexual manner, a signal travels from the brain to the genital area via nerves through the spinal cord. The signal is responsible for making the pelvic muscles contract rhythmically, which is how sperm is transported from the testes to the vas deferens. Extra fluid is added by the seminal vesicles and the prostate gland to protect the sperm.

The mixture of sperm and this extra fluid is called semen. The semen travels from the urethra to the tip of the penis where it is expelled. The act of the male expelling semen during sexual intercourse is known as ejaculation. The time taken from initiating sexual contact until the point of orgasm is known as the ejaculatory latency.

If the male is unable to control the urge to ejaculate and finds his release before he and his partner are ready for it to happen, it is termed as premature ejaculation. The World Health Organization termed the condition early ejaculation. With 75% of the male population reporting it, premature ejaculation is the most commonly seen male sexual problem, and it is also considered the most stressful.

Types of Premature Ejaculation

Lifelong (Primary)

In this case, the male has had the problem of premature ejaculation since first attaining sexual maturity. He has not had control over ejaculation during any incident of sexual intercourse he has ever undertaken. The condition may most likely be caused by some chemical imbalance in the brain center and will remain until treated.

Acquired (Secondary)

Here the male had been functionally normally in his sexual encounters in the past before a form of disruption, due to which he now suffers from premature ejaculation. It is usually caused by a psychological issue and this male may also suffer from erectile dysfunction.

What Causes Premature Ejaculation?

Both physical and psychological factors can cause premature ejaculation. Should the condition be affect the life of the male and his significant relationships, it is advisable to get a healthcare provider to rule out any physical health issues.

The condition can be caused by prostate problems, thyroid problems, the use of certain medication, and other health issues like obesity, high blood pressure, and addictions. In some cases, this can result when the male is just very sensitive. Diagnostic tests allow the healthcare provider to determine the precise problem so that treatment can be recommended accordingly.

In case the reasons are psychological, such as depression, stress, performance anxiety, a strict upbringing, childhood abuse, or fear related to forging or maintaining relationships, therapy will be required.

Treating Premature Ejaculation

The diagnosis of the condition is made after a physical examination. The healthcare practitioner may suggest blood or urine tests in order to exclude underlying medical issues as responsible. Should a physical condition be found responsible for the disorder, appropriate medication will be prescribed.

For psychological issues, a combination of sexual counselling and learning some techniques to handle the physical ejaculation will be considered. The counselling allows the male to overcome the feeling of shame and guilt that may be resulting in the disorder.

Such feelings often stem from a strict upbringing wherein anything related to sex is considered taboo and not openly discussed. If the male has been caught masturbating when young, and made to feel unclean and guilty, this early sexual conditioning can result in performance anxiety as an adult.

Should the male have undergone sexual trauma as a victim of child abuse, there may be a feeling of loathing with respect to the sexual act. The negative emotions associated with the traumatic childhood sexual experiences need to be addressed so that the adult can have a normal sexual relationship. Speaking with a professional can help the male overcome the trauma more easily. A partner’s support can go a long way in helping the patient.

If the problem lies with hypersensitivity of the penis, there are physical techniques taught to the male to help avoid premature ejaculation. It has been suggested that the male masturbate a couple of hours before sex with a partner, or use of a thick condom to reduce the sensitivity. Focus on breathing deeply to control the ejaculatory reflex and thinking of something that does not increase the sexual excitement, may be effective strategies.

If the partner is willing to help, there are two popular behavioural therapy methods called the “stop and start” and “squeeze” which can help the male control the urge to ejaculate prematurely. In the stop and start method, the partner stimulates the penis until the male is ready to ejaculate and then stops the stimulation. This is repeated three times and the fourth time the male is allowed to ejaculate.

In the squeeze method, the partner again does the same as before by stimulating the penis, but as the male nears climax, the partner squeezes the penis firmly until the erection begins to fade. This teaches the male to distinguish between the different sensations that lead to ejaculation, giving the male better control over his body’s reflexes, eventually allowing him to control his own climax.

Reviewed by Afsaneh Khetrapal BSc (Hons)

References

Further Reading

Last Updated: Jan 17, 2017

Comments

  1. Joe Crawford Joe Crawford United States says:

    Very good article! In doing some recent research on PE and effective treatments, I came across this PE IRB clinical survey. It appears that Promescent, a topical OTC spray manufactured in the USA is effective in delaying the time to ejaculation and increasing the odds of both partners having an orgasm.

    www.nature.com/.../ijir201631a.html

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