• November 6, 2019 by admin

    What is premature ejaculation?

    As the most common sexual dysfunctional condition befalling men, a lot of interest surrounds premature ejaculation (PE). Nevertheless, there isn’t a single encompassing definition to describe the condition.

    Scientists have carried out various studies to examine the condition and come up with definitions that try to do justice to the condition. However, these definitions are varied as can be seen with the different criteria laid out by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, International Society of Sexual Medicine, European Association of Urology and the American Urological Association.

    All the same, this boils down to one fact. Premature ejaculation is a condition when you reach climax during a sexual act faster than you would like to. This causes some personal distress like a bruised ego and a feeling of diminished masculinity.

    How exactly does normal ejaculation occur?

    Ejaculation is under the control of the autonomic nervous system, meaning that you have no conscious control over it. According to Alwaal, Breyer and Lue (2015, pp. 1051-1060), ejaculation occurs in two phases – emission and expulsion.1 Here is a closer look at the mechanism of ejaculation.

    • Emission stage: During this stage, the sphincter around the bladder closes so that the seminal fluid doesn’t flow back into it. Following this closure, the prostate gland secretes a nutrient-rich fluid into which the sperms from the vasa deferentia mix. Down the urethra, the seminal vesicle adds its seminal fluid. Further sexual stimulation triggers the expulsion of the semen.
    • Expulsion: At the peak of stimulation – also known as orgasm – the muscles around the pelvis contract, forcing the semen out of the uterus. During all this, the bladder remains closed so that there’s no retrograde flow of semen into.

    Premature ejaculation: What are the signs and symptoms?

    Despite the lack of a medical consensus on the exact clinical definition of premature ejaculation, there are some signs and symptoms that point to potential PE.2 

    Usually, a man can have an orgasm and ejaculate before he wants to. This is normal if it is an infrequent occurrence. However, if this occurs frequently, one might have to get checked out for PE.

    Here are some of the symptoms and conditions that point to premature ejaculation:

    • ejaculation during foreplay or before vaginal penetration is completed
    • ejaculation within one minute of penetrating the vagina since one’s first act of intercourse
    • significant reduction in the intravaginal ejaculation latency time to about 3 minutes or less
    • unable to stop or delay ejaculations whenever there is vaginal penetration

    If any of these holds, there’s bound to be some psychological implications on the man, including:

    • frustration
    • bruised ego
    • avoidance of sexual encounters
    • personal distress

    What are the causes of premature ejaculation?

    Many of the causes of premature ejaculation have been attributed to mental and psychological factors associated with anxiety. However, there are other causes that are biogenic.3

    Anxiety-related causes

    These causes of PE include:

    • Performance anxiety
    • Being very arousable
    • Limited sexual experience
    • Worrying about the PE itself
    • Lack of knowledge about the techniques that can prolong intercourse

    Biogenic causes

    Some of the causes of premature ejaculation are physical, pointing to problems with the body. These include:

    • Having high penile sensitivity, where the penis is very responsive to stimulation
    • Erectile dysfunction makes one eager to orgasm before the penis becomes flaccid
    • Abusing drugs like amphetamines, cocaine, alcohol and opiates
    • Sometimes the cause is genetic, like the variations in the 5-HTTLPR gene
    • Prostatitis, a condition where the prostate gland is swollen
    • Diseases of the nervous system like multiple sclerosis

    What can you do about premature ejaculation?

    If you believe you have PE, there are some methods that may help you last longer. For example, you can masturbate an hour so before having intercourse.

    The Masters and Johnson method entails stimulating the penis and then squeezing the glans when orgasm is near. Once the climax abates, your partner should stimulate again and squeeze just before orgasm. After a few times, one can have more control over their orgasms.

    Kegel exercises have also been suggested as a way of managing PE. These kinds of exercise train the pelvic muscles, enabling you to have more control over them.

    Condoms and some creams are known to decrease the sensitivity of the penis, helping you to last longer once you penetrate the vagina. Doctors can also prescribe medication as they see fit to help with premature ejaculation.

    References

    1. Alwaal A, Breyer BN, Lue TF. Normal male sexual function: emphasis on orgasm and ejaculation. Fertil Steril. 2015;104(5):1051–1060. doi:10.1016/j.fertnstert.2015.08.033
    2. Althof SE, McMahon CG, Waldinger MD, et al. An Update of the International Society of Sexual Medicine’s Guidelines for the Diagnosis and Treatment of Premature Ejaculation (PE). Sex Med. 2014;2(2):60–90. doi:10.1002/sm2.28
    3. El-Hamd MA, Saleh R, Majzoub A. Premature ejaculation: an update on definition and pathophysiology. Asian J Androl. 2019;21(5):425–432. doi:10.4103/aja.aja_122_18

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