Premature ejaculation (PE) is a type of sexual dysfunction that occurs when a man has an orgasm and releases (ejaculates) semen sooner than he or his partner would like. It often happens before or shortly after penetration during intercourse. Premature ejaculation can be a frustrating experience for both you and your sexual partner and makes your sex lives less enjoyable. However, the good news is that it can be treated.
Between 30% and 40% of men experience premature ejaculation at some point in their life.
Premature ejaculation(PE) can be classified as:
• Lifelong (primary)
Lifelong premature ejaculation occurs all or nearly all of the time beginning with your first sexual encounters.
• Acquired (secondary)
Acquired premature ejaculation develops after you’ve had previous sexual experiences without ejaculatory problems.
The only symptom of premature ejaculation is the condition itself.
If pressed for a time frame, many doctors would define prematurity as ejaculation within a minute of beginning intercourse. However, the problem might occur in all sexual situations, even during masturbation.
is defined by the presence of the following three features:
• Ejaculation always, or nearly always, happens before sexual penetration has been achieved, or within about a minute of penetration.
• There is an inability to delay ejaculation every time, or nearly every time, penetration occurs.
• Negative personal consequences arise, such as distress and frustration, or avoidance of sexual intimacy.
Secondary symptoms include:
• decreased confidence in the relationship
• interpersonal difficulty
• mental distress
▪︎ Psychological factors
Most cases of PE are not related to any disease and are instead due to psychological factors, including –
• sexual inexperience
• issues with body image
• novelty of a relationship
• overexcitement or too much stimulation
• relationship stress
• feelings of guilt or inadequacy
• issues related to control and intimacy
These common psychological factors can affect men who have previously had normal ejaculation. These cases are often called secondary, or acquired, PE.
The condition can often be traced back to early trauma, such as:
• strict sexual teaching and upbringing
• traumatic experiences of sex
• conditioning, for example, when a teenager learns to ejaculate quickly to avoid being found masturbating
▪︎ Medical causes
More rarely, there may be a biological cause.
The following are possible medical causes of PE:
• multiple sclerosis
• prostrate disease
• thyroid disease
• illicit drug use
• excessive alcohol consumption
Risk Factors –
Various factors can increase your risk of premature ejaculation, including:
• Erectile dysfunction.
You might be at increased risk of premature ejaculation if you occasionally or consistently have trouble getting or maintaining an erection. Fear of losing your erection might cause you to consciously or unconsciously hurry through sexual encounters.
Emotional or mental strain in any area of your life can play a role in premature ejaculation, limiting your ability to relax and focus during sexual encounters.
Premature ejaculation can cause problems in your personal life, including:
• Stress and relationship problems.
A common complication of premature ejaculation is relationship stress.
• Fertility problems.
Premature ejaculation can occasionally make fertilization difficult for couples who are trying to have a baby if ejaculation doesn’t occur intravaginally.
In most cases, there is a psychological cause, and the prognosis is good.
If the problem occurs at the beginning of a new sexual partnership, the difficulties often resolve as the relationship goes on.
If, however, the problem is more persistent, doctors may recommend counseling from a therapist specializing in sexual relationships, or “couples therapy.”
▪︎ Home Strategies
Two methods that can be helpful for men are:
• The start-and-stop method:
This aims to improve a man’s control over ejaculation. Either the man or his partner stops sexual stimulation at the point when he feels he is about to have an orgasm, and they resume once the sensation of impending orgasm has subsided.
• The squeeze method:
This is similar, but the man gently squeezes the end of his penis, or his partner does this for him, for 30 seconds before restarting stimulation.
▪︎ Pelvic floor exercises
Certain muscle exercises may also help. In particular, you may benefit from male pelvic floor exercises.
To find your pelvic floor muscles, concentrate on stopping urination in midstream or using certain muscles to keep you from passing gas. Once you understand where the muscles are, you can practice exercises known as Kegel maneuvers. You can do them standing, sitting, or lying down.
To do Kegel maneuvers:
• Tighten your pelvic floor muscles for a count of three.
• Relax them for a count of three.
• Do this several times in a row throughout the day
Work your way up to three sets of 10 repetitions each day.
When doing Kegel exercises, be careful not to use your abdominal or buttock muscles instead of your pelvic floor muscles.
▪︎ Decreased sensitivity
Decreasing the sensitivity of your penis during intercourse may also help.
Wearing a condom may decrease your sensitivity just enough to help you maintain your erection longer without ejaculating.
There are even condoms marketed for “climax control.” These condoms contain numbing medications such as benzocaine to help dull the nerve responses of your penis slightly.
Applying numbing agents directly to your penis about 15 minutes prior to intercourse may also be helpful, but discuss your options with your doctor first.
▪︎ Ejaculation Dysfunction (ED) medications
If ED is a contributing factor, talk with your doctor about ED medications, such as tadalafil (Cialis) and sildenafil (Viagra). They may help you maintain an erection, which could lead to delayed ejaculation.
These and other ED medications can sometimes take an hour to begin working. Getting the right dose may take some trial and error too, so be willing to work with your prescribing healthcare professional.
The physiology of ejaculation is under control of vatadosha. Vitiation of vata (especially apanavata) leads to PE. Ayurveda scholars compared PE with an Ayurvedic pathological entity called, Shukragata vata. Shukragatavata is a distinct pathological entity characterized by a group of clinical presentations either related with the impairment of ejaculation or with the impairment of seminal properties.
Vajikarana is the branch of Ayurveda, which deals with various types of physical, psychological, sexual problems like impotence, libido, poor erection, and early ejaculation in the males as well as sterility and frigidity in females.
The vajikarana drugs are helpful in providing strength and vigor to the person along with improvement of reproductive potentiality.
▪︎ Individual herbs
• Akarkarabh (Anacyclus pyrethrum)
▪︎ Ayurvedic formulations •
▪︎ Mineral compounds
Talking with your partner
If you experience PE, it’s important to talk about it with your partner, rather than ignore it or deny that it exists. Be calm and discuss your options.
Both of you should understand that:
• PE is usually a treatable condition.
• It’s very common.
• Exploring the causes and treatments for PE may help resolve other relationship issues or lead to treatment for anxiety, depression, or other mood disorders, as well as hormonal or other physical causes.
The key is to understand that PE can usually be resolved and that it’s only one part of a couple’s physical relationship. Being supportive and understanding of each other’s needs and concerns is the best way to approach PE or any challenge you face as a couple.
For more informative articles on other health related issues, please visit our website www.santripty.com and also feel free to consult.