Premature Ejaculation (PE) : Causes And Treatments

How do I control myself? How can I last longer, be firmer and do better? These are some of the questions men with premature ejaculation asks themselves every day.

Premature ejaculation or PE is most common sexual problem faced by many males. In simple terms it means any ejaculation which happens sooner than desired. If it happens once in a while, then one need not to be worried but if it’s frequent, then it can cause tension between a man and his partner.

Recently a new definition of premature ejaculation was presented by the International Society for Sexual Medicine panel of experts at the American Urological Association's annual meeting.

The panel said, PE should be defined as "a male dysfunction characterized by ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration; and, inability to delay ejaculation on all or nearly all vaginal penetrations; and, negative personal consequences, such as distress, bother, frustration and or the avoidance of sexual intimacy."

According to the health experts one in every three males is affected by this problem. Some men ejaculate right before penetration while some others ejaculate soon after penetration or as soon as foreplay begins. It varies from person to person -- the good news is that the problem can be treated but many a times, men feel embarrassed to talk to their health care provider or GP about it or seek treatment including psychological counseling, medications and learning sexual techniques to delay ejaculation can improve your sexual life.

One cause for the premature ejaculation is anxiety; many times men are worried about their performance in bed or stress at office or home, takes its toll in bed in the form of premature ejaculation. Some biological causes also lead to this problem.

Classification:

The GP after asking ones sexual history, will classify premature ejaculation as either primary or secondary:

• Primary premature ejaculation (Lifelong ) – A man will fall in this category if he has never had a control over his ejaculation from the time he has become sexually active or the doctor is unlikely to diagnose an underlying cause for the problem.

• Secondary premature ejaculation (Acquired) – If a man was able to control his ejaculation previously and had a satisfying sexual life without any problems. It is also most commonly associated with erectile dysfunction.

Causes:

Though, earlier experts thought the causes to be just psychological in nature, now they know it is due to complex interaction of biological and psychological factors such as:

Psychological causes

^ Stress (office or home)
^ Guilty feelings
^ Fear
^ Anger
^ Rushing around
^ Feeling anxious about rejection
^ Negative sexual experiences in childhood
^ Taboos or beliefs about sex

Few other factors which can cause premature ejaculation are:

• Anxiety -- Many times anxiety has been blamed for the problem of premature ejaculation for example a man worrying too much about his performance in bed or caused by other issues such at stress at home or work.

• Erectile dysfunction -- Erectile Dysfunction also known as ED or impotence is the inability to achieve or maintain an erection that is firm enough for a man to have sexual intercourse.

Biological causes

There are various biological factors which can play a major role in developing premature ejaculation such as few thyroid problems, infection of the prostrate, unusual hormone levels, change in the brain chemicals level (neurotransmitters), abnormal reflex activity of the ejaculatory system and inherited traits.

Treatments:

Don’t be shy to talk to your doctor or sex therapist about the problem. He may suggest you different treatments and see which one suits you best.

1. Squeeze technique: Be open with your partner and talk to her about the technique beforehand. While having sex when you think you are at the point of coming, ask your partner to gently squeeze the head of your organ. This will help in delaying the urge to ejaculate. A little practice will help get the right pressure.

2. Kegel exercises: These are the exercises of pubococcygeus muscles (PC) muscles. A man can do these exercises anytime and anywhere and no one will even know about it. To identify the muscles of your pelvic floor stop your flow of urine next time you go to the bathroom. Contract the muscles tightly holding for 10 seconds. Do this thrice a day repeating 10 times. The PC muscles control the urine and semen and firmness of your organ during erection, so keeping them strong means good sexual life.

3. Sexual therapy: A male is sometimes asked to masturbate an hour or two before having sex because a second erection afterwards usually lasts longer. The therapist also recommends feeling and touching other parts of the body during sexual act avoiding intercourse in order to remove pressure from your sexual encounters.

4. Simple change in the sexual position which is less stimulating may also help.

5. Medication: Your doctor may give you different doses of medication to see which one works best for you. He may pick up certain antidepressants and topical anesthetic creams, which helps in treating premature ejaculation.

Many antidepressants cause delayed orgasm and hence doctors use these medications to get the side effect. How clever! SSRIs (selective serotonin reuptake inhibitor) such as sertraline (Zoloft), paroxetine (Paxil) or fluoxetine (Prozac) are adviced by doctors for the problem.

Prevention:

It has been seen that many cases of premature ejaculation were caused by poor communication skills between a man and his partner or simply due to ignorance of the differences between male and female sexual functioning.

Talking about the issue openly with the partner and ready to try a variety of approaches to help both man and woman achieve satisfaction can aid in reducing the performance anxiety. If you still face problem, talk to your doctor about getting a referral to a sexual health therapist for further advice.