Premature Ejaculation Guide

Premature ejaculation (PE) can be a distressing disorder whereby a man experiences a loss of control and ejaculates too early during intercourse.  No precise definition exists regarding the duration of intercourse a man is able to achieve before ejaculation in order to be diagnosed with PE, as the length couples deem to be acceptable varies widely.  One study revealed that some men feel they are suffering from PE even when they are able to last up to 25 minutes.  Yet for most men plagued with the condition to enjoy intercourse a much shorter time than this would be satisfactory for both them and their partner.  Consequently this highlights the significant variability between different peoples opinion of what is normal.  Hence a broad and more suitable definition would be to suggest that if either partner is dissatisfied with the time taken to reach orgasm then the presence of PE at least to some extent is indicated.

The most basic parameter used to diagnose PE is a mans intravaginal ejaculation latency time (IELT), that is the time between first entering the vagina and the subsequent start of intravaginal ejaculation.  A cohort of men who described themselves as suffering from PE and a group who said they didn’t have the problem were provided with stopwatches to time their IELT during intercourse.  The average time of intercourse before ejaculation in men with PE was 1.8 minutes compared with an IELT of 7.3 minutes in men without the disorder.  Contrary to these figures, a man may still feel he has PE even if he lasts much longer than the 1.8 minute average of those with PE.  This, in part, will be the case if your partner takes longer to reach orgasm than yourself.  However if your current IELT is above the currently suggested time of less than 2 minutes for diagnosis, you could still be said to be suffering from mild PE but may not need to visit a doctor.  For example, say you currently climax after around 5 minutes but would like to last for 10, the behavioural methods you can learn will most likely be all you need and you should require no further medical intervention.

Although PE is only rarely caused by a medical condition, other possible factors must be ruled out before a diagnosis of PE can be made.  For instance, the onset of PE may have come about as a result of erectile dysfunction (an inability to either maintain or achieve an erection).  Merely treating the PE alone is not enough.  Occasionally, a man may be experiencing PE due to inflammation of the prostate gland (prostatitis).  Chronic prostatis is a relatively common condition which can be triggered by a number of different factors such as infection, trauma, surgical instrument and emotional factors including stress and depression.  In addition, PE may be misdiagnosed where in actual fact the issue lies with the female partner who is experiencing a delayed orgasm.  It is therefore beneficial to involve your partner in discussing matters to reach a conclusion on what is acceptable for both parties.  If psychotropic drugs are involved then further intervention, medical or otherwise may be required.

There are two types of PE which are distinguished by the time of onset.  Primary PE is present from the onset of puberty when individuals have become sexually functional whereas Secondary PE begins anytime later in a man’s life where a previously acceptable degree of ejaculatory control was observed.  Furthermore, in addition to these divisions the condition can also be characterised as either Global or Situational PE.  Global PE frequently happens under any circumstance regardless of partner or situation.  Situational PE on the other hand, occurs only with specific partners or particular situations.

PE is a relatively common problem with at least 1 in 10 men frequently suffering from the condition.  Unfortunately, only approximately 10% of these people seek and receive any treatment.  Reassurance may be sought with the knowledge that most men claim to have experienced PE at some point during their lives.  It is important not to panic if this is the first time it has happened to you as worrying about ejaculating prematurely can lead to performance anxiety and this only serves to make the problem worse.  Approaches recommended for the treatment of PE by sex therapists often incorporate techniques to prevent or delay ejaculation.  With practise, application of these methods can significantly improve the duration of intercourse before ejaculation.  Such therapeutic treatment options include the Masters and Johnson technique, stimulation to climax prior to sex and desensitising creams.

Certain medications have also been used to successfully combat PE; namely selective serotonin reuptake inhibitors (SSRIs).  Although generally thought of as antidepressants, SSRIs are also used in treating some anxiety disorders.  The occurrence of PE may relate to this, such as with performance anxiety.  Serotonin is an important chemical compound thought to be involved in producing positive feelings of well being and happiness.  SSRIs act to block the reuptake of serotonin after its release in the synapse.  This benefits the patient because serotonin remains in the gap between synapses (synaptic cleft) for longer, providing a greater chance that the compound will stimulate the receptors of the recipient cell more than once, therefore increasing its effect.  However drug therapy should be viewed as a last resort after other treatments have failed, as the compounds effects eventually weaken with long term use.  Moreover, as with all medications used to treat any health condition there may be side effects present.

The prognosis for men attempting treatment is usually good.  Even more positively, you may find that you need very little or no treatment at all and that the situation improves when stress and other worries are alleviated from your life.

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