What Is Premature Ejaculation?
Premature ejaculation symptoms, causes are now widely discussed due to the spread of the issue. The rapid climax is a leading male sexual health disorder in the world. Under different estimates, every third man has trouble controlling sperm ejection during sexual intercourse. Ejaculation is considered premature if it happens sooner than both partners would like. Ejaculation is also called premature if it happens before vaginal penetration or less than a minute after it. However, according to the International Classification of Diseases, ejaculation happening later than within 15 seconds of sexual intercourse is not considered premature.
1.8 minutes – the average amount of time a man suffering from premature ejaculation lasts after sexual stimulation begins.
How Does Ejaculation Work?
Ejaculation is the response of the body to the stimulation of the penis. This process is regulated by the central nervous system. During sexual intercourse, the impulses from the genitals are transitioned through the spinal cord to the specific brain areas controlling sperm release. When the male’s level of satisfaction from coitus reaches its top, the CNS sends signals to the genital organs for sperm ejection.
The process of ejaculation comprises two phases: emission and expulsion. Let’s find out more about each of them.
Phase 1: Emission
Emission is the first phase of ejaculation. At this stage, the sperm moves from the reservoir where it is stored, called ampullary, through vas deferens to the base of the penis shaft. Then, it is mixed with the seminal fluid that comes from the seminal vesicles, thus creating the semen.
Phase 2: Expulsion
The second phase, expulsion, is responsible for the semen ejection from the penis. During expulsion, the bladder neck is closed, and the muscles of the urethra start contracting to eject the semen.
Types of Premature Ejaculation
Based on when you’ve noticed the first manifestations of early ejaculation, the disease is differentiated into two types: lifelong and acquired.
Lifelong (or Primary) Premature Ejaculation
Lifelong premature ejaculation (PE) is diagnosed in about 2.5 – 3% of individuals. This health issue is characterized by the male inability to control the climax onset starting from his first sexual experience and each time he gets involved in sexual activity.
The primary reason for lifelong rapid ejaculation is thought to be heredity and the violation of the levels of neurotransmitters, which affect the speed of transitioning the signals from the genitals to the areas of the CNS responsible for ejaculation. The studies on hereditary causes say that men with a certain genotype are more prone to developing this type of ejaculation disorder than others.
Lifelong rapid ejaculation is treatable. However, this condition responds well only to medicinal treatments and is less likely to be improved by exercising or counseling.
Acquired (Secondary) Premature Ejaculation
Acquired premature ejaculation is a medical condition developing in those who have previously had no problems with ejaculation. The shortening of the intravaginal latency time in such men is explained by numerous factors, including psychological health conditions and some physical health issues that might influence the duration of sexual intercourse.
Unlike lifelong PE, which is usually incurable, acquired rapid ejaculation can be cured with the help of different medicinal, behavioral, and non-medicinal techniques. Usually, men with secondary PE respond to the treatment better than those dealing with primary premature ejaculation.
Premature Ejaculation and Erectile Dysfunction (ED)
Due to numerous studies, the interconnection between early ejaculation and impotence is a proven fact. But what connects these two types of sexual dysfunction? What is the main cause of erectile dysfunction? Let’s get down into some detail.
Both erectile dysfunction and premature ejaculation can be caused by physical and psychological health factors. The interplay between these two sexual disorders is proven by numerous clinical studies. A systematic review and meta-analysis by the Italian scientists published in the Journal of Sexual Medicine claim the presence of PE increases the risks for concomitant development of erectile dysfunction with the odds ratio of 3.68. Respectively, the likelihood of developing impotence increased with the growth of severity of premature ejaculation manifestations.
Age also plays a role in the incidence of PE and ED. The former is diagnosed in men of all ages, whereas the latter is more characteristic of individuals aged 40 and higher.
The most common causes for early ejaculation are:
- Continuous stress;
- The feeling of guilt;
- Sexual performance anxiety;
- Relationship problems;
- Hormonal imbalance;
- Imbalance of neurotransmitters;
- Hereditary factors;
- Chronic prostatitis and other prostate issues.
Also, the lifestyle of a man has a significant impact on his erectile and ejaculatory function. Alcohol abuse and smoking affect the functioning of the blood vessels and the nervous system, which results in loss of potency and the development of early ejaculation.
Serotonin has one of the leading roles in male sexual function. The mechanisms of sexual arousal, performance, and reflexes are controlled by two types of neurotransmitters – dopamine and serotonin. Dopamine enhances the processes related to sex life. It enables sexual motivation, performance, erection, and ejaculation onset. Serotonin, on the contrary, inhibits sexual activity. For this reason, men using SSRIs often develop erectile dysfunction as one of the side effects of the medication.
In individuals with early ejaculation, the activity of serotonin in the areas of the brain responsible for sperm ejection control is insufficient. This results in improper signal transitioning and early onset of ejaculation. The increase of the levels of serotonin may help suppress ejaculation and thus increase the duration of sexual intercourse. However, such a change in the levels of this neurotransmitter may negatively affect the male ability to attain and sustain a firm erection.
Psychological causes of premature ejaculation are responsible for the bulk of cases of this sexual disorder, whereas erectile dysfunction associated with mental health issues is diagnosed in only 20% of men. Anyway, the psychological causes for both sexual disorders are pretty much the same:
- Depression. A lack of interest in sexual activity leads to low libido and poor quality erections. As for the premature climax, depression doesn’t allow concentrating, thus weakening the control over sperm ejection.
- Anxiety, including sexual performance anxiety. The fear of failure during sexual intercourse increases the levels of anxiety, which negatively reflects on the male ability to get a firm erection and to have normal-duration sexual intercourse.
- Relationship problems. A lack of understanding between a man and his sexual partner may add to the development of both sexual inability and premature climax.
- Stress. When in continuous stress, the levels of cortisol in the man’s body are constantly high. This hormone is known for its suppression of sexual function, which often results in erectile dysfunction. Such psychological condition also reduces male ability to control ejaculation, leading to the development of early climax.
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The diagnosis of premature ejaculation is a task for professional doctors. Men should visit their healthcare providers once they start noticing the first signals of their ejaculation becoming premature. A doctor will likely perform several tests to determine the cause of your condition. They are:
- Health questionnaire to determine your current health complaints and know the details of your general health condition.
- A review of your medical history is useful for figuring out the possible PE triggers from your past health conditions (e.g. hormonal imbalance, prostate surgery, depression, etc.).
- Blood test for hormone levels and any inflammatory processes.
- Urine test for checking the health of your prostate gland and the genitourinary system overall.
- A test for evaluating your current mental health condition.
In case your GP won’t find any physical causes for your premature ejaculation, he/she might recommend you a consultation with a mental health specialist for a deeper and more thorough examination of your mental health.
As soon as you know the exact cause of your ejaculatory dysfunction, you may start looking for the most appropriate method of its treatment. Of course, you’d better consult a doctor who can give professional advice on what therapy can help your condition best and make you healthy with the lowest risks for unwanted reactions. The methods you may be offered are diverse and include:
- Behavioral techniques;
- Exercises for strengthening pelvic floor muscles;
- Pause-squeeze technique;
- The use of condoms;
- Intake of medicines.
The efficacy of behavioral techniques in the short term is rather high and reaches 45 – 65%. However, no results are available for the long-term perspective. Behavioral techniques may be used alone or in combination with counseling and medicinal treatments of early ejaculation. The behavioral techniques providing the best results for men with premature climax are:
- Stop-start. This one implies stopping active frictions for diminishing the rate of satisfaction from sexual intercourse when you feel you almost can’t control the upcoming ejaculation. By doing this, you’ll reduce the ejaculation impulse and learn to control this reflex. As you proceed in practicing this, you’ll gain more confidence about your ability to prevent early ejaculation and will be able to increase your intercourse duration.
- Avoidance of sex with penetration. Concentrating on the foreplay and your emotions, you’ll be able to learn to control your excitement and, consequently, ejaculation onset. This technique works well for exploring your sensitivity levels, establishing control over your body and its response to sexual stimuli.
- Masturbating in advance of sexual activity. Men can reduce their penis sensitivity and enhance the intravaginal ejaculatory latency time by self-stimulation an hour or two before the planned sex.
- Penetration with no motion following. Stimulation of the penis primarily happens due to frictions. Try to penetrate your partner but stay motionless for about two minutes or less if you can’t do longer. By regularly repeating this practice, you’ll be able to control your ejaculation reflex better.
Pelvic Floor Exercises
The strength of the pelvic floor muscles is important for healthy sexual function. Their weakness can add to the poor control over the ejaculation reflex and promote premature ejaculation. To change this state of things, men can start doing exercises for pelvic floor muscles, also knows as Kegel exercises. Although this may seem to be a waste of time for some men, the studies say that this method can significantly increase your durability in bed. In a study carried out by Italian scientists (Antonio L. Pastore, Giovanni Palleschi, Andrea Fuschi, Cristina Maggioni, Rocco Rago, Alessandro Zucchi, Elisabetta Costantini, and Antonio Carbone), 82.5% of men taking part in the experiment managed to prolong their ejaculation latency time from 39.8 s to 123.6 – 152.4 s within twelve weeks of pelvic floor muscle rehabilitation.
Here’s what you should do to start exercising:
- Find the muscles of the pelvic floor. This is very easy to do. Just try to stop urinating mid-process. The muscles you’ll feel at that moment are the ones you need.
- Start exercising. Contract the muscles, wait for three seconds and then relax them for the same time. Repeat it several times in a row. Every day, you need to do at least three sets of ten repetitions to notice any improvements.
- Concentrate on the needed group of muscles to avoid making mistakes. You can do Kegels when sitting, standing, or even walking.
The Pause-Squeeze Technique
Another way you can influence your durability in bed is by applying the pause-squeeze technique. The studies say that this method of premature ejaculation delay can increase the ejaculation latency up to three minutes from the basic duration of under one minute. This result is comparable with the one men can achieve taking sertraline (an SSRI, applied in the treatment of PE). However, unlike the medication, the pause-squeeze technique doesn’t have any contraindications or severe adverse reactions.
The pause-squeeze technique presupposes men to start intercourse as usual, yet at the moment they feel close to ejaculating, they have to stop and ask their partner (or do it themselves) to squeeze the penis in the place where the glans is attached to the penile shaft. Keep it squeezed for some seconds until your sexual excitement levels down. This can be repeated as many times during intercourse as you and your partner feel comfortable with. The only precaution is not to apply too much force as this may cause temporary loss of glans sensitivity.
Condoms don’t only protect us from sexually transmitted infections and unwanted pregnancies, but they can also be helpful in men dealing with rapid ejaculation. How can a condom stop premature ejaculation? The latex works well for reducing the sensitivity of the penis, which results in the reduction of pleasurable sensations man experiences. This prolongs male durability and delays ejaculation time.
Also, men can use condoms containing lubricant with the anesthetic. It is highly efficacious for penile sensitivity reduction and increasing the duration of sexual intercourse.
The list of methods of premature ejaculation treatment wouldn’t be complete without medications. The intake of drugs for ejaculation delay is the first-line treatment for premature ejaculation. It is highly efficacious and gives fast results. Although there is no medication that would cure early ejaculation once and for all, there are preparations that provide the temporary but worthwhile effect.
The drug applied in men with PE most often is Priligy. It has a rapid onset of action, and its effects last for about 3 hours. The rate of efficacy of the preparation is dose-dependent and is statistically significant. Taking into account that a lot of men suffer from both premature ejaculation and erectile dysfunction, the market also offers a wide selection of medicines containing two active substances for managing these conditions simultaneously. The best representatives are Viagra with dapoxetine, Super Avana (avanafil + dapoxetine), and Super P-Force (sildenafil + dapoxetine).
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Apart from the techniques described above, there exist several home remedies for premature ejaculation. Foods & vitamins make the basis of them. Naturally, the efficacy of such treatment is lower than of the medications, yet they may also help improve your overall health condition and increase your durability in bed. The most commonly used alternative medicines for PE treatment are listed below:
- Zinc supplements. These can boost your testosterone levels and thus increase your ejaculation latency. This over-the-counter treatment can do well for those men whose dysfunction is provoked by hormonal imbalance.
- Magnesium supplements. Some studies say that magnesium is involved in semen transport. This supplement deficiency leads to premature emission of the semen and, therefore, rapid ejaculation.
- Sprays, creams, and gels with anesthetics. Sprays, creams, and gels containing lidocaine are available over-the-counter, which makes them easy-to-get and effective home remedies for PE. They work by reducing the sensitivity of the penis. Avoid their use if you are allergic to lidocaine.
Get Drugs Now to Defeat Premature Ejaculation
The statistics say that only a quarter of men with early ejaculation ask for medical help. In fact, premature ejaculation treatment is utterly important, as it can improve not only the physical but also mental health condition of a man, increase his self-esteem and improve his relations with a partner.
Online pharmacies offer a diverse selection of medications that can resolve the issue within minutes. So why would you let yourself suffer from premature ejaculation? Get the drugs that can improve your quality of life and sex life in particular now. Don’t delay the treatment. The sooner you begin – the better.