Premature+Ejaculation

Samuel Spread **Premature Ejaculation** **WHAT IS IT?** Premature ejaculation (PE) is an uncontrolled ejaculation either before or shortly after sexual penetration (WebMD, 2008). This definition leaves room for interpretation as to the actual duration of intercourse before ejaculation. To provide some perspective, the average time from beginning of intercourse to ejaculation is about fiveminutes (Mayo Clinic, 2011). Social pressures to perform long-lasting sexual intercourse cn cause many healthy men to experience ejaculation before they wish it. Therefore, PE is a problem for sexual partners when it occurs on a regular basis and results in marked distress (O’Donohue & Jane, 2008). While premature ejaculation that occurs infrequently is not necessarily a concern, as many as 1 in 3 men complain about premature ejaculation at some point (Mayo Clinic, 2011).

**DIAGNOSIS** If you are curious about or suspect you may have premature ejaculation, you should not hesitate to consult your doctor. Because PE is both common and treatable, your doctor should be more than willing to discuss and help treat the disorder. While it is usually appropriate to bring up your concerns about PE during a routine check-up or other visit with your primary care physician, your doctor may be better prepared to help if you explicitly set up an appointment to discuss PE. Because doctors generally allot limited time and resources to each patient, they tend to focus on the main reason for the visit and brush off other topics like sex. In fact, general physicians report time constraints and “sex as an unrelated topic” as barriers to discussing sexual health (Verhoeven et. al., 2003). You should also prepare to be open about your sexual history and straightforward with regard to questions you want answered for best results from your visit.

Doctors generally classify premature ejaculation as either primary or acquired. Primary (lifelong) PE is ejaculation that usually occurs within one minute of vaginal penetration. Because a man cannot delay ejaculations, primary PE includes personal consequences like performance anxiety, stress, frustration, and avoidance of sexual intimacy. Secondary (acquired) PE shares these characteristics, except that it develops after a man has had past sexual relationships without ejaculatory problems (Mayo Clinic, 2011). Because various factors affect time until ejaculation, a doctor must consider age, newness of sexual partner, location of sexual activity, and recent frequency of sexual activity (“Premature Ejaculation,” 2011).

**CAUSES** Unfortunately, we do not know the exact cause of PE. Doctors believe it is a combination of psychological and biological factors. Biological causes include abnormal hormone and/or neurotransmitter levels, abnormal reflex activity of the ejaculatory system, thyroid problems, prostate or urethra inflammation and/or infection (Mayo Clinic, 2011). However, PE is rarely caused by a physical problem. In fact, evidence supports the notion that sexual control is actually a learned behavior that a man can relearn (“Premature Ejaculation,” 2011).

Past, often adolescent, sexual experiences may have contributed to inadequate learning early in life. One such situation may be that a man often hurried to reach climax to avoid being caught in the act. Another possibility is guilty feelings about the sexual act that caused a man to rush through sexual encounters. Present-day factors in a man’s life may include erectile dysfunction (ED), anxiety, and relationship problems. A man with ED may feel rushed to orgasm for fear of losing an erection. An association exists between men with general or sexual performance anxiety and men with premature ejaculation (Mayo Clinic, 2011). Because PE also leads to anxiety, the disorder may self-perpetuate and become worse over time (“Premature Ejaculation,” 2011). Relationship problems are often to blame in cases of acquired PE, as the relationship partner becomes the main variable (Mayo Clinic, 2011).

**SOLUTIONS** Now that we have a basic understanding of premature ejaculation, it is time to discuss ways of overcoming it. Three treatment methods include sexual therapy, drugs and medications, and cognitive behavioral therapy. Sexual therapy can be an effective way in relearning sex as an activity. A simple form of sexual therapy is masturbating to orgasm a short period (1 or 2 hours) before intercourse to delay ejaculation. During sex, using a condom or trying a different position can reduce sensation to the penis and delay ejaculation (WebMD, 2008).

A more advanced sexual therapy is the squeeze technique, which doctors often recommend as an effective psychological treatment. When you are almost ready to ejaculate, have your partner squeeze the head of your penis for several seconds until the urge to ejaculate subsides. Then, wait 30seconds before resuming foreplay. Repeating this process helps control your ejaculation (Mayo Clinic, 2011). This method may be most effective for men who have learned to ejaculate quickly to avoid being caught in the act, or for those who never learned to control ejaculation for means of birth control (ejaculating outside of the vagina). While the squeeze technique lacks rigorous research, researchers estimate that it teaches men ejaculation control for 15 to 20 minutes of sexual stimulation (O’Donohue & Jane, 2008). Given the stop-start nature of the squeeze technique, it requires open sexual communication and cooperation between partners.

Drugs and medications also offer treatment options for PE. Some doctors prescribe antidepressant drugs (selective serotonin reuptake inhibitors (SSRIs)) like Zoloft and Prozac for PE because of their common orgasm-inhibiting side effects. While the effect may take up to 10 days to surface in some instances, some men may achieve it by only taking small doses several hours before sex. Because PE is not related to depression, these drugs are not presently approved for PE treatment. Some men find success in delaying ejaculation through topical anesthetic creams (lidocaine or prilocaine). Although they wipe them off once the penis has diminished sensation, many partners report mutually reduced sexual pleasure due to lessened sensitivity (Mayo Clinic, 2011).

Finally, you could try cognitive behavioral therapy. Talking with a mental health provider about sexual feelings and experiences can reduce performance anxiety. Generally, discussing the problem with a credible counselor is an effective way to better understand the problem and arrive at a solution or combination of treatments that works best for you (Mayo Clinic, 2011). Because sexual communication with the partner is important in treating PE, it may be beneficial to have the partner attend meetings with the counselor. Between the sheets, partners should be ready to discuss and try different approaches to achieve mutual satisfaction. Women usually require prolonged stimulation to reach orgasm, and this pressure can increase risk of premature ejaculation. Sometimes, doctors even recommend that couples go on an intercourse hiatus to alleviate the pressure while they seek treatment. Above all, partners should avoid blaming one another for any lack of satisfaction (Mayo Clinic, 2011).

**REFERENCES ** [Awkward cuddle photograph]. Retrieved April 10, 2011, from [|http://natural-premature-ejaculation-cure.com] Mayo Clinic. (2011). //Premature Ejaculation//. Retrieved April 10, 2011, from [] O’Donohue, William T., & Fisher, Jane E. (Eds.). (2008). //Cognitive Behavior Therapy: Applying Empirically Supported Techniques in Your Practice//. New Jersey: Jo hn n++++ Wiley & Sons, Inc. Premature Ejaculation. (2011). In //Encyclopedia of Mental Disorders//. Retrieved April 10, 2011, from http://www.minddisorders.com/Ob-Ps/Premature-ejaculation.html [Squeeze technique sketch]. Retrieved April 10, 2011, from http://www.whitelotuseast.com/PremEjaculation.htm Verhoeven, V., Bovijn, K., Helder, A., Permann, I., Van Royen, P., Denekens, J., & Avonts, D. (2003). Discussing STIs: doctors are from Mars, patients from Venus. // ++++ ////Family Practice// 2003, 20(1): 11-15. Retrieved from Oxford University Press. Retrieved from https://compass.illinois.edu/webct/urw/lc5116011.tp0 ++++ /cobaltMainFrame.dowebct WebMD. (2008). //Premature Ejaculation – Topic Overview//. Retrieved April 10, 2011, from http://men.webmd.com/tc/premature-ejaculation-topic-overview