Premature Ejaculation: Do I Have It? Why It Happens? Is There A Treatment?

Diseases A-Z

The main symptom of premature triggering is that it occurs before both partners want it. When premature ejaculation occurs during most of the times, it creates worry, stress and frustration. Many men occasionally get earlier ejaculation during the intercourse than they themselves and their partners wish. As long as this only happens sometime sometimes there is nothing to worry about. If, on the other hand, you get a regular ejaculation earlier than yourself and the partner wants, for example, before the intercourse or immediately after it has begun, you probably have the premature ejaculation state.premature ejaculation

What is premature ejaculation?

In the United States as well as in several other countries, the prevalence of manifest premature ejaculation (often, almost always or always) has been reported to about 5-8% in adult men. Sporadically, PE appears to be significantly greater; Among American men there are about 40% in the age of 18 to 74. The incidence increases after age 65. PE is closely associated with both low sexual desire / decreased interest and with erectile dysfunction. Premature ejaculation is also a risk factor for the female partner’s orgasmic function.

Premature ejaculation is a common sexual problem. The numbers of incidence vary, but some experts believe that this affects as many as 20-30% of all men. Although it is a common problem that can be treated, many men do not dare to talk to their doctor about it or seek treatment. Earlier, specialists used to believe that this was a strictly psychological problem, but it is established now that biological factors determine whether or not a man develops premature ejaculation. It is not unusual to have premature ejaculation as a side problem of another sexual disease, erectile dysfunction.

There is treatment for premature ejaculation – medicines, psychological counseling and sexual engineering learning that delaying the trigger can improve sex life for you and your partner. For many men, best results are achieved through a combination of multiple treatments.

Premature ejaculation (PE) in special literature is defined as ejaculation occurring before or within about one minute after penetration and where the man experiences no or minimal control of ejaculation. A distinction is made between lifelong and acquired PE. Over the last decade, the term IELT (Intravaginal Ejaculatory Latency Time) has been established. It is considered that an IELT of 1 minute characterizes manifest PE, an IELT of 1-2 minutes represents the limit of PE and> 2 minutes is considered to be within a wide range of normal values.

In recent epidemiological studies, it has been found that men without premature ejaculation have an average IELT of between 5 and 14 minutes. It has been discussed whether circumcision men have shorter IELT than non circumcision. However, this is not clearly shown.

Premature ejaculation symptoms

There is no medical standard for how long it takes a man to get triggered. The main symptom of premature ejaculation is that triggering occurs before the man and his partner want it, and that happens during most intercourse, which creates anxiety, stress and frustration. The problem can occur in all sexual situations, even in connection with masturbation, but sometimes it occurs only in connection with sexual intercourse.

Doctors often share in premature ejaculation in a primary and a secondary type:

  1. Primary form of premature ejaculation occurs if you have had problems as long as you have been sexually active.
  2. Secondary form of premature ejaculation occurs if the condition has occurred after having previously had a satisfactory sex life without tripping problems.

Causes of premature ejaculation

Experts do not know for sure what causes premature ejaculation. Earlier, the perception was that the explanation was purely psychological, but today it is known that the phenomenon of early triggering is more complicated and involves a complex interaction between psychological and biological factors. The reason for premature ejaculation is multifactorial. In men with lifelong manifest PE there are data that suggest that the state of a part may be genetic. Central nervous dysregulation can also be a factor of importance for PE.

There are factors that increase the risk of premature ejaculation. Different conditions can increase the risk of premature ejaculation, such as:

Erectile dysfunction

There may be an increased risk of premature ejaculation if you sometimes or most of the time have problems with achieving or maintaining erection. Fear of losing the erection causes the man to hurry through the intercourse. As many as one in three men with premature ejaculation may have problems with retaining an erection.

Health problems

In the case of illness that causes the victim to feel worried during sex, such as heart problems, it can help to hurry to reach the trigger.

Stress

StressEmotional or mental stress in any area of life can play a role in premature ejaculation and limit the ability to relax and concentrate during intercourse.

Some drugs

In rare cases, drugs may affect chemical signal substances from the brain and lead to premature ejaculation.

When should you seek medical attention?

You should talk to your doctor if you ejaculate earlier than you and your partner wish. Even if you feel that you should be able to fix this yourself, you may need treatment to get a better sex life. Another good point to make here is that premature ejaculation, as well as its usual companion, erectile dysfunction, is often a sign of bigger health problems. You should be especially careful if other symptoms come along with inability to control your ejaculation, especially in a situation where this problem appeared only recently and you are in your late forties.

Men seek medical care later than women and then the risk is high that they are already advanced in the disease and it is more difficult to treat, which is why men die earlier. Women use healthcare more appropriately. Men live on average three to five years less than women, which means that at the age of 75 there are two women to one man. In different ways, doctors want to motivate men to seek help earlier. One tries to reach out with the message that erection problems can be an early sign of onset coronary heart disease.

Over 45 years, a simple health check should be done to measure blood pressure, blood lipids, blood sugar and more to rule out more difficult diseases. The most common is that problems arise because of an already diagnosed disease, such as obesity, diabetes or cardiovascular disease. The average age of those with erectile dysfunction is 40-60 years. Psychological problems associated with erection problems are usually younger men who receive.

measure blood pressureRegular exercise reduces erection problems by 70 percent. There are also good tools today, medicines that are effective, quite unaffected, harmless and non-addictive. They are not dangerous for cardiovascular disease, but it is important to know that they cross-react with nitroglycerin (ask your GP if necessary).

And here we come back again to the problem is premature ejaculation, which not only affects younger men, but you see an increase after the age of 40. Some have had it since they were younger, but others get the problem older and then often in connection with erection problems.

One expects an average latency (the time it takes for a man to get triggered) in four and a half minutes with northern American men. However, it has been seen that time is not all but the most important is how the men perceive the time / problem. There are men who think it’s ok with two to three minutes, but there are others who think it’s too short and hard for ten minutes. In an interview, 12 percent thought they were too early, but only three percent said that there was a problem. It may also be that it is the woman who thinks that there is a big problem and in some cases the relationship can break because of this.

There are several techniques you can use at home to try to cope with the problem on your own, and they will be discussed later in this article. One has to practice and repeat the method on several occasions, he points out. Antidepressants may work for some. Now there are also drugs that have an effect on early ejaculation. They are similar to antidepressants, but developed more specifically for problems with premature ejaculation.

It’s not easy to put your finger on early ejaculation, but what’s safe is that it’s common. Often it is thought that ejaculating within one to two minutes of penetrating intercourse is classified as premature ejaculation, or premature ejaculation. Research shows that the average time for a sexual intercourse in the U.S. is about five minutes.

There are several reasons why someone may ejaculate too early. Sometimes the condition is divided into two categories: primary premature ejaculation and secondary premature ejaculation. The cases where the condition is present from early age is called primary premature ejaculation and may be the cause of a desire to reach early ejaculation that is rooted in the masturbation habits. When the condition begins to develop after a time of normal ejaculation, for example, by nervousness or performance anxiety in a new relationship, it is often called secondary premature ejaculation.

In order to enjoy penetrative intercourse, an erection is required. But a common misconception is that ejaculation cannot happen without erection. This is not true. Male partner does not need to be able to have an erection to ejaculate. Similarly, a man does not need to lose erection after ejaculation. In biological terms, there is no direct connection between these two. However, one can indirectly lead to the other. For example, worry about getting premature ejaculation may cause anxiety which then causes erection problems.

This causal relationship can work in both directions: those who are prone to erection problems, those who are able to get an erection that is strong enough for penetration can simply be so concerned about maintaining it that they get triggered too fast. Treatments in erectile dysfunction are not printed at premature ejaculation. However, studies have found that drugs such as Sildenafil can help counteract the problems that the drug itself causes.

When should you seek medical attentionA survey conducted by Australian researchers about the use of Viagra in cases of premature ejaculation revealed that it could help men retrieve control over their trigger while increasing self-confidence. It was also reported that the time between ejaculation and a second erection was reduced; which can be interpreted as those who have or are at risk of premature ejaculation may benefit from taking Viagra because they could resume penetration within a short period of time and then better be able to satisfy their partner.

Another study showed that sildenafil produces better results in treating premature ejaculation than Paroxetine (an SSRI preparation that is essentially not available to treat premature ejaculation but has shown positive results in this in clinical trials). Sildenafil (Viagra) also proved to be more effective in ‘squeezing technique’, which means that you squeeze your thumb and index finger under the eyelids before tripping and thus stop it. 86% of those who received Sildenafil would continue treatment. Only 60% of those who used Parotexine and 45% of those who used the clamping technique would continue with these.

Another problem with men’s health is closely linked to such sexual issues as premature ejaculation and erectile dysfunction is testosterone deficiency. Some data suggest that every 10 years over 50 years of age may have testosterone deficiency. It has been seen that men with reduced levels of testosterone have an increased risk of cardiovascular disease. Normally, men retain their testosterone levels within the limit of normal values throughout their lives, i.e. age is not a factor in deficiency.

Epidemiological studies (comparing heredity and the environment) show that obesity has greater correlation with testosterone deficiency than rising age. Men with chronic diseases such as cardiovascular disease, rheumatic diseases, type 2 diabetes are at increased risk. Among healthy men over the age of 65, only three percent have a lower testosterone value than normal. In survival studies, a correlation between low levels of testosterone and increased mortality is observed. However, it is not known whether it is a secondary effect of various diseases or if low testosterone levels accelerate processes that lead to increased mortality. In intervention studies, inflammation markers are reduced when treated with testosterone in case of deficiency. There is some kind of connection, but more studies are required to understand more.

Symptoms of testosterone deficiency are fatigue, decreased vitality, depressedness, decreased sex drive, loss of bone mass, poor physique, rigidity (it is a myth that more testosterone causes aggression). If you have these symptoms you can ask your GP to measure the testosterone value. In case of deficiency, testosterone may be given in gel or syringe and should then be returned after three to four months for evaluation. In the case of testosterone supplements, the muscle mass increases and the fat mass decreases. In case of lack, men also have an initial effect on sexual activity, but libido continues to not increase if the testosterone amount is further increased. The quality of life can be improved considerably.

testosterone-testOlder men who have a deficiency can gain a lot of benefits from testosterone supplementation. They can have increased muscle mass and a better life quality – maybe they will drop their walker. There is no risk of getting testosterone for as long as you have not prostate cancer.

Epidemiological studies (comparing heredity and the environment) show that obesity has greater correlation with testosterone deficiency than rising age. Men with chronic diseases such as cardiovascular disease, rheumatic diseases, type 2 diabetes are at increased risk. Among healthy men over the age of 65, only three percent have a lower testosterone value than normal. In survival studies, a correlation between low levels of testosterone and increased mortality is observed. However, it is not known whether it is a secondary effect of various diseases or if low testosterone levels accelerate processes that lead to increased mortality. In intervention studies, inflammation markers are reduced when treated with testosterone in case of deficiency. There is some kind of connection, but more studies are required to understand more.

Symptoms of testosterone deficiency are fatigue, decreased vitality, depressedness, decreased sex drive, loss of bone mass, poor physique, rigidity (it is a myth that more testosterone causes aggression). If you have these symptoms you can ask your GP to measure the testosterone value. In case of deficiency, testosterone may be given in gel or syringe and should then be returned after three to four months for evaluation. In the case of testosterone supplements, the muscle mass increases and the fat mass decreases. In case of lack, men also have an initial effect on sexual activity, but libido continues to not increase if the testosterone amount is further increased. The quality of life can be improved considerably.

Older men who have a deficiency can gain a lot of benefits from testosterone supplementation. They can have increased muscle mass and a better life quality – maybe they will drop their walker. There is no risk of getting testosterone for as long as you have not prostate cancer.

Complications of premature ejaculation

Although premature ejaculation does not give rise to any major health problems, it can create stress in personal life, such as:

  1. Problems with the partner that also have reduced enjoyment of sex life and reduced libido as their result.
  2. Infertility: Premature ejaculation may sometimes make it difficult or impossible to fertilize couples who try to come with children.

Reduced libido

Reduced libidoMany believe that decreased libido, also known as impaired sexual drive, frigidity or hypoactive sexual disorder, means the same as erectile dysfunction. This is not true. Reduced libido is a reduced desire to have sex that can be induced by one or more factors, such as depression, stress, relationship problems or even undiagnosed medical condition.

It is also not uncommon that decreased libido is an adverse reaction of some drugs. However, the two states, decreased libido and erectile dysfunction may interact. Persistent cases of erectile dysfunction can affect the man’s libido; while impaired libido o can hamper a man’s ability to achieve erection. At the same time, however, it is important to remember that erectile dysfunction is not necessarily a sign of reduced sexual desire. Contrary to what many believe, it’s absolutely possible for a human being to be sexually excited while having this problem with an erection. The latter may be a sign of poor blood flow as well as pure performance anxiety. Prescription treatments are often very helpful in defeating a difficult pattern for men with erection problems.

However, these treatments are not a direct solution to impaired libido. An investigation shows that sildenafil gives positive outcomes to those men who experience related to antidepressant drugs. The same study, however, also shows that more research in the field is needed.

Infertility

Male infertilityMale infertility, also known as involuntary infertility, can be caused by a low number of sperm or the sperm of the man has reduced mobility and may result in an inability or reduced ability to make her partner pregnant. While the causes of infertility may be numerous, erectile dysfunction does not condition inability to become a parent. Neither can ED result from infertility.

Erectile dysfunction and infertility have a common point of contact which is that both can be exacerbated by low testosterone levels. In addition to this, erectile dysfunction may lead to inability to raise children if the male partner is unable to get erection. However, erectile dysfunction is by no means an indicator of low sperm count.

Those who experience erection problems can overcome such symptoms with prescription treatments in impotence. However, it is not entirely clear whether ED treatments interfere with the production of healthy sperm. However, some studies show that drugs may have an adverse effect on sperm production, while other studies have shown no harmful effects. In any event, you should always consult your doctor if you are trying to bring children while experiencing erectile dysfunction.

Diagnosing premature ejaculation

The investigation includes bodily examination, including prostate, as well as social names including alcohol and drugs. It is important to determine in the past how long the man has had premature ejaculation (lifelong or acquired) and IELT (Intravaginal Ejaculatory Latency Time). In addition, it should be noted that the man’s time for ejaculation differs from sexual activity, i.e. masturbation, manual smacking, penetrative intercourse, oral and anal sex.

The following questions should be answered:

  • Are there any other sexual dysfunctions – in the patient and in the (if any) partner?
  • How would he rate the sexual satisfaction?
  • Has the patient made his own attempt to control ejaculation?
  • Has the problem always been there?
  • How has the problem evolved?
  • Are there important psychological conditions?
  • Does the patient have performance anxiety?
  • Is the problem linked to certain situations and / or partners?
  • What does the partner say? Does she have a problem?

During anamnesis, doctor should primarily focus on the following:

  • Is ejaculation too fast or premature?
  • Those affected the most get trigger before or immediately after penetration.
  • The condition may be congenital, acquired, situational or occurring with other sexual problems, including erection failure.
  • Premature ejaculation can be associated with sexual problems in the female partner, such as anorgasmia and pain in intercourse (dyspareuni, vaginism), which may have caused the man to adapt.

Local changes or infections should be ruled out. Referring to various specialists may be recommended in case when GP, sexologist or urologist fail to establish the cause and the course of treatment on their own. The following checklist should then be used as a means of internal communications between healthcare personnel:


Premature ejaculation treatment

Many men who experience premature ejaculation feel frustrated and may even feel ashamed. Then it can help to know that it is a common problem that can often be corrected. You should talk to your doctor and / or partner if you have this problem. While trying out the different treatment options, one should tune down the importance of sex life in the relationship. Some doctors recommend total abstinence from six for a short period and urge to emphasize other forms of sexual intercourse during this time. By tapering down the importance of intercourse, it is possible to alleviate the concerns of premature ejaculation, which helps to lay the foundation for better functioning sex life.

Today, premature ejaculation is seen as a condition treated with pharmacology, counseling, psychotherapy or a combination of these.

1. Pharmacological treatment

Doctor may prescribe tablets containing the active substance dapoxetine specially formulated to treat premature ejaculation. A selective SSRI preparation, dapoxetine (Priligy) 30 and 60 mg, with short half-life and rapid onset has recently been registered (2009) with indication of premature ejaculation. Patients are advised to avoid situations where syncope or dizziness may pose a danger in taking the drug. One should ask if there are orthostatic reactions in the history of the illness and do an orthostatic test. Treatment is evaluated after four weeks or after six doses.

The drug is related to antidepressant SSRIsThe drug is related to antidepressant SSRIs

  • The usual dose is 30 mg. The doctor may raise the dose to 60 mg.
  • Only take one to three hours before the expected sexual activity.
  • Do not take dapoxetine more often than once a day (every 24 hours).
  • Swallow the tablets whole to avoid a bitter taste, with at least one whole glass of water.
  • Can be taken independently of meals.
  • Not to be used by men under 18 years or men 65 years of age or older, or men who have low blood pressure problems.

Discuss the treatment with the doctor after the first four weeks or after six doses, to decide whether to continue treatment. If treatment continues, consult your doctor continuously every six months to discuss further treatment.

Locally applied cream decreases the sensitivity of the penis, thus helping to delay the triggering. The ointment should be lubricated in a short period of time before intercourse and last for up to 20 minutes, and can then be easily wiped off when the penis has lost enough sensation to delay the trigger.

Some men who use local anesthetic ointment indicate that they lose a bit of sexual pleasure because of the reduced sensitivity. Even though the ointment is wiped off before intercourse, some women also report that their genital organs are weakened and the enjoyment is subdued. In exceptional cases, the drug may also cause allergic reactions.

Another common pharmacological treatment of PE has been SSRIs, preferably paroxetine (Seroxat), which have been taken at least two hours before intercourse or daily dosing over the last decade.

The hypersensitivity of penis glans has been considered as a cause of PE, which has led to treatment trials with local application of anesthetics (e.g. lidocaine prilocaine) and the use of special creams or condoms. However, in the case of circumcised or uncircumcised men, hypersensitivity has been objectively confirmed and the treatment results are somewhat uncertain.

Men with premature ejaculation, and otherwise good sexual function and ability, rarely have the effect of phosphodiesterase-5 inhibitors. In men with both erectile dysfunction and PE, such treatment can provide both dysfunctions.

2. Psychotherapy

PE, like other diseases, has a functional and psychological meaning. This applies regardless of whether there is a physiological cause of the symptom or not. In-depth understanding of the importance of lifelong, but also acquired premature ejaculation could lead to treatment strategies where the patient’s coping process is in focus.

PsychotherapyThis treatment involves talking about their relationships and experiences with a psychotherapist. Call therapy can help reduce performance anxiety or help find effective ways to deal with stress and solve problems. For many couples experiencing premature ejaculation, common conversations with a therapist can give the best results.

Men with experienced early ejaculation, despite normal or long IELT, may benefit from qualified counseling or psychotherapy with focus on an intra and / or interpersonal level. In men with acquired PE we can assume that the combination(s) of the above are effective.

3. Start-stop technique

A well-proven method of premature ejaculation is the so-called ‘start-stop technique’ that is used to increase the man’s body awareness and thus ability to control ejaculation. The method should be combined with qualified counseling or psychotherapy. In order for this method to work, the man / couple must follow the instructions carefully.

The exercises are based on the man focusing his senses (his attention) on the pelvic floor when the partner stimulates him manually. When he feels that the ejaculation is near, he signals that stimulation should be interrupted. The man continues to have all his / her concentration / focus on the feelings / experiences in the pelvic floor. When he feels that ejaculation is no longer near, he signals to the partner to continue. This is followed by a stop of a second.

This stop-start method is repeated three times and on the fourth occasion, stimulation can continue until the man gets ejaculation. The single man with PE can benefit from a start-stop when masturbating.

Prevention and overcoming of premature ejaculation

In some cases, premature ejaculation may be due to poor communication between a man and his partner and lack of understanding of the differences between how men and women work sexually. Women usually need more stimulation than men to reach orgasm, and this difference can create ‘sexual conflicts’ between the sexes and put pressure on sex life. Too many men increase the risk of premature ejaculation if they feel that they are under pressure during the intercourse.

Open communication and the willingness to try different methods to help each other achieve satisfaction can help resolve any conflict and mitigate performance gains. If you are not satisfied with sex life you should talk to your partner about the problem. Try to solve the problem in a loving way and avoid blaming each other for lack of satisfaction. If you cannot solve the sexual problem on your own, you can contact a doctor. The doctor can advise or give a referral to a sexual therapist with more experience.

The crucial step in getting over the above mentioned problem is to speak with your partner. In case of lost libido or premature ejaculation, an encouraging conversation may be enough to steer the boat in the right direction. If this is not enough then there is help getting from your GP. For those who have trouble with children, your doctor will also be able to propose self-help measures that can improve your chances of bringing children or, if necessary, put in touch with a specialist who can provide further guidance and treatment options.

The link between erectile dysfunction and other sexual problems mentioned above are essentially indirect. The presence of impotence is neither a definite indication of them nor a decisive factor in their case. What is the most important aspect of persistent cases of erectile dysfunctionary to rather consider the possible non-sexual elements associated with the condition. Even though most men will experience erectile dysfunction on occasional occasions, it is important that you repeatedly consult your dentist - to rule out the possibility of diabetes or high blood pressure.

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