PREMATURE EJACULATION

Premature ejaculation is one of the most frequent sexual problems in men and couples, accounting for 40% of the complaints found in sexual therapists’ offices.

Premature ejaculation happens to be commonplace in youth, in meetings with new partners or after a period of abstinence. When it is extended into mature age and becomes present in more than half of sexual meetings, it becomes thus a chronic condition and a sexual disorder.

What’s a normal ejaculation?

From the perspective of physical functioning , ejaculation takes place in two stages. In the first stage occurs the expulsion of the seminal fluid (semen) from accessory reproductive organs – prostate, seminal bladder, and ejaculatory canal – into the urethra. At the second stage, there’s a progression of this fluid throughout the extension of the urethra to the urethral meatus, which is the orifice in the glans through which also the urine exits. This physiological process is accompanied by a subjective sensation of deep pleasure known as orgasm.

How do I know if I suffer from premature ejaculation?

There’s no specific time prior to ejaculation for defining it as a sexual problem. The problem is defined by your and your partner’s perception that the ejaculation was faster than expected and that it wasn’t controlled. Sometimes the penis doesn’t even get around becoming erected, and the movement of approaching and the touch of the sheets are enough to put an end to what could be a pleasant moment. At times, the man maintains the erection for a few minutes, begins the penetration, but ejaculates shortly after, becoming frustrated and letting his partner down. Feelings of guilt and anxiety become constant. Greater difficulties may arise subsequently, such as erection dysfunction (impotence) and loss of intimacy for the couple.

Why does premature ejaculation occur?

Darwin followers (English evolutionist that proposed the natural selection theory – 1859) explain that premature ejaculation was an old defense method against predators.

Imagine the early days of mankind, where hundreds of dangers existed, the human animal being too fragile and small in face of the risks from their environment.

Those individuals that took too long to ejaculate into their partners would be more vulnerable to aggressions from enemies and wild beasts.

The premature ejaculator had more advantages in being done with insemination quickly and running away immediately, also allowing the female to escape, in order to inseminate the largest number of females within a shorter time. Thereby the probability of spreading his genes around would be elevated.

Other reasons assumed as causes of premature ejaculation are:
 

abnormal increase in the sensitivity of the glans,
sexual inexperience,
first experience with partner that stimulates a fast intercourse, and
guilt or negative feelings towards the partner.

Seldom is there a medical condition accounting for premature ejaculation, such as acute prostatitis or multiple sclerosis. As a matter of fact, there isn’t only one scientifically proven cause for premature ejaculation.

Does it have a cure?

Treatment exists, both with drugs and psychotherapy. The first line of treatment is reorientation and reeducation of the man or couple for a normal sexual function. Situations in which the shorter or unsatisfactory ejaculation time is considered to be normal are elucidated (common in the young, sex with new partners, or following a long abstinence). When premature ejaculation becomes steady, that is, occurs in more than half of sexual meetings, a more specific treatment is made necessary.

The second line of therapy is the so-called cognitive behavioral treatment. A set of exercises and tasks should be performed at home for control of the ejaculation time. Below are some merely illustrative examples:
 

distraction technique

During the sexual relation, the man is told to set his mind on some situation that deviates him from sex, as somebody’s death, a partner that isn’t of his liking, or bills to pay. As soon as he perceives that he’s losing the erection, he focuses on the partner again. He should use this distraction method a few times so that he can extend the penetration time prior to ejaculation.

squeeze technique

The man must compress the glans base for 4-5 seconds immediately after the first sensation of arousal. With this procedure he’s going to make it harder for the blood to enter the penis, delaying ejaculation a little.

stop-start technique

It consists of instructing the man to stay in a position above his partner in order to have control over the sexual motion. He must start the penetration and stop the movements altogether near the moment of greatest arousal. He can use the diversion technique concomitantly.

The goal of these tasks is to get the man to be aware of the moment preceding the first stage of ejaculation, becoming able to voluntarily control his ejaculation and avoiding frustration for his partner and himself.

A third line of treatment can be combined with these exercises: drugs. There’s a wide range of medications that have as side effect a delay in ejaculation time. Such drugs must be administered only with judicious medical prescription, as they present many other effects on the organism.

Some of them (e.g. tricyclic antidepressants) are contraindicated for people with heart rhythm problems. Some topical medications (ointments) based on herbs or anesthetics haven’t been proven to be effective for premature ejaculation treatment.

Anyway, this sexual dysfunction has a good prognosis, that is, shows good cure rates for most individuals that seek specialized advice. Usually, 6 to 10 sessions suffice to improve a man’s and couple’s sex life.

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