Ejaculation refers to the bodily discharge of semen. It is normal to have ejaculation occurring during sexual intercourse, but the problem starts when it occurs too soon.
This problem is called premature ejaculation. It can also be referred to as early ejaculation or premature climax.
Generally, premature ejaculation is not of great concern, but if it strains relationships with frustrating sexual experiences then it may get distressful.
If you think that you are suffering from premature ejaculation then asking a medical professional for sound advice can be the best decision.
Occasionally, it is common to lose control of ejaculation. Only when premature ejaculation occurs frequently, then it can be considered a problem.
A man might ejaculate quickly if he is having sex for the first time.
It is common for a man to typically lose control over ejaculation but that does not necessarily mean that he has a sexual issue or PE.
The issue of premature ejaculation can be annoying and can ruin your sexual experience but the good news is that it can generally be amended.
Premature Ejaculation: How does ejaculation work?
The central nervous system has control over ejaculation. When a man gets sexually excited, his spinal cord and the brain gets signals.
After they reach a specific level of arousal, their brain sends signals to the reproductive organs. Ejaculation happens when the semen is discharged through the penis as a result of this.
There are two stages of ejaculation-
Stage 1: Emission
Fundamentally speaking, the emission is referred to the sperm that has traveled from the testicles to the prostrate and then got combined with the seminal fluid to form semen.
The sperm is transported[1] from the testicles through the prostrate to the base of the penis with the aid of tubes called ‘vas deferentia”.
Stage 2: Expulsion
The expulsion takes effect when the muscles at the base of the penis contract, and expulsion occurs.
As a consequence, semen is forced to come out of the penis. In that case, ejaculation and the orgasm typically occur simultaneously. The erection typically disappears after this.
Causes Of Premature Ejaculation
For males, erection issues[2] like premature ejaculation can occasionally be problematic.
A lot of men might experience this when they are unable to achieve and maintain[3] an erection that is firm enough for sexual intercourse.
Since an erection disappears after ejaculation, so it can be challenging to determine whether premature ejaculation or erectile dysfunction is the underlying issue.
Psychological causes of Premature ejaculation may include-
- Depression
- Body Consciousness
- Excessive worrying
- Too Much Stress
Biological causes of Premature ejaculation-
- Irregular Hormone Levels
- Swelling of Prostate
- Hereditary
Other causes of Premature Ejaculation could be-
- Relationship Problems
- Too Much Work Load
- Erectile Dysfunction
Characteristics Of Premature Ejaculation
Men’s sexual dysfunction which might be called premature ejaculation can be characterized by-
- Ejaculation always or almost always takes place just before or shortly after vaginal penetration.
- The inability to postpone erection or issues with vaginal penetrations, advert personal effects, including distress, inconvenience, frustration, and avoiding sexual intimacy altogether.
Categories Of Premature Ejaculation
The following are the classification of premature ejaculation-
Lifelong
Since the first sexual intimacy, the patient has experienced premature ejaculation, which is considered to be lifelong premature ejaculation.
Acquired
It happens when the concerned patient was having effective conjugal relationships in the past but has recently developed acquired premature ejaculation.
Performance Anxiety
Performance anxiety is referred to[4] as a form of psychogenic ED that is usually caused by stress and can also lead to Premature Ejaculation or PE in males.
Diagnosis Of Premature Ejaculation
Patients with premature ejaculation might feel[5] distressed talking about every ejaculatory issue and they might put off getting the necessary treatment.
The therapy for PE starts with a proposed model[6] called the “PLISSIT model”. The traditions may make sexual health a regular topic of conversation during appointments.
Your medical professional will enquire about your sexual history and medical history.
A physical examination can also be done by your doctor and he may suggest blood tests if you experience early ejaculation in addition to difficulty achieving and maintaining an erection.
But due to conflicting ideas between the patient and the doctor, it seems premature ejaculation is usually misdiagnosed or at times, can also be ignored.
As there is an accepted definition of the condition in specific men with premature ejaculation cannot be distinguished from the men without premature ejaculation using approved tests or laboratory assays, and there are no clear risk factors for associations for this illness.
In addition, premature ejaculation is also frequently mistaken as[7] erectile dysfunction.
The sexual history of a reduced latency time, poor ejaculatory control, low enjoyment of intercourse, and concern over the disease is used to diagnose premature ejaculation or PE.
Treatment Strategies Of Premature Ejaculation
Depending on the cause there is a variety of treatments available for premature ejaculation.
These include medication, counseling, and behavioral treatment.
Behavior therapy or counseling is typically used to address any underlying emotional issues or performance anxiety, that might be contributing to the majority of reasons for premature ejaculation.
Multiple therapy modalities may frequently be used together in treating the condition-
-
Semans Technique
The Semans approach entails developing control over the feelings before ejaculation.
The goal is to repeatedly approach ejaculation, then stop, and after that relax. This practice, if done frequently, will make someone adept at identifying his point of no return.
-
Masters And Johnson Technique
To reduce the impulse to ejaculate, the masters and Johnson technique include squeezing the end of the Penis immediately before ejaculation.
You might perform these exercises either all by yourself or you may take the help of your partner.
-
Kegel Exercises
Strengthen your pelvic floor by practicing[8] a lot of Kegel exercises. You can start by stopping yourself in the middle of every rep to strengthen the muscles in your pelvic floor.
Just remember that you need to practice this exercise when your bladder is empty.
Muscles will be contracted formally and must be held for 10 seconds, three times daily, and lastly repeated 10 times.
-
Psychological Counselling
Any underlying sex-related phobias need to be investigated and reduced[9] through the use of psychotherapy and counseling under the direction of a skilled sex therapist.
-
Reducing Penile Sensation
To lessen penis sensitivity, it is highly recommended that you can use local anesthetics and some specific lotions that can be administered 30 minutes before sexual activity.
Along with that, it is better[10] to use a condom and then amalgamate it with these therapies to prevent your partner from becoming too absorbed.
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Utilizing SSRIs (Selective Serotonin Reuptake Inhibitors)
SSRIs can be used effectively to treat[11] premature ejaculation. If it is used by males with depression, it has got the adverse effect of slowing ejaculation.
These medications can be combined with counseling and they may have a beneficial effect on men who ejaculates too early.
Some of the other side effects of SSRIs may include decreased libido, nausea, sweating, bowel disturbance, and exhaustion.
As per the study[12], Premature ejaculation might be treated with SSRI known as dapoxetine, which has to be necessarily taken before sexual intercourse.
PDE5 inhibitors like Viagra, Cialis, and Levitra are erectile dysfunction medications that might help[13] regulate ejaculation if premature ejaculation is related to erectile dysfunction.
-
Additional Medications
Other additional medications may include –
- Antidepressants can help prevent premature ejaculation, particularly selective serotonin reuptake inhibitors including escitalopram, fluoxetine, and paroxetine, and set for the line are the tricyclic antidepressant clomipramine.
- Treatment to postpone ejaculation is an anesthetic done by applying lotions and sprays to the head and shaft of the penis.
- Premature ejaculation might also be treated with erectile dysfunction drugs such as Cialis, Viagra, Levitra, and Stendra, especially in men with underlying[14] erectile dysfunction.
- Some home remedies could also be beneficial.
Conclusion
Premature ejaculation can be avoided using a variety of treatment options.
You will be able to control ejaculation by seeking appropriate medical professionals including a urologist for an initial assessment.
Mix off therapy self-care techniques and medications may help you to get over your premature ejaculation.
It is also possible for you and your spouse to have an intimate, meaningful sexual relationship without placing as much focus on having sexual interactions.
Premature ejaculation can also be treated with non-sexual activities that may improve your emotional connection with your partner.
Understanding that premature ejaculation is typically resolvable and that it is but one aspect of a couple’s physical attraction is very crucial.
The greatest response to, or any difficulty you face as a couple is to support and understand each other’s needs and concerns.
References/Sources
Working4Health prefers using primary and verified references. We have strict sourcing guidelines and our primary references include peer-reviewed research, academic, and medical institution studies.
- Sperm release pathway. Available from https://medlineplus.gov/ency/anatomyvideos/000121.htm
- Marissa Crowdis; Saad Nazir. Premature Ejaculation. Last Update: June 27, 2022. Available from https://www.ncbi.nlm.nih.gov/books/NBK546701/
- Pranau K. Panchatsharam; Justin Durland; Patrick M. Zito. Physiology, Erection. Last Update: May 8, 2022. Available from https://www.ncbi.nlm.nih.gov/books/NBK513278/
- Ravi Philip Rajkumar, and Arun Kumar Kumaran. The Association of Anxiety With the Subtypes of Premature Ejaculation: A Chart Review. Prim Care Companion CNS Disord. 2014; 16(4): 10.4088/PCC.14m01630. Published online 2014 Jul 31. doi: 10.4088/PCC.14m01630
- Nicholas Gillman1 and Michael Gillman2, et al. Premature Ejaculation: Aetiology and Treatment Strategies. Med Sci (Basel). 2019 Nov; 7(11): 102.Published online 2019 Oct 25. doi: 10.3390/medsci7110102.
- Anne Rutte, Patricia van Oppen, Giel Nijpels, et al. Effectiveness of a PLISSIT model intervention in patients with type 2 diabetes mellitus in primary care: design of a cluster-randomised controlled trial. BMC Fam Pract. 2015; 16: 69.Published online 2015 Jun 2. doi: 10.1186/s12875-015-0283-0.
- Thushanth Sooriyamoorthy; Stephen W. Leslie. Erectile Dysfunction. Last Update: May 27, 2022. Available from https://www.ncbi.nlm.nih.gov/books/NBK562253/
- Kegel Exercises. Available from https://www.niddk.nih.gov/health-information/urologic-diseases/kegel-exercises
- Liron Bodinger 1, Haggai Hermesh, Dov Aizenberg, et al. Sexual function and behavior in social phobia. Comparative Study J Clin Psychiatry. 2002 Oct;63(10):874-9. doi: 10.4088/jcp.v63n1004. Available from https://pubmed.ncbi.nlm.nih.gov/12416596/
- Zhize Wang and Jianjun Yu. Efficacy evaluation of thickened condom in the treatment of premature ejaculation. Transl Androl Urol. 2022 Feb; 11(2): 253–259.doi: 10.21037/tau-22-8
- Andrew Chu; Roopma Wadhwa. Selective Serotonin Reuptake Inhibitors. Last Update: May 8, 2022. Available from https://www.ncbi.nlm.nih.gov/books/NBK554406/
- Chris G McMahon. Dapoxetine: a new option in the medical management of premature ejaculation. Ther Adv Urol. 2012 Oct; 4(5): 233–251.doi: 10.1177/1756287212453866
- Armaan Dhaliwal; Mohit Gupta. PDE5 Inhibitors. Last Update: May 20, 2022. Available from https://www.ncbi.nlm.nih.gov/books/NBK549843/
- Erectile Dysfunction (ED). Available from: https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction
- About the Author
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Michael has been in the male wellness industry for 25+ years. Before joining Working For Health as a full-time male wellness journalist, he contributed to multiple online portals in the male wellness field. Before that, he has been an assistant to several sexologists.