Premature
ejaculation Symptoms & causes
Premature ejaculation
occurs when a man ejaculates sooner during sexual intercourse than he or his
partner would like. Premature ejaculation is a common sexual complaint.
Estimates vary, but as many as 1 out of 3 men say they experience this problem
at some time.
As long as it happens
infrequently, it's not cause for concern. However, you might be diagnosed with
premature ejaculation if you.
·
Always or nearly always ejaculate
within one minute of penetration
·
Are unable to delay ejaculation during
intercourse all or nearly all of the time
·
Feel distressed and frustrated, and
tend to avoid sexual intimacy as a result.
Both psychological and
biological factors can play a role in premature ejaculation. Although many men
feel embarrassed talking about it, premature ejaculation is a common and
treatable condition. Medications, counseling and sexual techniques that delay
ejaculation — or a combination of these — can help improve sex for you and your
partner.
Symptoms
The main symptom of
premature ejaculation is the inability to delay ejaculation for more than one
minute after penetration. However, the problem might occur in all sexual
situations, even during masturbation.
Premature
ejaculation can be classified as:
·
Lifelong
(primary). Lifelong premature ejaculation occurs all or
nearly all of the time beginning with your first sexual encounters.
·
Acquired
(secondary). Acquired premature ejaculation
develops after you've had previous sexual experiences without ejaculatory
problems
Many men feel that
they have symptoms of premature ejaculation, but the symptoms don't meet the
diagnostic criteria for premature ejaculation. Instead these men might have
natural variable premature ejaculation, which includes periods of rapid
ejaculation as well as periods of normal ejaculation.
Causes
The exact cause of
premature ejaculation isn't known. While it was once thought to be only
psychological, doctors now know premature ejaculation involves a complex
interaction of psychological and biological factors.
Psychological
causes
Psychological factors
that might play a role include:
·
Early sexual experiences
·
Sexual abuse
·
Poor body image
·
Depression
·
Worrying about premature ejaculation
·
Guilty feelings that increase your
tendency to rush through sexual encounters.
Other
factors that can play a role in causing premature ejaculation include:
·
Erectile
dysfunction. Men who are anxious about obtaining or
maintaining an erection during sexual intercourse might form a pattern of
rushing to ejaculate, which can be difficult to change.
·
Anxiety.
Many men with premature ejaculation also have problems with anxiety — either
specifically about sexual performance or related to other issues.
·
Relationship
problems. If you have had satisfying sexual relationships
with other partners in which premature ejaculation happened infrequently or not
at all, it's possible that interpersonal issues between you and your current
partner are contributing to the problem.
Biological
causes
A number of biological
factors might contribute to premature ejaculation, including:
·
Abnormal hormone levels
·
Abnormal levels of brain chemicals
called neurotransmitters
·
Inflammation and infection of the
prostate or urethra
·
Inherited traits
Risk
factors
Various factors can
increase your risk of premature ejaculation, including:
·
Erectile
dysfunction. You might be at increased risk of
premature ejaculation if you occasionally or consistently have trouble getting
or maintaining an erection. Fear of losing your erection might cause you to consciously
or unconsciously hurry through sexual encounters.
·
Stress.
Emotional or mental strain in any area of your life can play a role in
premature ejaculation, limiting your ability to relax and focus during sexual
encounters.
Complications
·
Premature ejaculation can cause
problems in your personal life, including:
·
Stress and relationship problems. A
common complication of premature ejaculation is relationship stress.
·
Fertility problems. Premature
ejaculation can occasionally make fertilization difficult for couples who are
trying to have a baby if ejaculation doesn't occur intravaginally.
Diagnosis:
In addition to asking
about your sex life, your doctor will ask about your health history and might
do a physical exam. If you have both premature ejaculation and trouble getting
or maintaining an erection, your doctor might order blood tests to check your
male hormone (testosterone) levels or other tests.
In some cases, your
doctor might suggest that you go to a urologist or a mental health professional
who specializes in sexual dysfunction.
Treatment
Common treatment
options for premature ejaculation include behavioral techniques, topical
anesthetics, medications and counseling. Keep in mind that it might take time
to find the treatment or combination of treatments that will work for you.
Behavioral treatment plus drug therapy might be the most effective course.
Behavioral
techniques
In some cases, therapy
for premature ejaculation might involve taking simple steps, such as
masturbating an hour or two before intercourse so that you're able to delay
ejaculation during sex. Your doctor also might recommend avoiding intercourse
for a period of time and focusing on other types of sexual play so that
pressure is removed from your sexual encounters.
Pelvic
floor exercises.
Weak pelvic floor
muscles might impair your ability to delay ejaculation. Pelvic floor exercises
(Kegel exercises) can help strengthen these muscles
To
perform these exercises:
Find
the right muscles. To identify your pelvic floor muscles,
stop urination in midstream or tighten the muscles that keep you from passing
gas. These maneuvers use your pelvic floor muscles. Once you've identified your
pelvic floor muscles, you can do the exercises in any position, although you
might find it easier to do them lying down at first.
Perfect
your technique. Tighten your pelvic floor muscles,
hold the contraction for three seconds, and then relax for three seconds. Try
it a few times in a row. When your muscles get stronger, try doing Kegel
exercises while sitting, standing or walking.
Maintain
your focus. For best results, focus on tightening
only your pelvic floor muscles. Be careful not to flex the muscles in your
abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely
during the exercises.
Repeat
3 times a day. Aim for at least three sets of 10
repetitions a day
THE
PAUSE-SQUEEZE TECHNIQUE
Your doctor might
instruct you and your partner in the use of a method called the pause-squeeze
technique. This method works as follows:
·
Begin sexual activity as usual,
including stimulation of the penis, until you feel almost ready to ejaculate.
·
Have your partner squeeze the end of
your penis, at the point where the head (glans) joins the shaft, and maintain
the squeeze for several seconds, until the urge to ejaculate passes.
·
Have your partner repeat the squeeze
process as necessary
By repeating as many
times as necessary, you can reach the point of entering your partner without
ejaculating. After some practice sessions, the feeling of knowing how to delay
ejaculation might become a habit that no longer requires the pause-squeeze
technique.
If the pause-squeeze
technique causes pain or discomfort, another technique is to stop sexual
stimulation just prior to ejaculation, wait until the level of arousal has
diminished and then start again. This approach is known as the stop-start
technique.
Condoms
Condoms might decrease
penis sensitivity, which can help delay ejaculation. "Climax control"
condoms are available over the counter. These condoms contain numbing agents
such as benzocaine or lidocaine or are made of thicker latex to delay
ejaculation. Examples include Trojan Extended, Durex Performax Intense and
Lifestyles Everlast Intense.
Medications
Topical
anesthetics
Anesthetic creams and
sprays that contain a numbing agent, such as benzocaine, lidocaine or
prilocaine, are sometimes used to treat premature ejaculation. These products
are applied to the penis 10 to 15 minutes before sex to reduce sensation and
help delay ejaculation.
A lidocaine-prilocaine
cream for premature ejaculation (EMLA) is available by prescription. Lidocaine
sprays for premature ejaculation are available over-the-counter.
Although topical
anesthetic agents are effective and well-tolerated, they have potential side
effects. For example, some men report temporary loss of sensitivity and
decreased sexual pleasure. Sometimes, female partners also have reported these
effects
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