Premature Ejaculation *part 1: symptoms, causes, riskfactors*

 What is premature ejaculation?

Premature ejaculation (PE) is when during sexual intercourse, there is too rapid achievement of climax and ejaculation occurs in the male relative to his own or his partner's wishes. In this state, ejaculation occurs during the early stages of sexual excitement or soon after the insertion of the penis into the vagina. Premature ejaculation is one of the most common male sexual problems negatively impacting sexual life leading to worry, stress, or serious concern. About 1 in 3 men are affected by PE at some point in their life.

Premature Ejaculation can be differentiated between two types. Primary PE, which is present from the time a man attains puberty, and Secondary PE which is acquired later in the man's life.

Premature Ejaculation can be further divided between

·        Global Premature Ejaculation, which occurs with all partners and in all circumstances, and

·        Situational Premature Ejaculation which occurs in certain situation or with specific partners.

How is PE measured?

There is presently no medical standard that exists to indicate how long a man should take to ejaculate. Therefore, it’s almost impossible to get an accurate description of premature ejaculation, because what some couples consider a satisfactory length of intercourse would be very inadequate for others.

A study reported the average intravaginal ejaculation latency time (IELTs)-that is the time it takes a man from vaginal penetration to when he ejaculates- of 6.5 minutes in 18 – 30 year old.

While this could be considered standard, it is possible that men with very low IELTs, of say about 2 minutes could be happy and satisfied with their performance, while men with higher IELTs of even up to 20 minutes may consider themselves to have premature ejaculation.

So how is PE measured? Since there seem to be no agreed gold standard for classifying PE, it may therefore be based on both partners satisfaction with the length of time the man stays before coming.

How common is PE?

Premature Ejaculation is a very common form of male sexual dysfunction. As a matter of fact, it is the most common instance of sexual dysfunction for men under 40 years of age.

Recent estimates conclude that up to 1 in 3 sexually active men are affected by the problem to some degree. Most men experience premature ejaculation at least once in their lives.

What are the symptoms of premature ejaculation?

The primary symptom of premature ejaculation is the inability to delay ejaculation for more than one minute after penetration. However, the problem may occur in all sexual situations, even during masturbation.

Premature ejaculation is characterized by the following:

·        The inability of a man to control his ejaculation that interferes with optimal sexual or psychological well-being in either partner.

·        Ejaculating before he is ready to, or has satisfied his partner.

·        Ejaculating before penetration, upon penetration, or shortly thereafter.

When to see a doctor

Talk with your doctor if you ejaculate sooner than you wish during most sexual encounters. It's common for men to feel embarrassed about discussing sexual health concerns, but don't let that keep you from talking to your doctor. Premature ejaculation is a common and treatable problem.

For some men, a conversation with their doctor may help alleviate concerns about premature ejaculation. For example, it may be reassuring to hear that occasional premature ejaculation is normal and that the average time from the beginning of intercourse to ejaculation is about five minutes

What causes PE?

The exact cause of premature ejaculation isn't known. While it was once thought to be only psychological, doctors now know premature ejaculation is more complicated and involves a complex interaction of psychological and biological factors.

Some cases of premature ejaculation do not have a clear cause. However, for most cases, combinations of factors have been identified, these include:

·        Oversensitive glans penis ( head of the penis)

·        Intercourse with a new partner

·        Nervousness or performance anxiety

·        Long time since the last ejaculation

·        Temporary depression

·        Sense of guilt

·        Side effect of medications

·        Financial and emotional stress

·        Unrealistic expectations about performance

·        History of sexual repression

·        Hormonal imbalances

·        Thyroid issues

·        Genetic abnormalities

·        Neurotransmitter abnormalities

·        Abnormal reflex activity of the ejaculatory system

·        An overall lack of confidence

·        Inflammation and infection of the prostate or urethra

·        Nervous system damage from surgery or trauma

Risk factors

Various factors can increase your risk of premature ejaculation, including:

    Erectile dysfunction. You may be at increased risk of premature ejaculation if you occasionally or consistently have trouble getting or maintaining an erection. Fear of losing your erection may cause you to consciously or unconsciously hurry through sexual encounters.

    Health problems. If you have a serious or chronic medical condition, such as heart disease, you may feel anxious during sex and may unknowingly rush to ejaculate.

    Stress. Emotional or mental strain in any area of your life can play a role in premature ejaculation, often limiting your ability to relax and focus during sexual encounters.

References:

·         The Turek Clinic, male ejaculatory disorders http://www.theturekclinic.com/ejaculatory-disorder.html accessed 15 October 2012

·         Netdoctor.com, premature ejaculation, http://www.netdoctor.co.uk/sex_relationships/facts/prematureejaculation.htm

·         Waldinger MD, Quinn P, Dilleen M, Mundayat R, Schweitzer DH, Boolell M (2005). "A multinational population survey of intravaginal ejaculation latency time". The journal of sexual medicine 2 (4): 492–7.

·         PubMed Health, Premature ejaculation http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002492/

·         NHS Choices, Ejaculatory problems http://www.nhs.uk/conditions/ejaculation-problems/Pages/Introduction.aspx

- See more at: http://nobledoctors.com/article/20/Premature%20Ejaculation#sthash.qS4hgGAS.dpuf

.        Mayoclinic

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