Premature ejaculation is a sexual disorder that impacts millions of men around the world. The term describes the failure to postpone ejaculation during sex, which renders the sexual encounter a painful and unsatisfying experience for both partners. Even so, PE is one of the most poorly-understood diseases, riddled with myths about it. In this article, we’ll examine premature ejaculation – what it is, what it is caused by, and how it can be treated.
Definition
Premature ejaculation is characterized by the loss of control over ejaculation during sex whereby ejaculation occurs too early (typically within a minute of penetration). It is a subjective state, because the time it takes to ejaculate varies from person to person and even within one person depending on stress and arousal. According to the International Society for Sexual Medicine (ISSM), PE refers to “ejaculation that almost always or always precedes or occurs within approximately one minute of vaginal penetration” (1). This definition makes PE different from other sexual dysfunctions, including erectile dysfunction, which primarily refers to a lack of an ability to form or maintain an erection.
Two types of PE
PE comes in two forms, lifelong and acquired. While lifelong PE is the term used to describe men who have had PE ever since their first sex, acquired PE happens when men who had normal ejaculation at one time developed PE later in life. Although the root causes of PE are not fully understood, evidence suggests that it is a multifactorial mix of psychological, neurobiological and relationship factors.
Psychological factors contributing to PE
Performance anxiety is one of the major psychological drivers of PE. For men under pressure to perform sex or who are afraid of not being liked by their partner, increased levels of arousal might cause them to overejaculate. Other psychological influences include stress, guilt and depression. In addition, prior sexual experiences, religious or cultural upbringings and relationship problems can contribute to the formation of PE.
In neurobiology, PE is associated with a decrease in levels of neurotransmitters including serotonin, dopamine and noradrenaline. These neurotransmitters are involved in regulating sexual activity, and an imbalance can influence the timing of ejaculation. Some investigators suggest that PE men might be hypersensitive to the ejaculatory reflex, causing their ejaculatory threshold to drop.
Diagnosis of Premature Ejaculation:
The medical diagnosis of premature ejaculation is largely based on a person’s history of sex and symptoms. A doctor will inquire about the number and duration of the problem, as well as whether or not it is related to a psychological or medical problem. Sometimes you might need to do a physical exam to rule out other medical conditions.
Other diagnostic tests that can be used include the Premature Ejaculation Diagnostic Tool (PEDT) and International Index of Erectile Function (IIEF). These measures provide a measurement of the level of PE and its effects on an individual’s life.
Treatment for PE
PE is treated differently based on its cause. Therapy or counseling may be helpful when psychological reasons are primary. Psychotherapy can enable clients to find out and address a potential source of PE, including performance anxiety or relationship challenges. Couples therapy may also assist in the development of greater relationship communication and intimacy.
Medical treatments, such as medication, can be prescribed for biological reasons. Selective serotonin reuptake inhibitors (SSRIs) are antidepressants that delay ejaculation. Other medications, including topical anaesthetics and phosphodiesterase-5 inhibitors, can also be used to treat PE.
Behavioural interventions and exercises, including the ‘squeeze’ and ‘stop-start’ approach, can also help with PE. These include managing arousal and learning to ejaculate on an extended timescale. They can be mastered alone or in conjunction with a partner, and they promote greater control and more prolonged sexual contact.
Mindfulness-based techniques
Over the past few years, mindfulness-based approaches to treating premature ejaculation have also gained popularity. Mindfulness is simply experiencing what one thinks, feels and feels without judging. Research suggests that mindfulness interventions in PE therapy increase sexual satisfaction and prevent premature ejaculation.
Aside from medication, lifestyle modifications can reduce premature ejaculation. These could include regular exercise, cutting down on alcohol and drugs, and relaxing through deep breathing and meditation. Open communication with your partner can also help solve relationship issues and reduce performance anxiety.
PE is a treatable condition
Note that PE is treatable, and treatment through a health care provider is key to managing its symptoms. But we should also remember that PE is a multifactorial disorder and treatment options are far from universal. For some people what works might not work for others, and it can take a little trial and error to determine the best treatment strategy.
Much research needed
Premature ejaculation is a complex phenomenon and research remains incomplete on its causes and remedies. A challenge in examining this disorder is that there is no standardised definition of the disorder, which makes it difficult to generalise studies. An additional challenge is men’s aversion to seeking care for this disorder, which has prevented statistics and awareness of the disorder’s prevalence.
Conclusion
Premature ejaculation, finally, is a sexual disorder that plagues many males. It is defined by the failure to prolong ejaculation during sexual relations and is segregated into permanent and acquired forms. Premature ejaculation has psychological, neurobiological and relationship-based causes. PE treatment options include psychotherapy, medication and topical creams, depending on the cause. Getting treated by a medical professional to diagnose and manage PE is essential, as PE can negatively impact sexual enjoyment and wellbeing. Almost any male can get past PE with the right treatment and live a productive sex life.
