premature ejaculation


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Premature Ejaculation

 

Definition

Premature ejaculation occurs when male sexual climax (orgasm) occurs before a man wishes it or too quickly during intercourse to satisfy his partner.

Description

Premature ejaculation is the most commonly reported sexual complaint of men and couples. The highest number of complaints is among teenage, young adult, and sexually inexperienced males. Increased risk is associated with sexual inexperience and lack of knowledge of normal male sexual responses.

Causes and symptoms

There are several reasons why a man may ejaculate prematurely. For some men, the cause is due to an innate reflex or psychological predisposition of the nervous system. Sometimes it can be caused by certain drugs, such as non-prescription cold medications. Psychological factors, such as stress, fear, or guilt can also play a role. Examples of psychological factors include guilt that the sexual activity is wrong or sinful, fear of getting caught, or stress from problems at work or home.
In general, symptoms are when a male reaches climax in less than two minutes or when it occurs before the male or couple want it to occur.

Diagnosis

There are no tests used to diagnose premature ejaculation. It is usually determined by the male involved based on his belief that he reached orgasm too quickly. General guidelines for premature ejaculation is if it occurs in two minutes or less, or prior to about 15 thrusts during sexual intercourse.

Treatment

In 1966, William H. Masters and Virginia E. Johnson published Human Sexual Response, in which they broke the first ground in approaching this topic from a new perspective. Their method was devised by Dr. James Seman and has been modified subsequently by Dr. Helen Singer Kaplan and others.
A competent and orthodox sex therapist will spend much more time focusing on the personal than the sexual relationship between the two people who come for treatment. Without emotional intimacy, sexual relations are superficial and sexual problems such as premature ejaculation are not always overcome.
With that foremost in mind, a careful plan is outlined that requires dedication, patience, and commitment by both partners. It necessarily begins by prohibiting intercourse for an extended period of time—at least a week, often a month. This is very important to the man because "performance anxiety" is the greatest enemy of performance. If he knows he cannot have intercourse he is able to relax and focus on the exercises. The first stage is called "sensate focus" and involves his concentration on the process of sexual arousal and climax. He should learn to recognize each step in the process, most particularly the moment just before the "point of no return." Ideally, this stage of treatment requires the man's partner to be devoted to his sensations. In order to regain equality, he should in turn spend separate time stimulating and pleasing his mate, without intercourse.
At this point the techniques diverge. The original "squeeze technique" requires that the partner become expert at squeezing the head of the penis at intervals to prevent orgasm. The modified procedure, described by Dr. Ruth Westheimer, calls upon the man to instruct the partner when to stop stimulating him to give him a chance to draw back. A series of stages follows, each offering greater stimulation as the couple gains greater control over his arousal. This whole process has been called "outercourse." After a period of weeks, they will have together retrained his response and gained satisfactory control over it. In addition, they will each have learned much about the other's unique sexuality and ways to increase each other's pleasure.
With either technique, the emphasis is on the mutual goal of satisfactory sexual relations for both partners.
However, the 1990s ushered in a new era in the treatment of premature ejaculation when physicians discovered that certain antidepression drugs had a side effect of delaying ejaculation. Clinical studies have shown that a class of antidepressants called selective seratonin reuptake inhibitors (SSRIs) can be very effective in prolonging the time to ejaculation. The individual drugs and the average amount of time they delay ejaculation are fluoxetine (Prozac), one to two minutes with doses of 20-40 milligrams per day (mg/day) and eight minutes with 60 mg/day; paroxetine (Paxil), three to 10 minutes with doses of 20-40 mg/day; and sertraline (Zoloft), two to five minutes with doses of 50-200 mg/day.

Alternative treatment

There are several alternative products, usually found in health food and nutrition stores, designed to be sprayed or rubbed on the penis to delay ejaculation. Although the products promise results, there are no valid clinical studies to support the claims. A device called a testicular restraint, sold through erotic mailorder magazines, sometimes helps men delay ejaculation. The Velcro-like device restrains the testicles from their natural tendency to move during sex. Testicular movement can cause premature ejaculation.

Prognosis

The "squeeze technique" has elicited a 95% success rate, whereby the patient is able to control ejaculation. Treatment with SSRIs is effective in 85-90% of cases. However, the effectiveness begins to decrease after five weeks of daily administration. Although more studies are needed, this suggests the SSRIs are more effective when used on an as-needed basis.

Prevention

The best prevention is obtaining adequate information on normal sexual responses of males before having sex. It is also helpful to have sex in a comfortable, relaxed, private setting, free of guilt, stress, and fear.

Resources

Periodicals

"Lengthen Your Fuse." Men's Health November 1999: 56.
Rowland, David L., and Arthur L. Burnett. "Pharmacotherapy inthe Treatment of Male Sexual Dysfunction." The Journal of Sex Research August2000: 226+.

Organizations

American Association for Marriage and Family Therapy. 1133 15th St. NW, Suite 300, Washington, DC 20005-2710. (202) 452-0109. http://www.aamft.org..
American Association of Sex Educators, Counselors, and Therapists. P.O. Box 5488, Richmond, VA 23220. http://www.aasect.org..
Sexuality Information and Education Council of the U.S. 130 W. 42nd St., Ste. 350, New York, NY 10036. (212) 819-9770. http://www.siecus.org..

ejaculation

 [e-jak″u-la´shun]
forcible, sudden expulsion; especially expulsion of semen from the male urethra, a reflex action that occurs as a result of sexual stimulation. adj., adj ejac´ulatory. The three components of semen are expelled in quick succession. First to emerge is a lubricating fluid produced by the bulbourethral glands in the penis; next comes a fluid released into the urethral channel by the prostate, providing a neutral medium within which the sperm cells can swim; and lastly, the spermatic fluid, which has been stored in the seminal vesicles, is likewise injected into the urethral channel and ejaculated. See also reproduction.
premature ejaculation ejaculation consistently occurring either prior to, upon, or immediately after penetration and before desired, taking into account factors such as age, novelty of the specific situation and recent frequency of sexual activity.
retarded ejaculation male orgasmic disorder.
retrograde ejaculation ejaculation with discharge of the semen into the bladder rather than through the urethra to the outside. It often occurs after prostatectomy or spinal cord injury.

pre·ma·ture e·jac·u·la·tion

during sexual intercourse, too rapid achievement of climax and ejaculation in the male relative to his own or his partner's wishes.

premature ejaculation

n.
During sexual intercourse, more rapid occurrence of ejaculation than a male or his partner desires.

premature ejaculation

uncontrollable, untimely ejaculation of semen often caused by anxiety during sexual intercourse. Behavioral techniques can be learned by the man and his partner, or medication may be used to extend the length of time between erection and ejaculation. See also ejaculation, erection.

premature ejaculation

Ejaculatio praecox Urology A manifestation of sexual dysfunction, defined in the DSM-IV as 'Persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it.–Criterion A, which '…causes marked distress or interpersonal difficulty'–Criterion B, and is not substantially associated with the effects of a substance–ie, a drug or substance of abuse–Criterion C; in evaluating PE, factors weighed include age, novelty of sexual partner, recent sexual activity, etc. Cf Nocturnal emission, Onanism.

pre·ma·ture e·jac·u·la·tion

(prē'mă-chŭr' ē-jak'yū-lā'shŭn)
During sexual intercourse, too rapid achievement of climax and ejaculation in the male relative to his own or his partner's wishes.

premature ejaculation

The occurrence of a male orgasm at such an early stage in sexual intercourse as to deprive both partners of satisfaction. Premature ejaculation is usually due to sexual inexperience or over-excitement.

Patient discussion about premature ejaculation

Q. is there proven cure for premature ejaculation

A. great answer F3_4U. Glad to see you on the site. How are you?

Q. what medication can i take for fremature ejaculation is there a over the counter med?or do i need to see a dr.?

A. I think it is right that anti depressants work, the question is how efficient it is, do you need to take it regularly on not and what are the side effects...

More discussions about premature ejaculation
References in periodicals archive ?
Premature ejaculation is not dependent on age and is consistent across all age groups.
Polymorphisms of the serotonin transporter gene and their relation to premature ejaculation in individuals from Iran.
Prevalence of premature ejaculation in Turkish men with chronic pelvic pain syndrome.
Identify and understand important and diverse types of therapeutics under development for Premature Ejaculation.
One of the biggest ever surveys into sexual satisfaction in Asia-Pacific revealed today the intense levels of distress and frustration that premature ejaculation ("PE") causes men and their partners.
If premature ejaculation occurs frequently, the cause may be psychological.
They were seen monthly for review and completion 2 validated patient-reported outcome questionnaires, the Index of Premature Ejaculation (IPE) and the Premature Ejaculation Profile (PEP).
The most common problems were erection problems (69 percent), loss of sex drive (17 percent), premature ejaculation (12 percent), masturbation problems (10 percent) and genital problems (12 percent).
No medications are currently approved for premature ejaculation in the United States or in Europe, according to Dr.
The double-blind, placebo-controlled study involved 33 men with previously identified premature ejaculation (PE), along with 12 control subjects.
Currently, Priligy[R] is marketed for on-demand treatment of premature ejaculation in 15 countries in Europe, Asia and Latin America, while it is approved for that indication in 43 countries worldwide.