Premature Ejaculation
Premature Ejaculation and Its Treatment
Premature Ejaculation
If you are experiencing premature ejaculation, you are not alone. Premature ejaculation is the most common sexual function disorder among men worldwide, and it can arise for many different reasons. Sometimes it appears only for a period, brought on by stress; at other times it becomes a chronic disorder that affects a couple’s life together.
And this dysfunction — which creates so much stress, erodes self-confidence, causes communication problems in relationships and can even become grounds for divorce — can be managed. Yet the myths surrounding it are so widespread that taking the right first step becomes difficult.
So what exactly is the disorder we call “premature ejaculation”? Is ejaculating quickly after a long, stressful day a condition that requires treatment? Let us look at the details together.
What Is Premature Ejaculation?
Before explaining what premature ejaculation is, I would like to say a little about what ejaculation is and how it occurs.
When a man is sexually aroused, signals from the brain are carried to the genital area by nerves in the spinal cord. These signals cause the pelvic muscles to contract rhythmically. As those contractions begin, sperm travel from the testicles towards the main sperm duct, called the vas deferens. During this journey, in order to protect the sperm, fluids secreted by the seminal vesicles and the prostate gland combine with them to form the fluid we call semen. The expulsion of semen from the body after sexual pleasure is reached is what we call ejaculation.
Ejaculation that occurs before intercourse takes place, or immediately after it begins — uncontrolled, repeated and against the man’s wishes — is what we define as premature ejaculation.
The definition of this disorder, known medically as premature ejaculation, contains both subjective and objective criteria. The phrase “immediately after intercourse begins”, for instance, creates an imprecise sense of time. Approaching the subject scientifically, we can say this period has been set at approximately one minute.
The essential aim of sexual intimacy is a satisfying experience for both the woman and the man. Associating premature ejaculation purely with intercourse lasting under a minute would therefore not be quite right. The partner needs to reach satisfaction too, and that requirement makes ejaculating before one’s partner reaches climax part of the criteria as well.
Premature ejaculation is present in some men from the moment they reach sexual maturity, but more often it emerges later, during the period in which they are sexually active. This difference divides the condition into two distinct types.
What Are the Types of Premature Ejaculation?
Premature ejaculation is examined in two main categories: “primary”, that is lifelong, and “secondary”, that is acquired.
Primary (Lifelong) Premature Ejaculation
This is the type observed from sexual maturity and the first sexual activity onwards, continuing throughout life. It occurs less frequently than the acquired type and is generally observed as a result of hormonal problems.
Secondary (Acquired) Premature Ejaculation
In the secondary type, sexual function problems appear later in life. Men who have had no sexual function problems may encounter premature ejaculation for psychological and/or physiological reasons. This is the most common type.
At the heart of the difference between the two types lies the variety of factors that lead to premature ejaculation. Let us turn now to those causes.
What Causes Premature Ejaculation?
In the past the prevailing view was that the causes of premature ejaculation were purely psychological. Today it is known that physical, chemical and psychological factors can all lead to the problem.
- An underlying erection problem
- Irregularities in oxytocin, luteinising hormone, prolactin and thyroid-stimulating hormone
- Prostate and urinary tract inflammation
- Sexually transmitted infections
- Low levels of serotonin, dopamine and other brain chemicals that increase sexual desire
- An oversensitive penis
- Faulty circumcision surgery
- Performance anxiety, excessive excitement, the meaning attached to sexuality, bad sexual experiences
- Problems within the relationship
- Depression
Although premature ejaculation is common both in our society and worldwide, it does not always require treatment — and the experience may not even be classed as a sexual function disorder. Ejaculating quickly after a long, stressful day, or after a long period without intercourse, is considered entirely normal. Variables such as how often it happens, how long it has been happening and under what circumstances all shape whether a man is diagnosed with a sexual function disorder. Which brings us to the symptoms.
What Are the Symptoms of Premature Ejaculation?
For a man’s sexual difficulties to be defined as premature ejaculation, three criteria need to be present.
- The person ejaculates almost every time within the first minute before or immediately after sexual penetration,
- in a way that cannot be delayed or prevented, and
- has begun to avoid intercourse because of a chronic sense of failure.
Psychological symptoms — reduced trust in the relationship, difficulty communicating, anxiety, depression and shame — can appear in both the man and the woman. Although it is classed among male sexual function disorders, premature ejaculation does not affect the man alone; it can damage a couple’s relationship and their communication. It is important that couples with these complaints approach treatment options constructively.
Premature ejaculation is not a problem to be ashamed of, nor one that cannot be treated. On the contrary: with treatment it can be controlled and the duration of intercourse extended. Left untreated, it can have negative effects on sexual and family life. Accurate diagnosis is critically important if the right treatment is to be planned.
How Is Premature Ejaculation Diagnosed?
Men who have frequently experienced premature ejaculation over a period of around six months, and who have begun to feel anxiety both personally and about their relationship, should be examined by urology and andrology specialists. The doctor will take a history covering how long the problem has been present, under what conditions and how often. Patients need to answer every question fully and clearly so that diagnosis and the planning that follows are correct. During the examination, information is also gathered on the patient’s general health, any medication or supplements they take, and their lifestyle habits. If a medical condition is suspected as the cause, laboratory tests may also be used.
Can Premature Ejaculation Be Prevented?
Unfortunately there is no definitive answer to this question. The causes and the course of sexual function disorders may not be the same for every patient. Temporary measures — masturbating before intercourse, using a thicker condom to reduce sensitivity of the glans, trying a different position — will not prove sustainable. The fact that sexual function disorders, premature ejaculation among them, can be a reflection of other health problems should not be overlooked, and treatment options should always be pursued.
How Is Premature Ejaculation Treated?
Premature ejaculation is a sexual function disorder that can be treated according to its causes, with treatment aiming both to extend time to ejaculation and to revive the couple’s relationship. Within individually planned treatment programmes, both medical and psychological support can be provided, and the methods available are varied.
Treatment may involve monitoring, medication, exercises, or changes to ejaculatory habits. Today, filler applied to the glans has come to the fore in treating premature ejaculation, both for producing fast results and for its long-lasting effect.
At AndroKLİNİK, premature ejaculation is treated with filler applied to the glans. Thanks to dermal fillers applied to the area of highest nerve density, our patients can feel the effect within as little as a week and can enjoy roughly a year of intimacy free from the problems premature ejaculation causes.