Is premature ejaculation a far-fetched issue, or not? They say that there are no sexual problems which could not be created by people themselves. This affirmation is partially based on simple ignorance caused by the lack of sexual education and illiteracy. However, there is a deal of truth in it. How to define whether you suffer from premature ejaculation, and what can be done to solve this problem?
What is premature ejaculation?
Premature ejaculation is some kind of symptom complex when ejaculation comes at minimal sexual stimulation, or happens before or right after intromission (injection of penis into vagina), not allowing both partners getting full sexual satisfaction. Premature ejaculation leads to communication problems with a partner, and is not connected with direct effect of medications.
Talking about premature ejaculation, people mostly mean man’s inability to control the moment of his orgasm. This problem makes him face deep disappointment, becomes more serious with every similar failure, and grasps the mind of each male experiencing it, if we consider the fact that, according to different researchers, premature ejaculation is typical in 25% – 60% cases. Besides, most men ejaculate rapidly during their first sexual intercourses, and about 29% of men experience premature ejaculation regularly.
Some scientists and doctors characterize premature ejaculation as a specific fear of sexual intercourse, stress that consist of affective (“fear of action”) and cognitive (“visual”) components. In 20th century, premature ejaculation was regarded as a form of impotence. Duration of intercourse was defined as a number of fixed frictions, or measured by certain time. Sometimes scientists stated that if a woman does not experience orgasm during coital relations, a man leaves his semen too early.
“Premature ejaculation is an inability to control ejaculation to the extent necessary for both partners to get satisfaction from sexual act regardless of time of friction period.”
International Statistical Classification of Diseases and Related Health Problems, defines premature ejaculation as sexual dysfunction not conditioned by organic disorders or diseases, and residing in the inability to control ejaculation so that it would be enough for both partners to be fully satisfied from sexual transaction. Together with that, time of friction period is not taken into account, which can lead to mistakes in diagnosis in case of inorgasmia, or other pathological conditions of female partner. No matter what the exact definition of “premature ejaculation” is, there are certainly both psychological and social aspects causing the problem.
The mechanism of ejaculation: how does it work?
Ejaculation is a process of discharge of products generated by testicle and adventive sexual glands. The moment of discharge unavoidability comes about 2-4 seconds before emission from external urethral opening. As soon as a man reaches critical level of sexual arousal, ejaculation happens reflexively, and the centre of this reflective act is located in lumbar cord.
Due to strong nervous impulses and contractions of muscular walls of spermaducts and pelvic floor muscles, ejaculation may become so intense that some men can shoot sperm up to one meter! And men are capable of a series of ejaculations following one another with various pauses: short or long. But, in fact, biologists claim that golden hamster is the species that has maximum potential: it may ejaculate 50 times within one hour.
The volume of man’s single ejaculate reaches up to one teaspoon of 5 ml (about 120–600 mln of sperm cells), and the concentration of sperm in it depends on the frequency of ejaculations. Each subsequent ejaculation comes only after some brief reflective period – rest. Orgasm with ejaculation or without it, and with a reflective period following it marks the end of sexual intercourse. The moment when ejaculation with erection happens can indicate preliminary ejaculation, normal sexual intercourse, or impeded emission of seminal fluid.
Are reflexes to be blamed?
Many researchers of sexual relations claim that normally, a man can impede orgasm, or let it go when he wants. According to research performed during recent years, influence and control over ejaculation are possible in case of abidance to some terms, man’s knowledge, skills and experience. In other words, a man is able of controlling his orgasm and ejaculation.
This confirmation is debatable, though. European sexologists connect premature ejaculation with inability to control unavoidability of this reflective process. A man can bear high level of sexual arousal up to some certain moment, and then comes reflective ejaculation.
Some researchers are sure that there are people incapable of such control for a variety of causes (for instance, if premature ejaculation is the result of functional disorders of nervous control on it different levels). Those men who cannot control this reflective process without certain help, correction, or treatment become patients of sexologists with diagnosis “premature ejaculation”.
Premature Ejaculation and Psychological Aspects
Men with premature ejaculation often underestimate the level of their physical arousal during penis stimulation, and ejaculation happens before reaching maximum sexual arousal. These men have low ejaculatory control, which is why many of them try to solve the problem for tens of years, and cannot find a solution.
First of all, the point is that a man facing such problem starts paying attention to ejaculation only, being constantly under stress and waiting for premature ejaculation, which, in its turn, leads to this. Concentration on ejaculation affects erection. As the result, erectile dysfunction may develop.
Secondly, modern pornography, films and art tend distort men’s perception of normal sexual relationships. Media, video production, and Internet show us a male who is able to be satisfying his partner for hours without getting tired or even making pauses. Porn industry focuses on mechanical and visual aspects of sexual intercourse instead of emotional and psychological facets of the process. It’s no surprise that millions of men start perception their individual sexual behaviors as something abnormal and suffer from low self-esteem.
“Media and porn industry show us the image of an “ideal man” who can make love for hours without rest. Reality turns out to be so much different.”
It goes without mentioning that men themselves support this myth when saying that they “can be making love for hours without rest”. Males boast by huge intervals before ejaculations, and fast ejaculation is regarded as a sign of one’s weakness. Most often, this opinion is typical of young people. Sexologists’ patients with impeded sperm emission don’t think so. The truth is that the younger and sexier man is, the quicker ejaculation comes. In wild nature, animals are relatively defenseless during sexual act. Species which could not finish sexual intercourse quickly were easy prey for predators. It is social development, and changing of opinions about sexual relationship caused by evolvement of sexual culture that have greatly altered norms and formed behavior stereotypes, offering new values.
Types of premature ejaculation
Most specialists divide premature ejaculation into primary and secondary.
- Primary premature ejaculation happens during the initial period of sexual life, and is caused by alterations in central and periphery neural structures of copulatory function regulation. Most often, it is the result of psychological stress and hyperexcitability. Accelerated sperm emission and man’s attempts to control himself often lead to a situation when a man starts avoiding sexual contact, or regards himself sick, or challenged. And if no measures are undertaken to get rid of this problem, such type of premature ejaculation may stay forever.
- Secondary premature ejaculation is acquired in the result of various inflammations of prostatic gland, urethra, etc. This premature ejaculation is conditioned by pathological changes in other organs and body systems. Eliminating diseases that may cause premature ejaculation, a person may restore normal ejaculation. Course of premature ejaculation treatment is arranged individually, basing on the results of examination. This treatment is aimed at elimination of the factors leading to premature ejaculation and restoration of man’s ability to control duration of sexual intercourse.
Other types of premature ejaculation
Premature (accelerated) ejaculation – ejaculation that takes place at friction stage of copulatory interval from 1,5 to 3,5 minutes.
Absolute premature ejaculation – ejaculation that comes during friction stage of copulatory interval of less than 1 minute, or after 20-25 frictions.
Relative premature ejaculation takes place at friction stage of copulatory interval from 1,5 to 3,5 minutes, or more, but before a female partner reaches orgasm.
20 basic reasons for premature ejaculation
Data of literary sources, materials of research, and authoritative opinions show that physical causes of premature ejaculation and term “ejaculatory control” are not clearly defined up to this moment. However, it is considered, that deviation of psychological control over sperm emission and incongruity of tactile and deep penis sensitivity limits are among number one factors that cause premature ejaculation.
This is a broad view on the circumstances which lead to premature ejaculation. Different factors of physiological, organic, psychological, behavioral and socio-cultural character can also be considered as certain reasons for premature ejaculation:
- Syndrome of cerebral paracentral lobules. This disease can be both innate, or acquired. Cortex disorders of brain influence genitals and bladder, upsetting their activity. Apart from premature ejaculation, this syndrome causes other deviations: nocturnal enuresis, pollakiuria, anisocoria, asymmetrical rise and inversion of reflexogenous zones of tendo Achillis reflex. Disorders of ejaculation in this case are found in 3.8% of examined patients.
- Inflammation processes in seminal hillock. During sexual intercourse, blood flow increases, ascending impulses strengthen and penetrating zones of central neural system responsible for orgasm inside seminal hillock where inflammation process (colliculitis) appeared. In case of pathological enlargement (hypertrophy) and inflammation, such impulsion becomes stronger, orgasm comes earlier, and usually loses its quality.
- Inflammation processes of adventive sexual glands. Prostatitis and spermatocystitis – inflammation processes of adventives sexual glands – are closely connected with seminal hillock. And when they inflame, pathological reaction may involve it, too. But treatment of such diseases without curing of seminal hillock will not bring long-lasting effect.
- Distortion of sperm emission regulation in sacrolumbal part of spinal cord. Sometimes it is conditioned by primary damage of cerebro-spinal sexual centers with decrease of ejaculation centre arousal. It also happens in case of spine damage, damage of dorsal spinal cord and lumbar cord, fracture of the pelvis, separation of back urethra and rupture of bladder or urethra structure.
- Hypersensitivity of balanus. Neural ends located in balanus are main receptors in nerve arc that is closed in spinal cord. If there are extra receptors, or they are extra sensitive to arousal, premature ejaculation happens.
- Short penis frenulum.
- Low level of ejaculation reflex caused by peculiarities of sexual anatomy. Due to this reason, ejaculation may come at incomplete erection, or suddenly without preceding sexual arousal.
- Traumas of sympathetic nervous system during operations on aneurysm of abdominal aorta part, atherosclerosis, and arterial hypertension.
- Chronic intoxication by some toxins (alcohol, nicotine, drugs and other substances), which leads to excitement of all parts of nervous system.
- Negative influence of some kinds of medication therapy (chemotherapy, hormonal and antihypertensive therapy, antidepressant drugs, etc.) on sexual function, including ejaculation.
- Hypersexuality and high sexual activity in man, which manifests into ability to have frequent short sexual intercourses with brief pauses.
- Absence of experience of sperm emission control in the beginning of sexual relations. Some sexologists note that premature ejaculation is often caused by sexual intercourses in adolescence performed in a hurry, under stress, and because of the fear to be caught off-guard.
- Low frequency of sexual intercourses which leads to increase of sexual excitability (especially among young people).
- Uneasiness, anxiety and fear during sexual intercourse connected with exterior factors, or conditioned by interpersonal relationships of both partners.
- Developed habit of having fast ejaculation during masturbation, or previous sexual experience.
- The result of acquired experience in situations contributing to short sexual intercourses.
- Set-up-to-fail syndrome (taking place once, such failure is being expected next time).
- Interpersonal problems of sexual partners. The most frequent supposed interpersonal factors are: dissatisfaction with family life, failures to resolve interpersonal conflicts, lack of partners’ trust in each other, fear of intimate and romantic relationships, conflicts of sexual roles.
- Negative knowledge about sex. For instance, perception of intercourse as an exclusively quick process of sperm cell transfers to ovicell from man to woman for conceiving.
- General exhausting of nervous system as the result of unhealthy lifestyle, fatigue and lack of sleep. Nervous men with hyperexcitability are prone to aggravated sensitivity of nervous ends to exterior penetration. It functions with “increased speed”, but may fail in most common situations which do not cause any emotions in usual people.
There may be more reasons; moreover, some researchers classify them into different groups. For instance, premature ejaculation can be conditioned by reasons of psychological, somatic, or neurological character.
What is a short sexual intercourse?
Surprisingly, the duration of normal sexual intercourse varies from culture to culture. We got used to what is shown on TV and media – 15-30 minute sessions 2-3 times a week became the equivalent of “the normal” which is being mentioned universally today. However, every couple has their own habits and preferences, and social opinion shouldn’t play much role for those who know that their sexual relationships are mutually satisfying.
Representatives of other countries and nationalities assert their own principles and lifestyle. For instance, in ancient China, a 20-year-old man could have sex once in four days, 30-year-ols – once in eight days, 40-year-old – once in ten days, and 50-year-old – once in twenty days.
Practice of sexual consultation knows the cases when men complain about too long (prolonged) sexual act and inability to finish it with discharge. There are also many men who do not even manage to start sexual act, as it already finishes!
“If both partners get enough satisfaction and manage to reach orgasm (simultaneously or not), such sexual intercourse cannot be called “short”, even if it lasts for a few minutes.”
It is impossible to come to a common definition of normal sexual act duration. It is personal for every couple, people have their normal time. We can talk about relatively short time when sexual intercourse is enduring, but this duration is not enough for a woman to get enough sexual satisfaction. We can also compare time of a female and male partners, but statistics show that women usually need more time for reaching orgasm than men. Statistics show that average duration of sexual act needed for a woman to reach orgasm is 8 minutes while majority of men reach ejaculation in 2-4 minutes.
So does it mean that most women simply cannot be satisfied? Some can reach orgasm even in longer acts lasting about 12 minutes.
No. With duration of act from one to 11 minutes about 50% of women experience orgasm regardless of how long it was – 1-2 minutes, or 8-11 minutes. It is explained by the fact that in most cases short sexual act duration is compensated by endurable preparation – so-called foreplay. In other cases a man lives with a woman who reaches orgasm quickly, adjusts to her tempo, and does not strive to prolong sexual intercourse. Thirdly, partners may consequently reach orgasms, being content with it.
Therefore, if both partners are satisfied and reach orgasm (simultaneously or not), it’s inappropriate to label such sexual intercourse as “short”, even if it lasts a few minutes.
If one partner reaches orgasm and instantly loses arousal, it means that something went wrong, and such sexual act can be called short. Willing to prolong sexual act is normal, because in most cases it is done for pleasure. And it is natural for a man and woman to prolong this pleasure for a reasonable amount of time. Thus, short sexual act – is an intercourse that needs to be prolonged because of dissatisfaction of one partner.
Are there time boundaries of premature ejaculation?
There are men who can reach orgasm too quickly with some women, and don’t have such problem with others. Besides, some men ejaculate fast during sexual act only, but can masturbate for hours. Other men complain that they reach orgasm too soon, and then it turns out that they talk about 30-minute sexual intercourse.
There was a period when the majority of researchers tried to measure premature ejaculation in minutes. Time spent on sexual act was standardized. Men were divided according to the level of disease severity. Today, most doctors agree that premature ejaculation happens in cases when a man is unable to satisfy his female partner fully at least in half of sexual intercourses. At the same time, they highlight that this criteria depends on woman’s sexuality which can vary considerably.
According to some specialists, average duration of man’s friction stage of copulative cycle is about 2-3 minutes. Internet tells us that a sexual intercourse lasts for 5-10 minutes, while erotic or porn movies create an impression that this process can be endless. Therefore, sticking to some numbers is a mistake – every case is individual.
How to deal with premature ejaculation?
If one of partners is dissatisfied with time of sexual act, certain measures should be undertaken to prolong intimacy. Different cultures have different approaches to this problem.
Asian countries (China, Japan, Thailand, Korea, etc.) are known to prefer natural remedies for all kinds of health problems, including sexual disorders. Roots, herbs, extracts – all this stuff is widely used by Asian men and is considered to be a better alternative to traditional medications. However Western orthodox medicine offers proved, more reliable ways of premature ejaculation treatment.
Pelvic floor exercises
Sometimes ejaculation delay can be affected by weak pelvic floor muscles, and Kegel exercises can help to strengthen them. The most important is to identify the right muscles: stop urinating in the middle of the process and tighten the muscles that keep you from passing gas. This way, you will find pelvic floor muscles. Exercises can be made in any position: standing, sitting or lying.
Improve your technique. Tighten your muscles and keep the contraction for three seconds. Then relax for three seconds, and repeat. When the muscles will become strong enough, try performing Kegel exercises sitting, walking or standing. Do not tighten muscles in hips, buttocks or abdomen. Keep breathing steadily and freely. Such exercise should be repeated three times a day with sets of 10.
Condoms reduce penis sensitivity which helps to delay ejaculation. You can find over-the-counter condoms with numbing agents, or produced of thicker latex.
The pause-squeeze technique
This technique should be practiced with your partner. Start sexual intercourse as usual and reach the point when you’re almost ready to ejaculate. Ask your partner to squeese penis at the place where head is connected with the shaft and keep it for a few seconds until the need to ejaculate passes. Repeat the process as many times as necessary, and with the time you will learn to delay ejaculation without using the technique.
Topical anesthetics are produced in the form of creams and sprays and consist of numbing agents: these are often used to treat premature ejaculation. Apply a product to the penis 10-15 minutes prior to sexual intercourse to reduce penis sensitivity. Note that lidocaine-prilocaine creams can be bought with prescruption only, while Lidocaine sprays may be purchased over-the-counter. Possible side effects include decreasing of sexual pleasure and temporary loss of sensitivity.
Oral medications can also delay orgasms. Some analgesics (escitalopram, sertraline, paroxetine and fluoxetine) delay orgasms and are used in combination with other medications. Paroxetine appears to be the most efficient medication, and noticeable effect appears in 5-10 days. Side effects of antidepressants include nausea, drowsiness, excessive perspiration and low libido.
Phosphodiesterase 5 inhibitors contained in Viagra, Cialis, Levitra and other medications for impotence treatment also help to acquire better control over ejaculation. Some side effects include headache, flushing of face, problems with vision and hearing, and indigestion.
Premature ejaculation is also closely connected with man’s phychologial health. Performance anxiety and stress contribute to this problem, so you may need counseling together with drug therapy.
Some men say they lose the feeling of former closeness with their partner which contributes to low libido and poor sexual life. Solve all your personal problems together. Don’t let aggression and offence accumulate – discuss what bothers you. When you restore normal relationships with your partner, your sexual intimacy will improve.