Premature Ejaculation : Causes-Symptoms-Diagnosis-Treatment

What is Premature Ejaculation?

Ejaculation is the release of semen from the body. Premature ejaculation (PE) is when ejaculation happens sooner than a man or his partner would like during sex.

Premature Ejaculation

PE is also known as rapid ejaculation, premature climax, or early ejaculation. If it is not a cause for worry, it can be frustrating if it continues to happen even after efforts are made to correct it. If you have sex too often it can make it less enjoyable and impact your relationships. If this is happening often and it's causing problems for you or your partner's health, your health care provider can help.

About one third of American men aged 18 to 59 have problems with erectile dysfunction. The problem may be psychological, but biology may also be involved.

1. Male reproductive system

The male reproductive system is a complex and essential structure that carries out the essential function of producing offspring. This system includes the testes, which produce sperm; the epididymis, which stores sperm until they are injected into the vas deferens; and the prostate, which produces seminal fluid.

• Internal reproductive organs

1. Testes

2. Epididymis

3. Vas deferens

4. Seminal vesicles

5. Prostate

6. Bulbourethral glands

• External reproductive organs

1. Penis

2. Scrotum

Medical terms

Premature ejaculation occurs once a person ejaculates sooner throughout sexual issues than he or his partner would like. ejaculation may be a common sexual complaint. Estimates vary, however as several as one out of three men say they experience this downside at some time. 

As long as it happens infrequently, it's not cause for concern. However, you might be diagnosed with premature ejaculation if you:

• Always or nearly always ejaculate within one minute of penetration

• Are unable to delay ejaculation during intercourse all or nearly all of the time

• Feel distressed and frustrated, and tend to avoid sexual intimacy as a result

Both psychological and biological factors will play a job in ejaculation. Although several men feel embarrassed talking about it, premature ejaculation may be a common and treatable condition. Medications, direction and sexual techniques that delay ejaculation — or a mixture of those — can facilitate improve sex for you and your partner.

How Does Ejaculation Work?

Ejaculation is controlled by the central nervous system. When men are sexually stimulated, signals are sent to your spinal cord and brain. This causes semen to be ejected through the penis. Ejaculation is when a man releases semen.

Ejaculation has two phases: emission and expulsion.

Phase 1: Emission

Ejaculation is when sperm moves from the testicles to the prostate and mixes with seminal fluid to create semen. The vasa deferentia are tubes that help transport sperm from the testicles to the base of the penis. (When you are talking about just 1 of these tubes, it is called a vas deferens.) The sperm ducts are located near the prostate.

Phase 2: Expulsion

Ejaculation happens when the muscles at the base of the penis contract. This causes semen to be expelled from the penis. Most climaxes and ejaculations happen at the same time. In most cases, erections go away afterwards.

Premature ejaculation and erectile dysfunction (ED) are problems that can occur when a man does not have an erection or cannot have an orgasm when he wants to.

ED is a problem for men who have difficulty getting or keeping an erection. This can be difficult to determine, because an erection usually dissipates after ejaculation. If ED is not treated, it can lead to problems in other areas of your life such as relationships. First, if you have premature ejaculation (ED), it may not be a problem once the condition is treated.

Symptoms Premature Ejaculation

The main symptom of ejaculation is the inability to delay ejaculation for quite one minute when penetration. However, the matter would possibly occur altogether sexual situations, even throughout masturbation.

Premature ejaculation can be classified as:

• Lifelong (primary). Lifelong premature ejaculation occurs all or nearly all of the time beginning with your first sexual encounters.

• Acquired (secondary). Acquired ejaculation develops once you've had previous sexual experiences while not ejaculatory problems. Several men feel that they need symptoms of premature ejaculation, however the symptoms don't meet the diagnostic criteria for premature ejaculation. Instead these men may need natural variable premature ejaculation, which has periods of fast ejaculation similarly as periods of traditional ejaculation. 

When to see a doctor

Talk together with your doctor if you ejaculate ahead of you would like throughout most sexual encounters. It' common for men to feel embarrassed regarding discussing sexual health issues, however don't let that keep you from lecture your doctor. ejaculation could be a common and treatable problem. For a few men, voice communication with a doctor might reduce concerns about premature ejaculation. For example, it would be comforting to hear that occasional premature ejaculation is traditional, and the typical time from the start of intercourse to ejaculation is about 5 minutes. 

Causes Premature Ejaculation

The exact reason behind ejaculation isn't understood. whereas it had been once thought to be solely psychological, doctors currently know premature ejaculation involves a posh interaction of psychological and biological factors.

Psychological causes

Psychological factors that might play a role include:

• Early sexual experiences

• Sexual abuse

• Poor body image

• Depression

• Worrying about premature ejaculation

• Guilty feelings that increase your tendency to rush through sexual encounters

Other factors that can play a role include:

• Erectile dysfunction. Men who are anxious concerning getting or maintaining an erection throughout sexuality would possibly type a pattern of speeding to ejaculate, which might be troublesome to change. 

• Anxiety. Many men with premature ejaculation also have problems with anxiety — either specifically about sexual performance or related to other issues.

• Relationship problems. If you have got had satisfying sexual relationships with alternative partners within which ejaculation happened sometimes or not at all, it' doable that social problems between you and your current partner are conducive to the problem. 

Biological causes

A number of biological factors would possibly contribute to premature ejaculation, including:

• Abnormal hormone levels

• Abnormal levels of brain chemicals called neurotransmitters

• Inflammation and infection of the prostate or urethra

• Inherited traits

Serotonin

Some scientists believe that serotonin may play a role in the cause of PE. Serotonin is a natural substance made by nerves. High levels of serotonin in the brain can delay ejaculation. Low levels of serotonin can shorten ejaculation time and lead to PE.

Psychological Issues

Physical education (PE) can involve psychological or mental health issues. These can include:

• depression

• stress

• guilt

• People may have unrealistic expectations about their sexual performance.

• history of sexual repression

• lack of confidence

• relationship problems

Sometimes it is helpful to take care of emotional problems.

Other Issues

• PE and Age

Aging can cause problems with erections and ejaculation. Though aging does cause changes in these things, erections and ejaculation are not directly caused by aging. Older men might have weaker erections or they may ejaculate sooner than usual. These changes may lead to an older man ejaculating sooner.

• PE and Your Partner

Pretend activities like PE can lead to feelings of loss or separation from a sexual partner. In some cases, premature ejaculation may also have negative effects on the partner, including feeling less connected or hurt.

Talking about the problem is important. Counseling or sex therapy can help. There are exercises to help you and your partner have longer erections (see the treatment section of this article for more details). Most importantly, a couple should learn how to deal with the problem. There are ways to relax during PE.Worrying about a problem can make it worse.

Men typically have some control over when they ejaculate during partnered sex and masturbation. If a man feels that he does not have much control over when orgasm occurs, or if there is worry by the man or his sexual partners PE may be present.

If you are experiencing problems with your sex life, you should see a health care professional. The diagnosis is based on whether ejaculation occurs early, late, or not at all. Your health care provider will ask you some questions and perform a physical exam. Most often, the diagnosis of premature ejaculation will be made after talking with you. What does "ask are" mean?

• How often does PE happen?

• How long have you had this problem?

• What does this happen with just one person or with all people?

• Does PE happen with each attempt at sex?

• How often do you participate in different types of sexual activity (for example, foreplay, masturbation, intercourse)?

• How has PE changed your sexual activity?

• How are your personal relationships?

• What are some things that might make PE worse or better? (e.g. drugs, alcohol, etc.)

If your doctor finds something during your physical exam, you will need to have lab testing done. This is only if your health care provider thinks it is necessary.

There are a variety of treatments that can be used to treat PE. You can talk to your health care provider about the best choice for you. Sometimes more than one type of treatment is used at the same time.

Risk factors Premature Ejaculation

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

• Erectile dysfunction. You may be at exaggerated risk of ejaculation if you sometimes or systematically have hassle obtaining or maintaining associate erection. concern of losing your erection might cause you to consciously or unconsciously hurry through sexual encounters. 

• Stress. Emotional or strain in any space of your life will play a job in premature ejaculation, limiting your ability to relax and focus throughout sexual encounters. 

Complications Premature Ejaculation

Premature ejaculation will cause issues in your personal life, including:

• Stress and relationship problems. A common complication of premature ejaculation is relationship stress.

• Fertility problems. Premature ejaculation will sometimes create fertilization though for couples who are attempting to possess a baby if ejaculation doesn't occur intravaginally. 

Diagnosis Premature Ejaculation

In addition to raiseing regarding your sex life, your doctor can ask about your health history ANd may do a physical exam. If you've got each ejaculation and bother obtaining or maintaining an erection, your doctor might order blood tests to ascertain your male secretion (testosterone) levels or different tests. In some cases, your doctor might counsel that you just head to a medical specialist or a mental state skilled who focuses on sexual dysfunction. If you have frequent premature ejaculations, or if premature ejaculation is inflicting you anxiety or depression and poignant your relationship, build an appointment testine|to visualize} a medical specialist. Your urologist will begin AN exam by asking regarding your sexual experiences. you may seemingly be asked: 

• How long have you had this problem?

• Under what circumstances does it happen?

• How often does it happen?

• Does premature ejaculation happen at every sexual attempt?

• Does it happen with all partners?

• Does premature ejaculation occur when you masturbate?

• Do you have trouble maintaining an erection?

While the queries are personal, it's necessary that you simply answer your specialist honestly in order that they will best diagnose the supply of your problem. Your urologist also will raise regarding the other medical conditions you'll have and any medications together with over-the-counter medications, supplements and flavoring products you're taking. you'll even be asked about any alcohol and outlaw drug use.

Treatment Premature Ejaculation

Common treatment choices for ejaculation embody behavioral techniques, topical anesthetics, medications and counseling. confine mind that it would take time to search out the treatment or combination of treatments that may work for you. behavioral treatment and drug medical aid can be the foremost effective course.

Behavioral techniques

In some cases, medical aid for ejaculation may involve taking straightforward steps, similar to masturbating associate hour or 2 before intercourse in order that you're able to delay ejaculation throughout sex. Your doctor conjointly might advocate avoiding intercourse for a amount of your time and that specialize in different forms of sexual play so that pressure is aloof from your sexual encounters.

Pelvic floor exercises

Weak girdle floor muscles may impair your ability to delay ejaculation. girdle floor exercises (Kegel exercises) will facilitate strengthening these muscles.

To perform these exercises:

• Find the right muscles. To identify your girdle floor muscles, stop voiding in heart or tighten the muscles that keep you from passing gas. These maneuvers use your pelvic floor muscles. Once you've known your pelvic floor muscles, you'll be able to do the exercises in any position, though you would possibly realize it easier to try to do them lying down at first. 

• Perfect your technique. Tighten your girdle floor muscles, hold the contraction for 3 seconds, then relax for three seconds. attempt it many times in an exceedingly row. Once your muscles get stronger, try doing exercise whereas sitting, standing or walking. 

• Maintain your focus. For best results, concentrate on adjustment solely your girdle floor muscles. watch out to not flex the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely throughout the exercises. 

• Repeat 3 times a day. Aim for at least three sets of 10 repetitions a day.

The pause-squeeze technique

Your doctor may instruct you and your partner within the use of a way known as the pause-squeeze technique. This method works as follows:

1. Begin gender as usual, together with stimulation of the penis, till you're feeling virtually able to ejaculate.

2. Have your partner squeeze the end of your penis, at the point where the head (glans) joins the shaft, and maintain the squeeze for several seconds, until the urge to ejaculate passes.

3. Have your partner repeat the squeeze method as necessary. By repetition as persistently as necessary, you'll be able to reach the purpose of getting into your partner while not ejaculating. When some observe sessions, the sensation of knowing the way to delay ejaculation may become a habit that now does not need the pause-squeeze technique. If the pause-squeeze technique causes pain or discomfort, another technique is to prevent sexual stimulation simply before ejaculation, wait till the extent of arousal has diminished then begin again. This approach is understood because of the stop-start technique.

Condoms

Condoms may decrease member sensitivity, which may facilitate delay ejaculation. "Climax control" condoms are obtainable over the counter. These condoms contain desensitizing  agents that cherish local anesthetic or local anesthetic or are made from thicker latex to delay ejaculation. Examples embrace Trojan Extended, Durex Performax Intense and Lifestyles Everlast Intense.

Medications

Anesthetic creams and sprays that contain a desensitizing agent, admire benzocaine, local anesthetic or prilocaine, are typically accustomed to treat ejaculation. These merchandise are applied to the phallus ten to fifteen minutes before sex to scale back sensation and facilitate delay ejaculation. A lidocaine-prilocaine cream for premature ejaculation (EMLA) is out there by prescription. local anesthetic sprays for premature ejaculation are available over-the-counter. Though anesthetic agent agents are effective and well-tolerated, they need potential facet effects. For example, some men report temporary loss of sensitivity and diminished sexual pleasure. Sometimes, feminine partners even have reportable effects.

Oral medications

Many medications would possibly delay orgasm. Though none of those medications are specifically approved by the Food and Drug Administration to treat premature ejaculation, some are used for this purpose, as well as antidepressants, analgesics and phosphodiesterase-5 inhibitors. These medications may well be prescribed for either on-demand or daily use, and might be prescribed alone or together with different treatments.

• Antidepressants. An aspect result of sure antidepressants is delayed orgasm. For this reason, selective 5-hydroxytryptamine reuptake inhibitors (SSRIs), equivalent to escitalopram (Lexapro), selective-serotonin reuptake inhibitor (Zoloft), paroxetine (Paxil) or Prozac (Prozac, Sarafem), are accustomed facilitate delay ejaculation. of these approved to be used within the United States, paroxetine looks to be the foremost effective. These medications typically pause for ten days to start working. however it would take 2 to a few weeks of treatment before you'll see the complete effect. If SSRIs don't improve the temporal arrangement of your ejaculation, your doctor might inflict the tricyclic clomipramine (Anafranil). Unwanted aspect effects of antidepressants would possibly embrace nausea, perspiration, somnolence and shrunken libido. 

• Analgesics. Tramadol (Ultram) may be a medication ordinarily accustomed to treating pain. It conjointly has facet effects that delay ejaculation. Unwanted side effects might embrace nausea, headache, somnolence Associate in Nursing dizziness. it would be prescribed once SSRIs haven't been effective. Tramadol can't be employed in combination with an SSRI. 

• Phosphodiesterase-5 inhibitors. Some medications want to treat erectile dysfunction, corresponding to anti-impotence drugs (Viagra), tadalafil (Cialis, Adcirca) or vardenafil (Levitra, Staxyn), additionally would possibly facilitate premature ejaculation. Unwanted facet effects might embrace headache, facial flushing associated indigestion. These medications may be simpler once utilized in combination with an SSRI. 

Potential future treatment

Research suggests that many medicines which may be useful in treating premature ejaculation, however additional study is needed. These drugs include:

• Dapoxetine. This is an antidepressant drug that' typically used as the 1st treatment for ejaculation in different countries. It' not presently obtainable within the United States. 

• Modafinil (Provigil). This is a treatment for the sleeping disorder narcolepsy.

• Silodosin (Rapaflo).This drug is often a treatment for endocrine enlargement (benign endocrine hyperplasia).

Counseling

This approach involves talking with a mental state supplier concerning your relationships and experiences. Sessions will assist you scale back performance anxiety and realize higher ways of handling stress. message is possible to assist once it's utilized in combination with drug therapy. With premature ejaculation, you would possibly feel you lose a number of the closeness shared with a sexual partner. you would possibly feel angry, discredited and upset, and switch faraway from your partner. Your partner conjointly could be upset with the modification in sexual intimacy. ejaculation can cause partners to feel less connected or hurt. Talking concerning the matter is a crucial step, and relationship message or sex medical care could be helpful. 

Psychological Therapy

Psychological therapy is a way to work through the emotions and feelings that may lead to problems with sexual relationships. The goal of this type of therapy is to learn the sources of problems and find solutions that may help improve your relationship. It can also help couples learn to become closer. Sex therapy can help you feel less nervous about sexual performance. It can also help you better understand and satisfy your partner's needs. This type of therapy may be used as the only treatment or it may be used in conjunction with other medical or behavioral interventions.

Behavioral Therapy

Behavioral therapy uses exercises to help you get used to delaying ejaculation. The goal is to help you train your body so that you don't ejaculate prematurely. Some exercises work well, but they may not be permanent solutions.

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• The Squeeze Method
  This method helps you reach orgasm by stimulating your penis until you are close. When you are close, your partner forcefully squeezes your penis, causing some of your erection to go away. The goal is for you to become aware of the sensations that lead up to orgasm. The squeeze method may help you. You can better control and delay your climax on your own.

• The Stop-Start Method
  You or your partner stimulates your penis until you are about to ejaculate. When you are about to climax, your partner stops the stimulation. Then, as you regain control, you and your partner start stimulating your penis again. This process is repeated 3 times. You will ejaculate on the fourth time if you repeat this method three times a week. Once you have gained more control, you may then try it four times a week.

Medical Therapy

There are no drugs approved in the United States to treat premature ejaculation. Still, there are numbing creams and sprays that may slow ejaculation in men with this condition.

Drugs

Doctors have noticed that men and women taking antidepressants experience delayed orgasms.Drugs like fluoxetine, paroxetine, sertraline, clomipramine, and tramadol can affect serotonin levels. Some doctors prescribe these drugs off-label to treat premature ejaculation (PE). If one drug is effective for treating another condition, that drug may be used instead. Your doctor may not recommend using the drug that you are using if it is not working.If the first drug doesn't work, you may want to try a different one.

Other medications that target the "1-adrenoceptor" may be an option for drug therapy. These drugs may cause ejaculatory dysfunction, such as retrograde ejaculation and/or failure of emission.

There are drugs that can be taken to prevent PE each day, or they can be taken before sex. Your health care provider will suggest when you should take a drug based on your activity level. The best time to take the drug is not clear. Most doctors suggest taking the drug from 2 to 6 hours before sex. However, stopping the drugs may cause PE to return. Men who have preeclampsia need to take these drugs on a regular basis.

Numbing Creams or Sprays

You may apply numbing cream or spray to the head of your penis about 20 to 30 minutes before sex. If you leave the numbing cream/spray on your penis for too long, your erection may go away. Do not leave the numbing cream/spray on the exposed penis during vaginal sex; it could get in contact with your partner's vagina. Cream can cause vaginal numbness. Before sex, wash the cream off your penis by hand for about 5 to 10 minutes. Wearing a condom can also help lessen sensation.

With the techniques listed here, 95 out of 100 men will recover from PE. However, there is no way to guarantee recovery, but learning how to relax may help. If the problem continues, work with your health care provider to find solutions.

Premature ejaculation home remedies

1. Premature ejaculation is a sexual disorder that affects 30 million men in the United States In order to understand premature ejaculation it's important to know how you reach an orgasm and how your body responds during sex Although no two people are exactly alike here are some facts you should know Your penis thickens when you get sexually excited because of increased blood flow When you climax or have an orgasm every muscle in your body contracts at once as your semen is forcefully pushed out of the urethra opening on the tip of your penis For most men this takes about three to five seconds from start to.
2. Premature ejaculation (PE) is a common male sexual dysfunction defined as occurring before or shortly after penetration and causing personal distress PE affects many men although it can be improved with treatment.1-3 Prevalence rates range from 10-24% in studies of primary care populations4 to 39% in adolescent males attending an emergency department for sexual assault.5 Many men are reluctant to ask their healthcare provider about the problem It is important that physicians recognize the prevalence and burden of this disorder as well as have these discussions with their patients because it may be a source of substantial personal distress.

Alternative medicine

Several medicine treatments are studied, together with yoga, meditation and acupuncture. However, a lot of analysis is required to judge the effectiveness of those therapies.

Preparing for your appointment

It' traditional to feel embarrassed once talking about sexual problems, however you'll trust that your doctor has had similar conversations with several different men. ejaculation could be a quite common — and treatable — condition. Being able to remark premature ejaculation can assist you get the treatment you wish to place your sex life back on track. The knowledge below ought to help you prepare to form the foremost of your appointment.

Information to write down in advance

• Pre-appointment restrictions. When you build your appointment, raise if there are any restrictions you wish to follow within the time leading up to your visit. 

• Symptoms. How often do you ejaculate before you or your partner would wish? How long after you begin having intercourse do you typically ejaculate?

• Sexual history. Think back on your relationships and sexual encounters since you became sexually active. Have you ever had issues with ejaculation before? With whom, and underneath what circumstances? 

• Medical history. Write down the other medical conditions that you've been diagnosed with, together with mental state conditions. conjointly note the names and strengths of all medications you're presently taking or have recently taken, including prescription and over-the-counter drugs. 

• Questions to ask your doctor. Write down queries earlier to create the foremost of it slow along with your doctor. 

Basic questions to ask your doctor

The list below suggests inquiries to raise your doctor regarding premature ejaculation. Don't hesitate to ask additional queries throughout your appointment.

• What may be causing my premature ejaculation?

• What tests do you recommend?

• What treatment approach do you recommend?

• How soon after I begin treatment can I expect improvement?

• How much improvement can I reasonably expect?

• Am I at risk of this problem recurring?

• Is there a generic alternative to the medicine you're prescribing?

• Are there any brochures or other printed material that I can take home with me? What websites do you recommend visiting?

What to expect from your doctor

Your doctor may raise terribly personal queries and may additionally wish to speak to your partner. to assist your doctor confirm the reason behind your downside and also the best course of treatment, be able to answer questions such as:

• How often do you have premature ejaculation?

• When did you first experience premature ejaculation?

• Do you have premature ejaculation only with a specific partner or partners?

• Do you experience premature ejaculation when you masturbate?

• Do you have premature ejaculation every time you have sex?

• How often do you have sex?

• How much are you bothered by premature ejaculation?

• How much is your partner bothered by premature ejaculation?

• How satisfied are you with your current relationship?

• Are you also having trouble getting and maintaining an erection (erectile dysfunction)?

• Do you take prescription medications? If so, what medications have you recently started or stopped taking?

• Do you use recreational drugs?

What you can do in the meantime

Deciding to speak together with your doctor is a crucial step. within the meantime, take into account exploring alternative ways in which you and your partner will connect with one another. Although ejaculation can cause strain and anxiety during a relationship, it's a treatable condition.

General summary

1. Premature ejaculation is more common than you think It is the second most prevalent sexual dysfunction affecting up to 30 percent of men at some point in their life But don’t fret; it’s a treatable problem with techniques that can be learned and mastered In fact premature ejaculation can fix itself if it’s approached correctly and your partner is willing to help If you or your partner are unsatisfied with your sex life because of premature ejaculation follow this plan for self-treatment: Step 1: Discuss Premature Ejaculation With Your Partner: Speak openly with.

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