Premature ejaculation in men is defined as involuntary ejaculation with limited sexual stimulation before or just after the penis enters the vagina.
Premature ejaculation is a common occurrence among men.
Although there are differences between the estimates, it is thought that approximately one out of every three men has encountered this problem during their lifetime.
Although the question of what causes premature ejaculation attracts a lot of attention, it is not a cause for concern unless it happens frequently.
Although a full definition of premature ejaculation cannot be made, it can be diagnosed as premature ejaculation if the following characteristics are observed in the person:
- Ejaculation that occurs approximately 1 minute after vaginal penetration at all times or for most intercourse
- Failure to delay ejaculation after vaginal penetration or until vaginal penetration
- Avoiding sexual intercourse due to stress and anxiety
Both physiological and biological factors may play a role in premature ejaculation.
Although premature ejaculation is an issue that men are ashamed of and avoid talking about, it is a common health problem with treatment.
In men with premature ejaculation, the problem is mild at first and may worsen over time.
In some cases, men try not to make their partners feel their premature ejaculation problems.
This can lead to communication problems and related sexual problems between the couple.
Heterosexual couples may have arousal disorders as a result of lack of sexual desire in women, inability to have an orgasm, and a man’s inability to spare enough time for foreplay.
In its heavy forms, unification cannot occur.
If couples do not approach the problem in a constructive way, they may experience serious problems in their relationships.
What Will We Learn?
Types Of Premature Ejaculation in Men
- Lifelong premature ejaculation: This type of premature ejaculation is observed with the first sexual activity and continues throughout life. It is the least common type of premature ejaculation in the general population. Studies conducted in China and Turkey report that it is observed between 2.3 and 3.2% in the general population.
- Acquired premature ejaculation: It is a more common problem. It can occur as a result of a physiological or psychological change. It is observed between 3.9% and 4.2% of the general population.
- Variable premature ejaculation: It is the most common type of premature ejaculation. It is seen in 8.5-11.4% of the general population. The person experiences normal ejaculation from time to time and premature ejaculation from time to time.
- Sensory (Subjective) premature ejaculation: In this type, the person does not really have a problem with premature ejaculation, but thinks that he has premature ejaculation due to cultural and psychological reasons. The incidence rate in the general population is between 5.1% and 6.4%.
Causes Of Premature Ejaculation In Men
The causes of premature ejaculation are divided into psychological and biological.
Psychological Causes Of Premature Ejaculation
- Sexual inexperience
- Negative perception of one’s own body image
- Relationship innovation
- Excessive excitement and arousal
- Relationship stress
- Self-blame and feelings of inadequacy
- Control and proximity
These psychological factors are the most common causes, especially in men who have experienced normal ejaculation before and then face premature ejaculation.
One of the reasons that cause premature ejaculation problems with psychological factors may be obesity.
On the other hand, lifelong premature ejaculation problem is experienced due to earlier traumas. As an example of these:
- Be sexually abused
- Strict sex education and upbringing
- Traumatic sexual intercourse experience
- Conditions such as psychological conditioning (the rapid ejaculation of young people by masturbation due to fear of being caught)
Biological Causes Of Premature Ejaculation
There are hormones, infections and nervous system diseases that can cause premature ejaculation.
- Diabetes: Although diabetes is a disease that usually causes erectile dysfunction in men, a study published in the Journal of Translational Andrology and Urology in 2016 showed that a significant majority of diabetes patients with erectile dysfunction also have premature ejaculation. The biological mechanism that causes diabetes to cause premature ejaculation is not fully known.
- Hormone disorders: Testosterone hormone deficiency, thyroid hormone disorder and pituitary gland diseases cause premature ejaculation.
- Multiple Sclerosis: Premature ejaculation is one of the many sexual dysfunctions observed in multiple sclerosis patients.
- Prostate gland problems: Research shows a correlation between prostate gland infections and premature ejaculation.
- Other causes: Recent studies show the role of penile hypersensitivity and neurophysiologically increased excitability of the ejaculation center in premature ejaculation.
Can Premature Ejaculation Be Prevented?
Men with premature ejaculation may develop inappropriate strategies when attempting to solve this problem on their own.
Men who seek a solution to premature ejaculation may avoid foreplay, as increased stimulation of the penis during foreplay will shorten the duration of sexual pleasure.
This situation reduces sexual satisfaction and communication in their partners and themselves.
It can also cause arousal problem in the female partner.
Another wrong strategy is to act painfully on themselves during intercourse (pinch, lip bite). The aim of this approach is to try to increase the duration by reducing sexual pleasure.
Even if the duration is prolonged, the quality of the sexual act will be impaired.
n men who previously ejaculate with masturbation and aim for the second and third ejaculation, the sexual environment may become anxious.
Providing sexual satisfaction of the partner by prolonging the foreplay is the most accurate strategy that the individual can take on his own.
How Is Premature Ejaculation Diagnosed In mMn?
In order to be diagnosed with premature ejaculation, the patient must have an active sexual life.
A long discussion with the doctor and a physical examination are essential in the diagnosis of premature ejaculation.
If erectile dysfunction is also experienced with premature ejaculation, the doctor may order some tests to look at hormone levels.
During this interview, the patient’s medical history as detailed as possible ensures the correct determination of the treatment strategy.
In the medical history, past and present diseases, accidents, traumas, medications used will be asked, and the patient’s sexual life will be listened to.
Treatment Of Premature Ejaculation In Men
Today, the treatment of premature ejaculation is pleasing.
After determining the underlying cause of the disease, one or more of the following treatments can be used together, depending on the patient’s condition.
- Medication: Oral medications are one of the most preferred treatment methods for premature ejaculation. When drugs called SSRI (Selective Seratonin Reuptake Inhibitor) are taken orally every day, the effect begins to be observed after 5-10 days. However, the need for daily use of these drugs and the occurrence of side effects such as fatigue, nausea, sweating, and yawning cause a low rate of patients to continue treatment. Dapoxetine, a new form of the same type of drugs, provides success when used 1-3 hours before intercourse. Since it does not require daily use, patient satisfaction is very high in this treatment.
- Exercise and sports: Kegel exercises, which are also used in children, women and men with urinary incontinence, are also used in the treatment of premature ejaculation. This exercise works the pelvic muscles and can be practiced at any time of the day. During sexual intercourse, when the person feels that he will ejaculate, by contracting the muscles in this area, the muscle structure in the bladder neck will also contract and will control the ejaculation. Kegel exercise is one of the effective treatment methods against premature ejaculation. Apart from this, fitness and similar sports that work the pelvic floor muscles are also useful in preventing premature ejaculation.
- Creams and gels: Another method used in the treatment of premature ejaculation is the use of creams containing local anesthetics. Cream/gel/spray applied to the penis before intercourse causes loss of sensation in the penis and delays ejaculation. Since these treatments are local, systemic side effects observed in pills are not observed. However, creams and gels can prevent the feeling of orgasm in men and women, depending on the amount of use. Especially the bad smell of the gels used can create an unpleasant environment during intercourse.
- Condoms: Like creams and gels, condoms are one of the treatment methods used to prevent premature ejaculation, as they reduce the sensation of sensation during intercourse.
- Sex therapies: One of the effective methods in the treatment of premature ejaculation is sex therapy. Applying the maneuvers taught to keep the foreplay period as long as possible brings success in the treatment. These maneuvers are “stop-start” and “squeeze” techniques. The stop-start technique is a gradual technique and each phase lasts an average of 2 weeks, and the recommended maneuvers should be performed at least three times each week. These maneuvers aim to reduce penile stimulation and thus delay ejaculation. The tightening technique, on the other hand, is to stop the intercourse when ejaculation is felt during intercourse, to squeeze the tip of the penis until the feeling of ejaculation is gone, thus delaying ejaculation.
- Surgical treatments: This method is an irreversible method and is rarely applied. The rationale in this treatment is based on the assumption that the penis is hypersensitive in patients and it is aimed to reduce this hypersensitivity by cutting the nerves going to the penis in various ways.