Premature ejaculation or ejaculatio praecox is a common ejaculatory disorder in men. From a medical point of view, it is not a painful disease, yet the disorder can greatly affect the sexual life of the affected person and his partner. The phenomenon is highly prevalent and the suffering of those affected is sometimes considerable.
What is premature ejaculation?
There is no single definition for premature ejaculation. If a man cannot control the time of ejaculation and orgasm is triggered earlier than desired, this is generally referred to as premature ejaculation. In this case, ejaculation (ejaculation of semen) occurs either shortly before or shortly after penetration of the vagina. In some definitions, the ability to sexually satisfy the woman also plays a role. Here, premature ejaculation is said to occur when the man is unable to control his ejaculation in such a way that both partners are satisfied during sexual intercourse. The phenomenon is distinguished between a congenital and an acquired disorder. The congenital form may have physical causes, while the acquired form is often due to psychological causes. Premature ejaculation always represents a great psychological burden.
Causes
There can be various causes for premature ejaculation. However, these have not yet been definitively clarified. Thus, scientists are still discussing whether possibly, in addition to psychological and physical causes, neurophysiological reasons can also be responsible for premature ejaculation. In the case of psychological causes, there can be a wide variety of triggers. Thus, early childhood sexual disorders, sexual performance thinking, a limited sexual education or fear of failure can lead to premature ejaculation. Among physical diseases, urinary tract infections or diabetes mellitus are often responsible for the phenomenon. Taking certain medications can also lead to premature ejaculation. Ejaculation is influenced by various messenger substances in the brain. Among other things, the neurotransmitter serotonin is also involved. Increased serotonin levels in the brain can increase the time it takes to ejaculate. Premature ejaculation can occur as a congenital or acquired phenomenon. In the congenital form, physical diseases are usually causally responsible. The acquired form can usually be attributed to psychological causes. Premature ejaculation may be a lifelong complaint. However, premature ejaculation may also occur only for a temporary period.
Diagnosis and course
Few men affected by premature ejaculation seek medical treatment. In order to make a diagnosis, first of all the questioning and the conversation with the affected person are important. The doctor can arrive at a diagnosis by asking precise questions about the symptoms, but also about sexual experiences and development, as well as any existing fears. If he suspects physical causes, further examinations can be performed. The doctor will pay particular attention to the patient’s medical history. This gives the physician important information about the sexual life of the patient and can thus provide an important contribution to further treatment.
When should you go to the doctor?
Premature ejaculation can occur naturally exclusively in sexually mature boys or men. Therefore, they belong to risk group. However, in normal cases, there is no need for further action. In most cases, this phenomenon is a lack of experience in the field of sexual experiences. Therefore, premature ejaculation occurs mostly in people of the male sex at a young age. With increasing sexual activity in the course of life, in almost all cases the symptoms subside. Tips from the field of self-help are often sufficient to regulate premature ejaculation independently. A doctor therefore only needs to be consulted in exceptional cases. These are given as soon as mental suffering occurs. In addition, consultation with a medical professional should be sought in the event of persistent disturbances of the libido or irregularities in sexual behavior.Pain during the sexual act, strong emotional stress or irregularities of the erection should be examined more closely by a doctor. In a large number of cases, premature ejaculation can be prevented if successful masturbation has taken place before the actual sexual act. Multiple ejaculation in a short period of time leads to relief of existing symptoms and can already initiate freedom from symptoms. However, permanent irregularities that already lead to disturbances in the partnership should be discussed with a doctor.
Treatment and therapy
Premature ejaculation can be treated with the help of medication, psychotherapeutic or physical measures. Decisive for the choice of treatment method are always the triggering causes. In psychotherapeutic methods, various therapies are used. For example, sex therapy, couple therapy, behavioral therapy or family therapy can be used. With the help of appropriate psychotherapy, fears can be reduced. But also ways of thinking and behavior can be changed, as well as an existing pressure to perform can be cultivated. Treatment with medication is usually used when psychotherapeutic therapy has not been successful. Often so-called serotonin reuptake inhibitors are used, which can delay the orgasm reflex. Creams and gels that reduce the sensitivity of the penis are also used. Drug methods may resolve the symptoms, but the causes remain. In addition, special methods have been developed that can help affected men cope with the problem. These include, for example, the so-called stop-start method, in which those affected learn to control their arousal and thus prevent premature ejaculation. A continuation of this method is the squeeze method, in which pressure on the penis interrupts the ejaculatory reflex.
Prevention
Since premature ejaculation is an orgasmic disorder, there are no direct preventive measures against the occurrence of the symptom. However, through various therapies or methods, it is possible for those affected to better perceive their own arousal and thus be able to prevent premature ejaculation. In addition, it is important to counteract sexual performance pressure, as this can be a triggering factor for premature ejaculation.
Aftercare
Premature ejaculation, like many other potency disorders, can be treated. After treatment, follow-up care occurs immediately. In most cases, follow-up care is composed of a medical history and a physical examination. During the patient interview, the patient is advised on how to deal with the potency problems. The urologist is usually responsible for this, and will also ask about any unusual symptoms during the case history in order to be able to treat the premature ejaculation effectively. If symptoms persist, ongoing treatment takes place. Sustained follow-up is adapted to the needs of the patient and is usually done in collaboration with the family doctor or another specialist who has an eye on the medical history. It continues until the potency problems have been resolved or the patient wishes to discontinue treatment. In general, however, follow-up care is based on the cause of the potency disorders. If, for example, the cause is a tumor, the aftercare is much more complex. In the case of psychological causes, a therapist is usually also involved in the treatment. Follow-up care then takes place promptly after completion of treatment and must be continued over a longer period of time.
What you can do yourself
Men who ejaculate prematurely can take various measures to delay ejaculation. Effective, for example, is the training of the pelvic muscles, for example, with the help of the Kegel method. This exercises the sphincter and pelvic floor, which helps to better control ejaculation. The start-stop method has also proved successful. Here, the penis is regulated until just before the so-called “point of no return” and then the stimulation is stopped. The targeted stimulation improves control over ejaculation. In addition, sexual tension can be reduced in this way. Shortly before ejaculation, the so-called squeeze grip can be used. Here, the glans is pressed with the thumb until the pressure is released.The emergency method is particularly useful when premature ejaculation is unexpected. The doctor can also prescribe anesthetic creams that make the penis insensitive to stimuli. Condoms with appropriate active ingredients are now also available. Communication with the partner is equally important to achieve a fulfilling love life. When practicing together with the partner, the timing of ejaculation can be trained. If the symptoms persist, a visit to a urologist or a sex doctor is recommended. Occasionally, premature ejaculation is also based on psychological suffering that needs to be worked through.
