Category Archives: Premature Ejacuation

Premature Ejacuation

New Science to Counter Age Old Problem of Premature Ejaculation

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What is premature ejacuation?

Premature ejaculation is one of the many sexual-related conditions that can either impair or diminish the quality of a person’s sexual life, either for a specific period of time or in a permanent fashion. Compared to other similar complications, premature ejaculation is not as severe, as it doesn’t completely ruin a person’s sexual experience. It can be very unsettling, specially if the person becomes too self-aware because of it and develop psychological insecurities. In that case it can lead to erectile dysfunction, which then in many cases completely ruin a person’s sexual life. Or it can make someone completely avoid having sexual relationships, trying to avoid the embarrassment resulting from it.

Since there are many personal and subjective reasons for someone to think that their ejaculation is happening too fast, the International Society for Sexual Medicine standardizes the condition as when someone ejaculates on the first minute after penetration. For reference, information is available that says about three-quarters of men ejaculate within two minutes of penetration in over half of their sexual encounters, and the more general categorization says that the typical process of ejaculation takes between 4 to 8 minutes. Of course ultimately the partner or partners of each person is supposed to communicate if they feel that ejaculation is happening too quick, and anyone who experiences this can and should be looking into ways to deal with their situation, since mutual pleasure is essential to any healthy sexual relationship. But what that standard serves for is to diagnose when a medical intervention would be necessary. Still, that diagnosis can only properly happen after dialogue with the patient, and a specific analysis of their particular case.

With that many variations of cases, it is very hard for doctors or health professionals to establish a cause for premature ejaculation

There seems to be a strong correlation between excessive masturbation and complications with sexual sensations in general, including in some cases premature ejaculation. Psychological reasons can come from all sides, and can only be useful in individual, case by case, appliances. The most radical, and somewhat rare cases, may be an indication that a person has prostatitis, an inflammation of the prostate gland which requires medical intervention for many other reasons, beyond the symptomatic effect on ejaculation.

In some cases, people are able to perform self-treatment, and just ‘re-educate’ their psychological processes during sexual intercourse, since naturally the mental processes are as responsible for those processes as the physical ones. Although some people report managing to delay their ejaculation, this type of procedure tends to make the sexual act feel unnatural or disrupted, and so they are not recommended as truly capable of improving the quality of sex life someone would be seeking.

Usually, for those who want to cure themselves, the method with a higher success rate and that feels more natural is to explore the physical sensations, along with the partner, and try to find the sensations, rhythms, touches and ways of having sex that make the most sense for each person.

For those who are not able to sort their situation in these manners, there are treatments, some of them quite easy and without dangers, and, even better, with a very high success rate

Out of those, the one that has the most striking record of improving people’s sexual performance, even if they do not feel they ejaculate too fast, is the set known as Kegel exercises. Those consist on movement that strengthen the muscles of the pelvic floor by doing repetitive movements with their genital apparatus and related regions, in order to work the muscles the same one would do with their arms and legs. Another techniques that are mentioned as having helped people looking to deal with premature ejaculation are called Master and Johnson’s “stop-start technique”, which consists in creating very short but constant intervals that make the sensitive responses more controlled, and the “squeeze technique” one, which consists in squeezing one’s penis in a moderately aggressive way until the arousal is reduced.

Drugs can also have a similar effect, such as the substances known as paroxetine, dapoxetine or clomipramine. They are able to increase the time one takes to ejaculate even 10 times more than before the treatment started. Those are intense substances and can bring about many undesired effects, and should be considered a last case scenario.

Premature Ejacuation

Premature Ejaculation? Is your Partner Worried About That? You Might Want to Read About this Issue

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‘Quick sex’ or premature ejaculation: two words that many men hate to hear. But what are the margins of time that define it?

Three minutes or less, according to a new study by an international group of scientists who have agreed to diagnose the disorder for over a century since it was first documented.

The vague definitions have so far caused confusion among doctors and led many men to mistakenly believe they suffer from the disorder, explains the director of the South African Center for Sexual Health, Chris McMahon, one of the authors of the report published in the Journal of Sexual Medicine. While historical studies of the population suggest that between 25 and 30% of men reach orgasm too soon, the most recent data indicate that the proportion is much lower.

According to the definition of the diagnosis agreed in the study, he suffers from the permanent form of the condition, which occurs from the first time one has sex, between 2 and 3% of men. These men typically last a minute or less. In another 4-6% of cases they get it during their lifetime and ejaculate after about three minutes or less.

There are three conditions in the diagnosis, McMahon explains, and it is necessary that all three occur

In addition to duration, it is necessary that men cannot control or delay ejaculation during sex, and that these performance problems cause negative psychological consequences of frustration, to the point of avoiding sex. Cases of ‘variable premature ejaculation’, when the man sometimes comes too early and sometimes not, and ‘subjective premature ejaculation’ when he only has the impression that the conclusion was premature are not included in the diagnosis.

Remedies for Premature Ejaculation

Premature ejaculation is by far the most felt and frequent male sexual dysfunction. It occurs when the man, during sexual intercourse, reaches intercourse after a brief sexual arousal, since he cannot dominate his ejaculatory reflex. Premature ejaculation is due to a complex intertwining of emotional factors (stress, anxiety, fatigue, etc.) and physical-organic factors (alcoholism, short frenulum, prostatitis, urethritis, vesiculitis, erectile dysfunction, etc.).

What to do

  • Carve out a daily space for yourself: this behavior relieves anxiety and drives away stress, the worst enemies of love
  • Supplement the diet with zinc supplementation, a useful remedy against stress
  • Constantly playing sports: practicing sports allows you to get a greater awareness of yourself and your body
  • To fully live the relationship as a couple, trying to remove anxieties and fears that hinder the relationship
  • Always discuss with your partner about the disorder: dialogue can benefit the couple and the relationship itself
  • Perform the “start and stop” practice: the woman interrupts her partner’s sexual stimulation as soon as she senses an excessive (male) excitement. After that, the woman gently squeezes the penis under the glans. After a short period of time, stimulation is resumed. Repeat this procedure up to 10 times. Such behavior helps the man to control his own ejaculatory reflex, in addition to identifying the point of inevitability of ejaculation (beyond which orgasm is no longer controllable).

What NOT to do

  • Consume large meals: especially before a relationship, a large lunch or dinner could prevent or hinder a subsequent sexual relationship
  • Don’t admit the disturbance: hiding the disturbance behind excuses can cause serious problems to the couple’s relationship
  • Lack of dialogue and exchange of opinions: in the couple, communication is essential to tackle any disorder together, including premature ejaculation
  • Postponing the doctor’s check: when premature ejaculation becomes a big problem for humans, consulting with a specialist is recommended (eg sexologist)
  • Sedentariness and smoking
  • Drug addiction: abuse of illegal drugs can cause serious disorders in the sexual sphere (eg erectile dysfunction, premature ejaculation)
  • Take vasoactive drugs – such as sildenafil, tadalafil and the like – in case of heart disease, regressed history of stroke, blood pressure changes (hypertension), administration of anticoagulants, angina, uncontrolled diabetes.
  • Trying to reduce pleasure during intercourse (eg thinking about other topics, politics, economic problems, etc.), in the belief that such an attitude can delay ejaculation. Instead of stifling pleasure, it is advisable to surrender to it.
  • Believing that the partner can achieve maximum pleasure exclusively through coitus: this thought can instill anxiety in the man and, seeking female pleasure, ends up unconsciously accelerating his ejaculatory times.

What to eat

  • Follow a healthy and balanced diet, limiting excesses
  • Prefer foods rich in omega 3 and omega 6 (fish, nuts, flaxseed oil)
  • Take food rich in bioflavonoids (lemons, grapefruit, grapes), very useful for controlling ejaculatory impulses
  • Take lots of fruit and vegetables, as it is rich in antioxidants (vitamin C and E).

What NOT to Eat

  • Avoid consumption of foods that are difficult to digest, such as dips, fries and foods rich in fat (especially before a report)
  • Limit the consumption of foods rich in caffeine (coffee, chocolate, cocoa, cola-based drinks, mate, guarana), which with their stimulating effect can aggravate erectile dysfunction, reducing the time needed to produce an ejaculatory stimulus

Natural Cures and Remedies

Natural remedies are recommended when the patient suffering from premature ejaculation does not interpret this condition as a serious and impassable problem.

Among the remedies indicated to overcome the mild forms of premature ejaculation sprout plants with active anti-sedative-sedative principles, useful for removing anxiety and stress:

  • Valerian (Valeriana officinalis) – relaxing, anxiolytic properties
  • Passiflora (Passiflora Incarnata) – sedative properties
  • Tiglio (Tilia cordata) – relaxing, anxiolytic properties

Pharmacological care

Topical application (directly on the penis / glans) of desensitizing creams: local anesthetics are a useful remedy to postpone ejaculation. The use of anesthetic creams can lead to a reduction in female pleasure: therefore, we recommend using a condom

  • Lidocaine (eg Lidoc C FN cream, Xylonor spray)
  • Prilocaine (eg. Emla)

Tricyclic antidepressants: prolong the duration of a relationship by postponing ejaculation:

  • Fluoxetine (eg Azur, Prozac)
  • Sertraline (eg. Zoloft, Sertraline)
  • Lomipramine (eg. Anafrinil)

Vasoactive substances: for severe forms of premature ejaculation associated with erectile dysfunction. The drugs promote the relaxation of the smooth muscles of the cavernous bodies of the penis, improving erection:

  • Sildenafil (ES. Sildenafil Teva, Viagra, Revatio, Sildenafil Actavis, Sildenafil ratiopharm).

Prevention

  • Avoid stress and anxiety
  • Perform Kegel’s exercises consistently: the domination of the pubococcygeus muscle in the male prone to premature ejaculation allows the management of ejaculatory impulses, postponing orgasm.
  • Alternative treatments and remedies
  • Sexological rehabilitation therapy
  • Psychodynamic therapy
  • Alternative therapies: ayurveda, aromatherapy, homeopathy
  • Circumcision associated with glandular neurotomy: this surgical practice reduces glans hypersensitivity, a useful remedy for premature ejaculation.
Premature Ejacuation

Premature ejaculation is a very common dysfunction seen in men all over the world

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Premature ejaculation is the inability to control, manage or delay an ejaculation. In turn, this results are a dissatisfied sexual partner and unaccomplished man during intimacy. Premature ejaculation has been classified as something that is either acquired or a lifelong condition, with lifelong condition being a primary issue.

Premature ejacuation

In South Africa, the occurrence of premature ejaculation observed in men is around 21 to 31 percent.

In a dramatic sense, premature ejaculations have a very diminishing effect on the quality of one’s life and the life of their sexual partner. Premature ejaculation can lead to other more damming issue that correlate with the quality of life. Some things that may occur due to premature ejaculation is men feeling distressed psychologically, a decrease in self-esteem and adequacy, erectile dysfunction, anxiety, a decrease in libido and/or stressed interpersonal relationships. Because of the emotional burden that premature ejaculations causes a man, some men are reluctant to the idea of seeking help from a medical professional.

 

Usually conditions involving sexual dysfunctionality is under-reported and under-treated because men have shame and low self-esteem due to the condition

This along with doctors being uncomfortable helping men manage the condition because they are uncertain as to how to approach treatment and the discussion to uncover what the condition is that is being experienced. The implications of premature ejaculation is heavily a contributor to psychological effects and become damaging to interpersonal relationships. Premature ejaculation causes men to avoid emotional and physical intimacy due to the psychological stress the condition puts on them and they do not want to pass on that stress to a partner or expose their condition. Men experiencing this condition and hiding it usually fall victim to bogus medical claims and advertisements that has no evidence basis to actually help men overcome premature ejaculation. These advertisements prey on the weak and profit greatly from men vulnerability.

Premature ejaculation is a very common sexual dysfunction among men, with a greater impact observed among men of the younger age group

In seeking help in a medical setting, some doctors are uncertain on how to approach the assessment process to uncover the issue. This makes its challenging when trying to obtain the necessary information to be able to properly remedy the dysfunction. Men should undergo a full medical assessment to investigate their medical, sexual, social, psychological and drug history, accompanied with their sexual partner’s history. Treatment should be done with the man and his partner to ensure that there are not other factors contributing to the condition.

Treatment choices are likely to vary based on the symptoms being experienced, psychological implications, side effects and patient decision of what approach they want to explore

Currently, surgical management for premature ejaculation is not recommended. Surgical management is under investigation and is in an experimental phase. Some of the surgical therapies that are underway are the dorsal penile nerve cryoablation, neuromodulation and hyaluronic acid gel gland augmentation.
Also, botulinum toxin injection are being explored to be injected into the ejaculatory muscle in the penis to help minimize the sensitivity during sexual activity. None of these treatment options are currently promoted as the side effects are undetermined. There are no particular investigation that is done to confirm or reject premature ejaculation.

Even though surgical management is not currently recommended, in South Africa there is a new device that is designed to elongate the time men experience a sexual encounter prior to ejaculation

The device is currently approved by the US Food and Drug Administration and is available locally to South Africans and online to everyone else. The device works in a way to greatly reduce the sensitivity during intercourse that cause premature ejaculation. The idea of the device is that a man will masturbate with a start-stop process three times while the device is in place. Men are expected to see results from using this device after the use of 3 times a week for 6 weeks.

All in all, men who experience premature ejaculation will more than likely require multiple management techniques that will target psychological and behavioral components. Men should be under the supervision of a medical provider when being treated for the condition to ensure the targeted results are being met and sexual satisfaction is being obtained. Additional investigation is more so geared to rule out contributing factors that are uncovered in the history.