Knowing Premature Ejaculation - PART 2: Diagnosis, Types & Causes

As many as 30-40 % men across the world including India experience problem of PE at some time of life. In Part 1, we learnt about the condition called Premature Ejaculation (PE). In this 2nd part, let’s understand about it’s diagnosis & types of PE - why and how it happens.

How to Diagnose PE:

The specific criteria for premature (early) ejaculation are as follows:
- In almost 75-100% sexual activity, the experience of ejaculation occurring during sexual intercourse within 1 minute after vaginal penetration and before the individual wishes it.
- The problem has persisted for at least 6 months and is a cause of mental stress to the person.
- The dysfunction cannot be better explained by any other nonsexual mental disorder, any medical disease, the effects of a drug or medication, etc
 
Severity of PE:
 
The severity of premature (early) ejaculation is broadly defined as follows:
1. Mild (occurring within approximately 30 seconds to 1 minute of vaginal penetration)
2. Moderate (occurring within approximately 15-30 seconds of vaginal penetration)
3. Severe (occurring even before sexual activity, at the start of sexual activity, or within approximately 15 seconds of vaginal penetration). In such cases conception will not be possible unless artificial insemination is used.
 
TYPES and Characteristics of P.E. :
Premature ejaculation can be Chronic (lifelong) or Acquired (recent).
Chronic PE:
With chronic (lifelong) premature ejaculation, the person has been experiencing premature ejaculation since he became sexually active (ie, post puberty). 
Acquired PE:
Acquired (recent) premature ejaculation means that the condition began in an individual who previously experienced an acceptable level of ejaculatory control and only recently has developed PE.

What are the Causes?
The causes of PE can be divided into two broad sub-heads, which are psychological or biological cause:
 
 
1. Psychological Causes:
Premature ejaculation is believed to be a psychological problem and does not represent any known organic / physical disease involving the male reproductive organs or any known defect in the brain or nervous system. It is usually due to a pattern that is hard to change and is a result of your previous sexual experiences.
 
One of the most common reason is childhood habit of reaching climax/ ejaculation quickly because of fear of discovery when masturbating or during early sexual experiences with a female partner. This pattern of rapid attainment of sexual release is difficult to change in later stage of life (in marriage or long-term relationships).
 
Other reasons are situations in which one may have hurried climax/ ejaculation in order to hide any problem or feelings of guilt that make you rush through sexual encounters. Also, psychological causes include anxiety and relationship issues which can also result from deep anxiety about sex that relates to bad experiences encountered by the patient during development (eg: incest, sexual assault, conflict with parents, etc ).
 
2. Biological Causes
 
A number of researchers have found differences in nervous stimulations and hormonal differences in men who experience premature ejaculation compared with individuals who do not.
 
Some believe that some men have hyper-excitability or oversensitivity of their genitalia.
 
Abnormal functioning of the ejaculatory system can be attributed to:
- Thyroid problems; infection or inflammation of the urethra or prostate.
- Nerve damage occurring due to trauma or surgery (a very rare cause).
- Abnormal levels of hormones and/or neurotransmitters (chemicals present in the brain)
- Higher free and total testosterone levels or varied other biochemical markers
*The research however has been non-conclusive.

In Part 3 and 4, we will discuss the right approach and therapy for the men / couple suffering due to PE.



Knowing Premature Ejaculation - PART 2: Diagnosis, Types & Causes

All you need to know about Premature Ejaculation

Many of the sexual issues are primarily not big problems. However, because of the taboo and inhibition around them, they are not discussed openly, hence they also fail to get resolved and become bigger. In fact most of the times there are no visible symptoms of any functional problems. Many of them are very basic issues and because of ignorance, myths, and social taboos lead to development of anxieties, distress and further worsening of the problem.

Often men are concerned about their performance in bed with their partner. They worry about- how best then can do, masturbation habits, size of penis and sperm quality. 

Consequences of Premature ejaculation (PE): 
Both you and your partner may end up experiencing highly unsatisfactory sex. In fact, it can significantly increase anxiety, which may deteriorate the problem. 

PE is one such sexual issue. It's not a disease; Not at all..!! 
If a person is sexually fit and experiences normal erections but just fail to hold the orgasm/ discharge for reasonable time then he is suffering from premature ejaculation. It's  a very normal problem, which if managed properly it can be easily resolved.

We will discuss this PE in 4 parts covering: what it is in actual, how does it happen, how to approach to resolve this problem with behavioural methods, exercise, techniques and medical remedies present in both modern and alternative medicine. 
Let s understand the problem in this 1st part!

What is Premature Ejaculation? 

Premature (early) ejaculation also referred to as rapid ejaculation; also called as early discharge. 
PE is the most common type of sexual dysfunction in men younger than 40 years and seen across all age groups. In elderly men (>60 years) erectile dysfunction is more common. A study conducted by the Journal of Sexual Medicine revealed that this condition is almost equally prevalent in sexually active men of all age groups. 
If a man experiences uncontrollable ejaculation (discharge of semen from your penis) either before or shortly after sexual penetration (usually within 1-2 minutes of penetration), he may be suffering from PE. The Mayo clinic at the United States defines PE as a condition in which  a man  always or nearly always ejaculates within one minute of penetration."

Instances of PE:
An occasional instance of premature ejaculation might not be cause of concern, but, if the problem occurs more than 50% of attempted sexual relations signifies existence of abnormal pattern for which treatment is required.

Premature ejaculation takes place with negligible sexual stimulation and even before the desire 
to ejaculate. Another way of describing PE by most therapist or clinicians is the occurrence of ejaculation sooner during sexual intercourse than he or his partner would like. 

This broad definition thus avoids specifying a precise  normal  duration for sexual activity and reaching a climax. The duration of sexual activity is highly variable and depends on various factors specific to each individual. Take a situation, a male may reach orgasm after 7 to 8 minutes of sexual intercourse, but if his partner is able to achieve climax mostly in 5 minutes and both are satisfied with this timing, then this is not defined as PE. 

Alternatively, a male might delay his ejaculation for up to 15- 20 minutes of sexual intercourse, but if his partner, even with foreplay, requires 25-30 minutes of total sexual activity before reaching climax, he may still consider his ejaculation premature because his partner has not been satisfied (at least, not through intercourse). But in routine practice this kind of situation is NOT called as PE. So every individual and every couple is unique. Same individual may have different sexual behaviour with different partners and different circumstances. Varied situations and varied places of performing the act have a vital role to play in determining the outcomes of individual sexual performance/s.



Knowing Premature Ejaculation - PART 1: Understanding What is PE

When Should You Use Viagra?

Viagra is a very common drug prescribed for treating erectile dysfunction. It works by enhancing the flow of blood to the penis during sexual intercourse to bring about erection. Viagra actually contains the active ingredient Sildenafil Citrate which is a selective inhibitor of Cyclic Guanosine Monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5).

This drug works efficiently with sexual stimulation. Erectile dysfunction is very common among older men whose sexual function tends to fall after they reach their 50s. But these days even younger men in their 30's and 40's are experiencing an increased incidence of erectile dysfunction.

Doctors can even recommend the drug to both younger and elder men who suffer from erection problems.

Solidification of the arteries, the blood vessels that supply blood to the penis, can occur during the teen years. The problem then develops by the time they reach the age of 20-30 years and more, hindering their ability to get and maintain an erection. Men suffering from diabetes and facing the problem of Erectile dysfunction can be assisted by this drug.

The drug should be ideally taken an hour before the sexual intercourse.

On the other hand, you can also take Viagra half an hour to 4 hours before the sexual intercourse. You don't require having food in order to take the drug. But you need to keep in mind that if you take it after a meal high in fats, it can take a little bit longer for you to experience its effects.

Most importantly, the misuse of Viagra should be avoided. It should be taken only under medical supervision. The drug doesn't have the power to help you ejaculate easily if you suffer from problems related to orgasm or even enhance your sexual appetite. It does not enhance sexual timing, so should not be used to treat premature ejaculation. Men also shouldn't expect the drug to take the erections to unexpected heights.

Word of Caution:

One should never take the drug for recreational purposes. One can end up suffering from minor erectile dysfunction due such abuse.



When Should You Use Viagra?

People who have healthy sex life are not only happier but also healthier than those who don't. Here are 9 health benefits you never knew sex can provide -

1) Rocking Immune System: Regular sex ensures higher levels of what defends your body against germs, viruses, and other intruders.

2) Lowers Blood Pressure: One landmark study found that sexual intercourse specifically (not masturbation) lowered systolic blood pressure.

3) Great Exercise: Sex is a really great form of exercise. It is a muscular exercise that burns calories and increases your heart rate.

4) Lowers Heart Attack Risk: Great sex life is good for your heart. It not just raises your heart rate, sex helps keep your estrogen and testosterone levels in balance.

5) Reduces Pain: Getting an orgasm can block pain. Vaginal stimulation can block chronic back and leg pain, and can reduce menstrual cramps, arthritic pain, and in some cases even headache.

6) Improves Sleep:  People usually dose of quickly after sex and tend to get a sound sleep.

7) Relieves Stress: Sexual arousal releases a brain chemical that revs up your brain's pleasure and reward system. Sex and intimacy relieve you of stress and boost your self-esteem and happiness too.

8)  Reduces Risk Of Prostate Cancer: A study, published in the Journal of the American Medical Association revealed that men who ejaculated frequently (at least 21 times a month) were less likely to get prostate cancer.

9) Helps Women's Bladder Control: Incontinence, a problem that affects about 30% of women at some point in their lives is helped with a regular sex. Good sex is like a workout for their pelvic floor muscles. An orgasm causes contractions in those muscles thus strengthening them

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Having Sex - 9 Health Benefits

3 handy tips to eliminate stress from your sex life

Stress plays a significant role in creating rifts in relationships as it mostly forbids partners from meeting each other?s physical and emotional needs. This reduces intimacy in a relationship and results in an unhappy sex life. In the modern world of continuous work pressure and fast paced lifestyle, stress generally takes away all the energy required to enjoy a fulfilling sex life. Here are some tips, which will prove to be very effective in keeping stress away from your sex life.

1. Don?t make it seem necessary to have sex even if your partner is tired

If you find that stress due to problems at workplace or financial issues is affecting your partner considerably, then respect his/her decision of saying no to sex. Don?t pressurise your partner to get intimate just because you want it. Your patience and understanding nature will increase your partner?s admiration towards you, in turn leading to a more passionate and happier sex life.

2. Try to stay away from performance anxiety

Don?t let performance anxiety take a toll on your sex life. Studies show that being conscious about their performance in bed leads men to lose their erection, which takes all the pleasure away from intimate moments. Instead of being stressed about your sexual performance, focus on your partner?s needs and attend to them for a more pleasurable sex life.

3. Focus on getting rid of other stressful issues from your life

Common tensions of your daily life and everyday issues like the normal household chores, and your duties and responsibilities towards your family often leave you too exhausted to spend time with your partner. Moreover, getting preoccupied with social commitments also minimises the time available for just the two of you.

To prevent these stressful situations from affecting your sex life, try to focus on removing them. For this, you can ask for help from other family members to carry out household chores or diminish your time at social gatherings to be available for each other exclusively. Spending more time in each other?s company will not only brighten your day, but will also give you an enhanced and more intimate relationship.

If you would like to consult with me privately, please click on'consult.


How to Eliminate STRESS From Your SEX Life

The primary difference between pickle and chutney lies in the fact that pickles are meant to be preserved for months together while chutneys are devoid of preservatives and are required to be consumed very soon. Both of these food items proffer a host of health benefits including an optimum supply of all the needful minerals and vitamins along with the antioxidants. Some of the ingredients present in the pickle and chutney help in controlling high blood pressure, diabetes, improves digestion and immunity.

Pickles and the process of preparing the pickles
The process of making pickles is known to have originated in India, and it was the most viable way of preserving food items so that it can be stored for future usage. The process started as a means of preserving those food items, which are not available all through the year. The conventional means of preparing pickles in oriental style incorporates the usage of ingredients like oil, salt, chilli powder along with other condiments. The ingredients are mixed as per the set proportions, and there are many health benefits of eating pickles on a regular basis.

As per the reports of NSDA, pickles contain moisture, energy, fat, protein, carbohydrates, fibres, vitamins and sugar. The long list of vitamins includes Vitamin A, Vitamin B, Vitamin B-12, Vitamin C, Vitamin E, Vitamin K, riboflavin, niacin, thiamin, and folate. Indian pickles abound in phosphorus, iron, magnesium, sodium and potassium. The health benefits of pickles include the supply of necessary antioxidants, probiotics which are the gut-friendly antibiotics, helps in digestion, improve haemoglobin levels in anaemic people. There are some pickles which aid in controlling blood pressure levels and have hepatoprotective properties.

Chutney and their health benefits
Chutneys are a ubiquitous component of Indian cuisine, and some of the most common flavours added to the chutneys include ginger, garlic, onion salt, sugar and tamarind among others. Homemade chutneys prepared in almost all Indian households can be preserved for about a week in the refrigerator. Chutneys are filled with vitamins along with other nutrients, and less usage of oil makes it fat-free. They are rich in antioxidants, and sometimes fresh leaves are added to ensure inclusion of chlorophyll.

Just like pickles, chutneys also offer a wide range of advantages for one s health. It provides the body with the needful amount of antioxidants which are the micronutrients that aid in protecting the body from the free radicals. These free radicals are a type of unstable chemicals being generated at the time of cellular metabolism and react with the cells and cause damage to the DNA. The DNA then becomes unstable and gives way to the production of more free radicals which can be controlled by the consumption of antioxidants. The chutneys also supply the body with all the vitamins, minerals and other micronutrients which are necessary for sustaining healthy living.

To conclude, both pickles, as well as chutneys, are a significant part of the Indian food habits. Both of these items have a great taste and offer a wide variety of health aids which testifies to their consumption on a regular basis.

Pickle vs Chutney - Which Is Healthier?

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