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

There are phases in life when you do not feel energetic enough to engage in sex. It could be due to stress, long work hours or other biological reasons. A healthy, active sexual life helps in reducing a number of health issues, keeps you de-stressed, happier and most importantly, helps in keeping the relationship's spark alive! Certain foods are known to address just that and help in running your libido.

Try these boosters to get the spark back in your life.

1) Black Raspberries - They will get you into mood. Snack on it as it helps in increasing your sexual endurance. Consume at least 10 black raspberries an hour before getting busy.

2) Figs - Figs are considered excellent stimulants of fertility, enhance the secretion of pheromones. Try feasting on a few figs every day to notice a difference.

3) Cloves - Cloves are sex-superfoods. In fact, they have been used as a natural treatment for sexual dysfunction for years. They possess aphrodisiac qualities. Having a few will naturally up your libido.

4) Watermelon - Watermelon is known for boosting serotonin and endorphin levels, both of which are linked to improved sexual performance. Have the fruit regularly.

5) Eggs - Poach them, scramble them, make an omelette or do a sunny side up. There are just so many ways to eat an egg. But no matter how you eat it, the results will be the same - your libido will rocket up. It is used for heart ailments and erectile dysfunction as well.

6) Ginger - A little bit of ginger every day boosts circulation and so enhances your libido.

7) Lettuce - Lettuce is a libido booster for both men and women. Have iceberg lettuce with little salad or just nibble it and you will be good to go!

If you have any questions on improving sexual health, please click on 'Consult.

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Boost Your Sex Drive With These 7 Foods

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?

5 Common Causes Of Male Infertility

Till some time ago, male fertility wasn't paid much attention to, in our country. But, with changing times and increasing awareness, much is being discussed about male fertility. For couples trying to go family way, it is important to know how male fertility works. For a woman to get pregnant (assuming everything is fine within her body), the following things must occur in the male partner’s body: 
a. Healthy sperms
b. Sperm must get carried in delicate tubes to mix with the semen right before ejaculation.
c. Good sperm count
d. Movement and function of the sperm should be normal.
If any of the above are not happening as should be, it could indicate male infertility. Some of the reasons for male infertility could be:
1) Infections - Infections can interfere with the sperm health of an individual.
2) Varicocele - This happens when the veins which drain the testicles develop a swelling in them. This leads to reduced sperm count and fewer moving sperm. This can be treated and it is possible to improve the result with the help of assisted reproductive techniques like vitro fertilization.
3) Inflamed Testicles - Certain infections are known to interfere with the sperm health and production. These infections include STDs, prostatitis and inflamed testicles due to mumps. Few infections can lead to permanent testicular damage.
4) Inherited Disorder - Infertility can result from inherited disorders like Klinefelter’s syndrome where instead of being born with one X and one Y chromosomes, some males are born with two X and one Y chromosomes. Disorders in the testicles can also be the cause of male infertility.
5) Sexual Issues - Erectile Dysfunction pain during intercourse, premature ejaculation and such can also be the reasons for male infertility.
It is best to consult a doctor to understand the exact cause behind your problem.



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5 Common Causes Of Male Infertility

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

Click on consult privately to ask me any follow-up questions on this.

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Having Sex - 9 Health Benefits

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