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

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

8 Steps to a Happier Sex Life - Sex is probably the most important part of a relationship along with compatibility, trust and comfort. To make your relationship stronger and deeper, happiness in sex life is crucial. It must be the part of your life that you always look forward to and that brings the two of you together irrespective of the way your days go.

Follow these simple protocol to make for a happy sex life and therefore a happy life.

1) Believe you are sexy - Stop undermining yourself. You are sexy, accept it. And believe that your partner gets turned on by you. When you believe that your partner finds you sexy, you will be more interested in sex and so will your partner be.

2) Believe in the little gestures - Sex is not always awesome while you are in the act. The build up through the day can be made with the simplest of actions. A meaningful touch on the breakfast table, a mid-day text saying you miss him and an intimate evening message, or simply holding hands while shopping for grocery, all add up to build the connection between both of you.

3) Focus on the positive - Tell your partner what he does that you like. The kiss on the nape or how their breathe on your skin makes your senses tingle ? tell that. When your partner knows what you like, your bedroom experiments can take interesting turns. Always help your partner focus gently to what gives you pleasure.

4) Make time for sex - When new in a relationship, couples tend to have more sex and the frequency diminishes once they are comfortable in the situation. Avoid this; sex should be in your priority list at all times. Sex indeed should be a natural event. However, our lifestyles don't permit it. Also, there are too many distractions. If you need to schedule sex, it's okay. The idea is to indulge in it. You both have your needs and they should be fulfilled, right?

5) Fantasize - One great way to keep the passion alive is to share your fantasies. Doesn't matter how dirty it is, don't worry about what your partner will think. Far from judging, you yourself might realize something new about your partner. Chances are, that you might love the fantasies you both talk about.

6) Take it easy -  In real life, it is okay to not be perfect, to stop to catch breath and be real. To be happy with your sex life doesn't mean having spectacular sex every time. More than how you perform, it is how the experience was for both of you. Enjoy the process, it is for real.

7) Be responsive - Respond, even if you are not in the mood. Don't shun your partner because you are not in the mood. But if one of you wants to have sex, pushing them away is not a good idea. And if you still don't want to go ahead, explain that it's not them, but the time and plan to connect some time in near future.

8) Be willing to have sex - If you would rather watch tv all day rather than have sex and then do it nevertheless just because your partner initiated it, they would know. Never make your partner feel that you are having sex out of obligation. This is a mood killer and a guarantee for low satisfaction derived. Make sex an enjoyable affair, think what all you like and show them to your partner. 

If you have any further questions on sexual health, ask me by clicking on 'Consult'.

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Having Better Sex - 8 Steps to a Happier Sex Life

From a medical standpoint, sex during menstruation is completely fine. Most men have claimed that period sex seems messier when compared to intercourse on normal days, but, other than that, there aren t any risk regarding period sex. In fact, it is advisable to engage in vaginal intercourse during periods for a variety of reasons.

Here are a few things you should know about period sex:

Intercourse during periods isn t harmful: Contrary to the popular myth, period blood doesn t contain impurities which might affect the penis in any way. Instead, menstrual blood is normal blood mixed with disposed off tissues from the lining of the uterus and the penis isn t affected by menstrual blood in any way. The menstrual blood serves as excellent lubricant to make the process of intercourse smoother.
Chances of pregnancy still persist: It is not okay to completely ward off protective measures during periods because even though it is safer than other days, there might be a small chance that the sperm of a man lives on in the female body till early ovulation. Besides, the chance of getting a sexually transmitted disease is the same during period sex.
Can relieve cramps: Some women claim that having sex during their period helps ease their cramps as having an orgasm releases  pain- reducing endorphins  into the bloodstream. Also, some medical practitioners believe that sex provides relief by using up chemicals which are responsible for cramps. Thus, having period sex can prove to be relaxing and less painful than normal days.
Sexual arousal ups during menstruation: Most women feel hornier and more aroused during periods because of the increase in the hormonal levels. Some women feel heavier in the pelvic area which increases the sex drive; precisely the reason why having sex during this time is a good idea. So, for all you know, you might actually have a brilliant intercourse session when she s on her period.

Sex During Periods - What Should You Know About It!

Physical intimacy between couples can be something that can never be judged based on their relation. Many factors can hamper the satisfaction of the people involved, and you would have said that at least one point of time in your life that the zest has fiddled out. Do not fret as you are not alone. You are voicing something which billions of couples would have expressed at some point in time in their life. In a long-term relationship, the partners can almost complain about the same things which they believe is needed to make their physical intimacy to work out even more.

There are enough diseases and infections related to sex that can physically veer a couple from having a healthy intimacy. Add to that; there are many psychological parts too that can hamper a robust and active sexual life. Thanks to the times we live in almost all the sexual diseases and infections can be treated and kept at bay. However, the psychological imbalances have to be adequately addressed and channeled using the right medium. It can be very beneficial to consult a sex therapist for the underlying problems and more often it can be better if the sessions are had as a couple. Let us look at a few of the symptoms that can lead to issues in bed:

Laziness: The intimacy cannot have the desired result if you find that if you or partner is lagging in the enthusiasm. Boredom can easily set in, and this can easily have an effect on how physical you are. Talk this out with a therapist and try to look for ways in which the laziness and the routine can be reduced.
Body Image: It is true that a body image can be one of the factors for a good sex life, but as we age we tend to get loose and do not make an effort to keep our body fit. This, in turn, can affect the intimacy has the partners can lose interest in each other as a couple. Have a healthy lifestyle and stay away from foods that can hamper your wellbeing. Exercise regularly and keep surprising each other.
Exhaustion and Stress: Needless to say this one factor and the modern times have been the main culprit for making you have issues in bed. Our work nature has forced to work 24/7 sometimes leaving us little time for other crucial intricacies of life. This has left us with a void and has made a dent in our space and the way we react to a sexual urge. The only way by which this can be minimized is by having a good work life balance and by giving the needed importance to the relationship. Remember that your work is not important than your physical well-being, and if your nature of the work is the cause of your ailments, then it is high time you think about changing it.
Communicate: More importantly, talk to a counselor about the problem you face and about your anxiety levels. Try having an open communication between you and your spouse and know your interest quotients. It is not wrong to appraise each other as far as physical intimacy s concerned. Remember that an open mind is always the fostering channel for dissolving the issues in bed.

Are You Having Issues In Sex Life? Know The Possible Reasons Behind It!

How too much sugar can adversely affect your sex life

Sugar is an important source of calories in the body as it can provide immediate energy to the body after consumption. Sugar being a simple carbohydrate is digested quickly and released into the bloodstream to be used as energy. However, too much sugar in the bloodstream at once can cause a host of disorders in the body including affecting one's sex life. Outlined below are the ways how sugar adversely affects sex life-

1. Impairs the gene that regulates sex hormones

Glucose and fructose are synthesized in the liver, where the excess is converted into fat. When fat synthesis rate goes up in the body, it affects SHBG (sex hormone binding globulin) gene in the body. This gene is responsible for regulating the levels of testosterone and estrogen in the body. Hence, in this case, the affected person becomes highly susceptible to infertility.

2. Lowers testosterone levels

Indulging in a diet that consists of too much sugar affects insulin resistance. Due to this, testosterone levels drop in both men and women. This causes disorders related to sexual function such as erectile dysfunction and also reduces sex drive.

3. Fatigue and reduced energy levels

Foods high in sugar cause temporary spikes in blood sugar which in turn results in fatigue, thus reducing sex drive. It also decreases levels of Orexin, a neurotransmitter that regulates feelings of arousal in the body, causing fatigue and lethargy.

4. Increases stress

Increased stress levels as a result of sugar consumption occur when high insulin levels cause the body to produce cortisol, a stress hormone. Too much cortisol in the body decreases libido



How too much sugar can adversely affect your sex life

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