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

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

Knowing premature ejaculation - part 3: management and techniques (non-medical methods)

As shared in part 1and 2 of this series, because of premature ejaculation (pe), both the partners may end up experiencing highly unsatisfactory sex. In fact, it can increase anxiety, which may deteriorate the problem. 
Remember there is not a single magical drug or medicine in the chemist shop which can solve your problem overnight especially if you have chronic pe. Before seeking any medical treatment for pe, it is appropriate to consider the varied options for solving this issue. These include counseling with a sexual therapist, non- medical treatments like various exercises/ techniques and medical treatments including both modern and alternative medicine.

A. Counseling from an expert - sexual therapist or sexual medicine practitioner:
It is well understood that sex is in the mind. However, repeated pe/ failures can lead to lot of stress and disappointments. Anxiety due to pe itself is a big issue and can lead to recurrence of pe.
Reassurance from sexual therapist / counselor that pe is not a disease and can be easily treatable is relaxing for men who are facing this problem. So please share your detailed history and sexual habits with the expert. This may help the expert to guide you well.

B. Behavioral changes:

Some basic things may also help you to deal with the problem. 

1. Some men attempt to treat themselves for premature ejaculation by distracting themselves by thinking nonsexual thoughts (such as naming cricket players and records) to avoid getting excited too fast when approaching their partners. This helps them to focus their attention away from the sexual stimulation.

2. It is also suggested to men that they should relieve themselves of the sexual tension by ejaculating with self masturbation 1-2 hours before attempting sexual intercourse with their partner.

3. Using condoms is known to help in premature ejaculation in some men by decreasing sensation.

4. Women on top position usually helps to delay orgasm in men

 
C. Exercises &amp; techniques:

There are several exercise and techniques you can try sitting in your home.

1. The" stop and start" method:
This technique involves sexually stimulating the man by self until he feels like he is about to reach orgasm. Then he needs to stop the stimulation for about 20-30 seconds and then start it again. Repeat this pattern until the man wants to ejaculate. This can be continued for 10-15 minutes. At the end of say, 10th or 15th minute, continue stimulation until the man reaches orgasm and ejaculates.
2. The" squeeze" method:
 This technique involves sexually stimulating the man by self or by his partner until he recognizes that he is about to ejaculate. At that point, the man or his partner gently squeezes the end of the penis (where the glans penis meets the shaft) for at least 15 seconds. Stop sexual stimulation for about 60 seconds, and then start it again. The person or couple may repeat this pattern for at least 10-15 minutes. At the end of say, 10th or 15th minute, continue stimulation until the man reaches orgasm and ejaculates.
3. Practice breathing exercises 

Deep breathing can greatly help in controlling the arousal and tension that cause early ejaculation. Men must avoid shallow breathing as it can trigger premature ejaculation. Instead, what you should do is spend 5 seconds taking in a long deep breath; then hold it for 3 seconds and then exhale for the next 5 seconds. If you can do this for 5 minutes in the bedroom without pause then you can control premature ejaculation.

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

Knowing Premature Ejaculation - PART 3: Management and Techniques (Non-medical methods)

Why you must try kegel exercises for an amazing sex life!

Kegel exercise, also known as pelvic floor exercise, is the repeated contraction and relaxation of the pelvic floor, which is the muscular base of the abdomen connected to the pelvis. These simple exercises are proven to enhance the functioning of the pelvic organs and improve sexual health. How you ask? read on to find out.

Both men and women can improve their sex life to a great extent by practicing Kegels.

How does it improve sexual function in women?

 tones and strengthens the vaginal muscles that boost arousal

 causes a tighter grip during intercourse

 leads to more intense contractions during orgasm

How does it improve sexual function in men?

 allows for men to have stronger, long-lasting erections

 keeps the hips and pelvic region healthy

 leads to greater control over ejaculation

 prevents the occurrence of erectile dysfunction

How does kegel exercise betters sex life?

To get started on kegel exercises for a better and healthier sex life, follow these simple steps:

1. Locating the right muscles: the most important part of doing kegel exercises is locating the pleasure-maxing muscles in the pelvic region. This can be done by stopping urination midstream or blocking the passage of gas. Once you've successfully managed to identify the target muscles, kegel exercises can be done anywhere at any time.

2. Staying focused: it is important to stay focused on exercising the pelvic floor muscles. Easy breathing while doing the exercise and keeping from flexing other muscles in the abdomen and buttocks are necessary parts of the routine.

3. Sharpening the technique: practice tightening and releasing the pelvic floor muscles till you have perfected the technique, working up to a 10-second hold before releasing and relaxing for 10 seconds between each contraction.

Repeat daily

Get into a regimen doing 10 to 20 kegel exercises three times a day, holding each one for 10 seconds.

Kegel exercises will not only improve your sex life, but also combat disorders of the bladder and lower intestines. Plus, they've been proven to enhance orgasms, turning them into more frequent occurrences than before.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: 5 Do's + Don'ts for a Healthy Sex Life

Why You Must Try Kegel Exercises for an AMAZING Sex Life!

6 Unexpectedly easy ways to give your sex life a whole new dimension

New Year is a good the time for new beginnings. At times our sex lives needs to be revived too. After a few years together, a couple’s sex life may begin to stagnate. A boring sex life can negatively impact your relationship as well. But by employing some very easy tricks in the bedroom, you can bring back the passion and add spark to your life. 
Can’t figure out where to start? Here are 6 tips and tricks to help you out. 

1. Be spontaneous: One of the main reasons a couple’s sex life dwindles is because they fall into a routine. Whether it’s the position you choose, or the sequence of events- right from foreplay to the actual intercourse- every couple has their own set routine. Break this monotony and try out new positions that can greatly enhance your pleasure. Also, try having sex somewhere else in the house that you haven’t before to spice things up.

2. Don’t be shy: Sex is one of the most intimate acts you can share with someone. However, sometimes you may find yourself being unable to open up to your partner about what gets you in the mood. This can make sex an unfulfilling experience. Try telling your partner what you’d like him/her to do. You might end up discovering that both of you share a common fantasy you hadn’t spoken about before.

3. Explore all erogenous zones: There are a lot of erogenous zones on a man and woman’s body. Take your time and get to know every single one of them. If you don’t know where they are, explore your partner’s body and see what turns him/her on and where. This is a great exercise that also sets the foundation for more fulfilling sex in the future. 

4. Experiment with your lingerie: Clothes can be a turn on or a turn off depending on what you wear. Try experimenting with your lingerie. A host of options are available out there for both men and women. These days you can even buy edible lingerie on leading online shopping sites. Choose bright shades like red, as they’ve been proven to increase arousal.

5. Play around with sex toys: Introducing sex toys in your bedroom can prove to be very stimulating as well as exciting for both you and your partner. Sex toys come in all shapes and sizes, for both men and women. You can take your pick from vibrators and vibrating rings, handcuffs, etc; even lubricants and gels can be used to enhance pleasure and make sex more exciting.

6. Shave your pubic hair: Another way to give your sex life a whole new dimension, shaving off your pubic hair can increase the sensitivity in your genitals making sex a more pleasurable experience. Besides, for many shaved genitals have a visual appeal and cause intense arousal, which is very important when it comes to having a satisfying sex life. 

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

6 Easy Ways to Give Your Sex Life a New Dimension in 2016

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