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

In today's time there are various factors, which affects our relation with our partner and among such factors is low libido. Low libido or a decreased sexual activity can affect a relationship in a big way. In some extreme cases, the impact is such that it leads to irreconcilable marital discords. Time and again, an individual, irrespective of their age, sex or occupation can go through periods of low libido. Decreased sexual desire over a longer period of time needs thorough investigation. It could be an indication of something big and serious lying ahead. 
7 critical factors that attribute to low libido: 

1. Hormonal imbalance: women, mostly menopausal and postmenopausal, experience low libido. This is because during menopause, there is a significant drop in the oestrogen level. Reduced oestrogen level can have a huge impact on sexual desires and performance. It can also make the vagina dry, resulting in painful penetration and intercourse. Hormonal imbalance or changes during pregnancy can also result in low libido in females. In males, low libido has been found to be associated with decreased levels of testosterone. 

2. Stress: an individual's mental and emotional state is greatly reflected in their sexual performance. A sound mental health can enhance a performance thousand folds. On the contrary, factors like depression, anxiety and stress, lowers the sexual desires in a person. To enjoy a healthy and normal sexual life, it is important to keep stress and chronically blue moods at bay.

3. Sound sleep to the rescue: the benefits of a sound sleep are beyond imagination. A good 6 - 8 hours of sleep can do your sexual desires or libido a world of good. A sleep deprived soul will be agitated and cranky, both on and off the bed. Continuous sleep deprivation can also lower the testosterone level, resulting in low libido.

4. Medical condition: medical conditions like diabetes, cardiac problems, high blood pressure, or ailments of the coronary artery can rupture an individual's sexual life immensely. Improper functioning of the thyroid glands is another factor contributing to low libido. In such cases, it is best to consult a physician at the earliest. Rest legs syndrome can also contribute to low libido. It is a condition whereby, a male experience an uncontrollable urge to move his legs.

5. Smoking: a killer habit, which affects a person's sexual activity is smoking. Drug abuse and drinking (to some extent) can be equally responsible for a low libido.

6. Change in weight: a sudden change in body weight (gain or loss) can play a significant role in low libido. Take pride in your body structure. There is nothing to be ashamed of.

7. Take a break: boredom can mask your sexual life greatly. Break the monotony, take short breaks, go on vacations and low libido will be a thing of the past.

7 Things That Might Be Causing Your Low Libido

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

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

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?

Habits causing reduction in sperm count

There are a few very common things that a man consumes or does every day without even realizing, that they have a tendency to reduce his fertility. These causes start from drinking and could end with something as harmless as caffeine. Let’s see which habits can cause reduction in sperm count thereby reducing fertility of a man.

1. Eating processed meat harms sperm quality.
2. Excessive usage of laptop can also lead to reduction in sperm count because of the heat that a laptop releases.
3. Hormonal imbalance also causes low sperm production.
4. If a man is underweight or overweight, this could also lead to less production of sperm. So, a man should watch his weight before thinking of extending his family.
5. Exposure to too much heat for a prolonged time leads to reduction in sperm count.
6. Regular smoking also leads to reduction in sperm count.
7.Excessive stress also causes reduction in sperm count.
8. Regular and continuous exposure to chemicals like xylene, painting material and metal like lead also leads to low sperm count.
9. Chemicals present in sunscreen lotion can harm a man’s sperm count so one should be alert while using a sunscreen lotion.
10. Sex toys also cause infertility in men because of presence of phthalates in   them.
11. Regular intake of canned food can also contribute in low sperm count.
12. Regular drinking habits reduce testosterone levels thereby reducing the quality and production of sperm.
13. Excessive intake of canned food leads to intake of bisphenol A which lowers down the quality of the sperm.
14. Excess intake of caffeine also leads to reduction in sperm count.
15. Lack of exercise and laziness also reduces sperm count to a great extent.

Some of the above-mentioned things can be unavoidable, but point here is that taking everything in moderate quantity doesn’t do any harm but problem occurs when the intake is excessive, regular and beyond limit. So, it’s better to reduce the quantity and regular use of such things than letting it affect your sperm count.




Did You Know These 15 Habits Are Reducing Your Sperm Count?

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