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

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

4 Easy ways to increase your libido

Libido is a term that is used to describe the sexual desire for sexual activity. According to WHO, sexual health is a state of physical, mental and social well-being, which is why libido is one of the key factors to a sound and healthy life. As men have 40 times as much testosterone as women, they are thought to have a more intense sexual drive. Dopamine plays a strong role in libido and motivation. Physical issues like low testosterone, too much exercise, and alcohol can cause low libido. Psychological issues may include depression and stress in everyday life.

The good news is that libido can be increased through some simple measures, which are:

1. Have a positive outlook

Prolonged stress can diminish your interest in sex, and men and women have different reactions to stressful situations. Both partners need to discuss their stressful jobs each day and find a non-stressful time for sex. Besides, being self-confident and optimistic makes you feel more sexual and charming to your partner.

2. Following a proper balanced diet

Natural supplements can increase your blood flow and help fight vaginal dryness. You can try the much-touted libido-boosting foods, known as aphrodisiacs. Figs, bananas, avocados, eggs, chocolate, and mangoes can help to increase libido. Foods rich in vitamin E, vitamin C, vitamin B complex, and zinc may help to boost sperm count, improve sperm motility and increase testosterone production in men.

3. Prepare for intimacy

If you are planning some quality time with your partner and hope to get him/her 'in the mood' you can try chocolate and coffee. Chocolate has been as the symbol of a desire not only for its delectable taste but because of its power to improve sexual desire. Coffee and chocolate both produce positive mood states, releasing endorphins, providing energy and increasing physical endurance. Wine, or any other form of alcoholic drink, consumed in a small amount, may help people to relax and get in the mood. However, caution must be maintained as excessive consumption can result in impotence in men.

4. Take time to meditate and relieve stress

Being stressed out can affect your sex drive. To relieve stress you can indulge in sports activities and exercises. Lifting the weight or doing resistance training exercises like pushups help to break down and rebuild muscles, creating a spike in testosterone production. For many couples, working out together can become a stimulating experience that gets them in the mood. Exercises can increase performance, range of motion, endurance, boost confidence and help you look younger and more attractive.



4 Easy Ways to Increase Your Libido

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.

From Lybrate: If you found this tip useful, please thank the doctor by clicking on the heart icon below. Also, spread good health by sharing this tip with your loved ones over WhatsApp, Facebook and other media.

Boost Your Sex Drive With These 7 Foods

Does watching porn together help you have a better sex life?

It is often said that the couples who do most day-to-day activities together are more committed towards each other. But does the same stand true when it comes to watching sexual content or pornography? Well, research certainly seems to indicate that, with a whopping 96% couples watch pornography together. Here are some pros and cons of viewing porn with your partner.

PROs-

1.  It may help you both in discovering your sexual preferences
It is important for both you and your partner to be on the same page when it comes to discovering your sexuality and figuring out each other’s sexual preferences. Just like adolescent sex education, pornography too educates you about the mechanics of sexual play. It is a useful tool that brings out the kinky side in you and makes you more open to discussions on things that pique your curiosity in the bedroom. As and when you see such visual imagery, it may appeal to you enough to try it out with your partner. Discuss such desires with your partner. This may help you in discovering what really turns you and your partner on.

2. It may help you in maintaining sexual fidelity in your relationship
Watching porn together with your partner can potentially increase the intensity of physical attraction between the two of you.This, as a result, leads to greater gratification for both of you, and if you are sexually satisfied by your partner, you are less likely to look for pleasure outside your relationship. Also, it is way healthier to indulge in it as a team rather than discovering your partner watching porn alone.

3. It may help both of you to pick up newer positions
Porn has the ability to expose you to new and exciting positions you never knew. About 58% of couples who viewed pornography claimed that the shared activity had a positive effect on their sex lives. New moves and unique positions are known to spice up sex lives. Men can surprise their women (or vice versa) with an exotic move or two. Porn may also help in decreasing shyness and in opening up your minds so that you can pick up and practice new moves.

CONs-

Although porn viewing may consist of potential benefits, it may also affect your relationship adversely. When watched in excess, porn may cause certain problems in your relationship, which are-

1. It might set up wrong expectations in reality
Porn movies give you a warped view of what beauty is. It may cause you to have unrealistically higher expectations from your partner, whereas the reality may not match your imaginative hopes and standards. As a result, it may also lead to frustration, aggression and infidelity.

2. It may lead to pornography addiction
 The visual and physical appeal of porn may impact a person’s mental or social well-being. Increased porn viewing may hint at a person’s social isolation, loss of interest in career and other activities etc. It may also make you highly dependent on it, as it allows immediate sexual gratification. As a result the usage may go out of control and relate directly to compulsive behaviour.

3. It may affect your sexual drive and libido
Making love to your partner in real-life may become a foreign concept, as porn can decrease your physical drive with the possibility of making you sexually lazy. Porn may also have certain side effects including probable loss of libido and even difficulty in lasting longer. It may also make regular intercourse seem boring as it may not have the same sensual and visual appeal as pornography.
After realising its various pros and cons if you want to use porn, it is advisable to not use it as replacement but as an accessory for better sexual well-being.

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

Does Watching Porn Together Really Help You Have a Better Sex Life?

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