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

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

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.



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

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5 Common Causes Of Male Infertility

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 reasons your partner doesn't want to have sex anymore

There are innumerable explanations as to why couples in long-term relationships find themselves in situations when either one of the partner's starts avoiding sex for a reason the other cannot comprehend.

The explanation for your partner's behaviour may be due to an underlying medical issue or various emotional or psychological factors. Following are a few reasons why your partner does not want to have sex anymore:

1. Physical factors: your partner might be experiencing a loss of libido due to physical ailments, particularly ones pertaining to the endocrine and circulatory systems. Disorders such as diabetes, hypothyroidism, heart complications to name a few, affect the hormone levels in the body, which leads to the lack of sexual drive.

2. Psychological factors: Many mental and emotional factors also affect libido in both men and women. Stress and depression, which often cause sleep deprivation, are two of the biggest causes of unwillingness to have sex. Talk to your partner about what the root of the problem is and ascertain what is creating stress and triggering depression. Communication and counselling are the main ways of dealing with such a situation.

3. Excessive masturbation: If a person watches too much pornography and consequently indulges in masturbation frequently, sexual function is automatically lowered when it comes to performing during intercourse. If your partner masturbates too much, simply ask that the practice needs to be put an end to.

4. Lack of affection: When there is a lack of warmth and affection between partners, the desire to engage in sexual intercourse is automatically diminished. Communicate with your companion to determine ways in which you can rekindle love and passion in the relationship.

5. Addiction to narcotics: If your partner has developed an addiction to certain narcotics, such as nicotine, morphine and various anti-depressants that reduce sex drive, it could be the reason for not wanting to have sex.

The reasons for developing an aversion to sex are often extremely subjective and complex. Open and honest communications between partners may unravel the problem but in many cases, therapy and medical assistance provides the solution.



5 Reasons Your Partner Doesn't Want to Have Sex Anymore

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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