Intercourse is meant to be a pleasurable and intimate experience. But it might become an unpleasant act if you are suffering from performance anxiety. When you are mentally occupied by questions such as "Do I look too fat?" or "Did I do that right?", sex stops being a gratifying experience.

Incessant anxiety over your ability or appearance can result in sex becoming nerve-wracking and stressful for you. It might even have you avoiding sex altogether. This psychological condition is termed as sexual performance anxiety.

Sex isn't only a physical reaction, there are emotions tied to it as well. If you are too stressed out and your mind is preoccupied, your body reflects your inner turmoil and you cannot get aroused.

Causes
The causes of sexual performance anxiety include:
1. Fear that you wouldn't be able to satisfy your partner and perform well sexually
2. Body image issues (Such as stressing about your weight)
3. Problems in your relationship
4. Men worry that their penis don't 'measure' up
5. Men might be concerned about taking too much time to orgasm, or about premature ejaculation
6. Women worry about not enjoying the experience or being unable to have an orgasm

Symptoms
Your mental state has a deep impact on your physical state. The effect of stress hormones norepinephrine and epinephrine can hinder your sexual performance. Symptoms of sexual performance anxiety include:

1. In men, blood vessels constrict due to the effect of stress hormones. This leads to reduced blood flow to the penis, thus making it difficult for the man to get an erection.

2. Often though it is less diagnosed in women, sexual performance anxiety leads to trouble in lubrication during sex. Lack of lubrication dims the desire to have sex.

Sexual performance anxiety is a vicious, inescapable cycle. Increased anxiety hampers you from having sex, making you think you won't be able to perform well, which causes even more anxiety.

Treatment
Consult a doctor you will be comfortable with discussing your problems. Sexual performance can be either treated by medication (if you have an underlying medical condition such as erectile dysfunction) or through therapy.

Talking to a therapist or counsellor about your problems can help you in several ways. You can learn to become more comfortable with yourself and your body. You can also understand your problems better, which can eliminate your anxiety.

All About Sexual Performance Anxiety

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

Why do men and women respond differently after sex?

Men and women look differently, act differently, dress differently and even communicate in dissimilar ways. Therefore, it's no surprise that their reaction to sex should be different. While men's minds and genitals are usually in alignment, women are less likely to have a link between their mind and genital area. This is because of one of the most complex creations of nature is the human brain, and there are subtle differences in its reactions to different things for both men and women.

How different are the reactions of both the genders to sex?

A study carried out by a psychology professor at queen's university, Meredith chiversk, revealed that while in men the mind and body seem to be in tune with each other, a woman's mind and genitals sometimes respond oppositely to sexual arousal.

What is the reason for this difference in responding?

Firstly, in the case of women, oxytocin (also known as intimacy/cuddle hormone) is released during sex and this hormone encourages bonding and empathy, which leads to an increased feeling of bonding and intimacy.

In the case of men the brain releases more of a hormone, which can make them susceptible to sex addiction. When a man has an orgasm, the main hormone which is released is dopamine (pleasure hormone) and this surge can be addictive.

Men's arousal pattern has repeatedly emphasized their sensitivity to visual stimuli. As soon as the lust-inspiring image registers in their brain, they become turned on, not only physically but also psychologically. Exposure to such erotic stimuli immediately activates that part of their brain that is related to getting an erection. Women, on the other hand, react differently to different stimuli, with their responses varying from emotional to sexual or a mix of both.

The study made use of a total of 134 previous studies of which approximately 1, 900 men and 2, 500 women were a part to come to this conclusion.

If you would like to consult with me privately, please click on 'consult'.
Tip: 8 Unbelievable Health Benefits of Masturbation

Why Do Men and Women Respond Differently After Sex?

Link between Erectile Dysfunction and Premature Ejaculation

Erectile Dysfunction is the inability of a man to achieve a penetrable erection while premature ejaculation is a man's inability to take control of his ejaculations during or before sexual intercourse. These conditions are two of the most common sexual dysfunctions observed among men. The prevalence of these two conditions can be found among all socioeconomic groups and among men of varying ages.

The incidence of premature ejaculation is higher and hence more common among both young and old men. Studies show that an estimated 40% of men suffer from the condition of premature ejaculation. On the other end, research also reveals that erectile dysfunction is associated with advancing age though a host of other factors like diabetes, kidney and heart diseases and certain medications can also be responsible.

How are these two conditions actually related?

It is found that in most men who have been primarily diagnosed with erectile dysfunction, the secondary concern has been premature ejaculation. The reason for both the problems is more or less the inadequate flow of blood to the penis required for a penetrable erection.

Moreover, in some cases, it was found that premature ejaculation occurred when a person was diagnosed with both mild and acute erectile dysfunction. In a similar manner, it was found that among men who suffered from ED and required constant stimulation to maintain a penetrable erection found out the instances of occurrence of premature ejaculation was high.

In some cases, it was found that the chief cause of erectile dysfunction was premature ejaculation. Because of these reasons, the two conditions are often found to co-exist and overlap one another.

In cases where both the conditions exist, treatment for ED is recommended to be sought first.

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

What is the Link between Erectile Dysfunction and Premature Ejaculation?

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

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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