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

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

The primary difference between pickle and chutney lies in the fact that pickles are meant to be preserved for months together while chutneys are devoid of preservatives and are required to be consumed very soon. Both of these food items proffer a host of health benefits including an optimum supply of all the needful minerals and vitamins along with the antioxidants. Some of the ingredients present in the pickle and chutney help in controlling high blood pressure, diabetes, improves digestion and immunity.

Pickles and the process of preparing the pickles
The process of making pickles is known to have originated in India, and it was the most viable way of preserving food items so that it can be stored for future usage. The process started as a means of preserving those food items, which are not available all through the year. The conventional means of preparing pickles in oriental style incorporates the usage of ingredients like oil, salt, chilli powder along with other condiments. The ingredients are mixed as per the set proportions, and there are many health benefits of eating pickles on a regular basis.

As per the reports of NSDA, pickles contain moisture, energy, fat, protein, carbohydrates, fibres, vitamins and sugar. The long list of vitamins includes Vitamin A, Vitamin B, Vitamin B-12, Vitamin C, Vitamin E, Vitamin K, riboflavin, niacin, thiamin, and folate. Indian pickles abound in phosphorus, iron, magnesium, sodium and potassium. The health benefits of pickles include the supply of necessary antioxidants, probiotics which are the gut-friendly antibiotics, helps in digestion, improve haemoglobin levels in anaemic people. There are some pickles which aid in controlling blood pressure levels and have hepatoprotective properties.

Chutney and their health benefits
Chutneys are a ubiquitous component of Indian cuisine, and some of the most common flavours added to the chutneys include ginger, garlic, onion salt, sugar and tamarind among others. Homemade chutneys prepared in almost all Indian households can be preserved for about a week in the refrigerator. Chutneys are filled with vitamins along with other nutrients, and less usage of oil makes it fat-free. They are rich in antioxidants, and sometimes fresh leaves are added to ensure inclusion of chlorophyll.

Just like pickles, chutneys also offer a wide range of advantages for one s health. It provides the body with the needful amount of antioxidants which are the micronutrients that aid in protecting the body from the free radicals. These free radicals are a type of unstable chemicals being generated at the time of cellular metabolism and react with the cells and cause damage to the DNA. The DNA then becomes unstable and gives way to the production of more free radicals which can be controlled by the consumption of antioxidants. The chutneys also supply the body with all the vitamins, minerals and other micronutrients which are necessary for sustaining healthy living.

To conclude, both pickles, as well as chutneys, are a significant part of the Indian food habits. Both of these items have a great taste and offer a wide variety of health aids which testifies to their consumption on a regular basis.

Pickle vs Chutney - Which Is Healthier?

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

Oral sex is a form of sexual activity, which involves the arousal of one's genitalia by his/her partner using the mouth (tongue, lips and throat). It is also called Cunnilingus (performed on a female) and fellatio (performed on a male). It is done before intercourse and during foreplay for sexual arousal. It is safe as compared to vaginal or anal sex, the rate of getting a sexually transmitted disease or HIV is comparatively lower. 

Oral sex can spice up your life and can also make your partner reach orgasm. It is also a safe way of getting sexual pleasure without getting pregnant. But necessary precautions must be taken in order to have safe oral sex.

Some of these necessary precautions are:

1. You can get throat cancer from oral sex: Human papillomavirus (HPV) is a cancerous virus found in the body of infected people. This virus can be transmitted to the person with whom you are engaging in oral sex. Studies show that people who engage with more than 6 sexual partners at once are more prone to get oral cancer. It is advisable to get your partner tested for HPV virus before engaging in oral sex.

2. Oral sex also causes stress: Oral sex is generally related to hygiene, therefore the partner can be self conscious and worried about his/her genital hygiene. If oral sex is performed on a daily basis, some people prefer to wax their pubic hair often. This is harmful because it can cause red bumps and burning sensation occurs. It is advisable to trim your pubic hair and wash it properly before engaging in oral sex.

3. A condom should be worn by the male during oral sex so that there is no risk of male fluid entering the woman's body.

4. A latex, which is made into a thin sheet called dental dam can be used on the vagina or anus. This creates a thin barrier between the mouth and the genitalia. Hence, chances of getting infected by sexually transmitted diseases are greatly reduced.

Oral sex can be pleasurable and fun, but the risks of getting sexually transmitted diseases like herpes, gonorrhea and crabs is not altogether misplaced. So it is advisable to use proper protection and to maintain hygiene before engaging in oral sex.

4 Ways to Have Safe Oral Sex - Necessary Precautions

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