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

How to End Sexual Problems? Is Exercise the Real Solution?

Whether you suffer from premature ejaculation, erectile dysfunction, are unable to get an orgasm - or you just want to improve your sex life, Every problem is connected to one major solution, it's important to exercise your 'sex' muscles.

A. Kegel Exercises - Cure For Erectile Dysfunction, Urinary incontinence and Nightfall

What Are Kegel Exercises?

Kegel exercises are easy exercises to strengthen your pelvic floor muscles.

How Do I Find My Pelvic Muscles?

In order to help strengthen you pelvic floor muscles, it is important that you take time to make sure you are exercising the right muscles.

Try to stop and start your urine stream while you are about to urinate . Try to do this two or three times. The muscles you use to stop your urine flow are your pelvic floor muscles.

How Do I Do A Kegel Exercise?

Now that you have located your pelvic floor muscles, you can exercise them even when you do not have to urinate  by following these simple steps:

1. Tighten and hold your pelvic floor muscles for five seconds (count 1 one thousand, 2 one thousand, 3 one thousand, 4 one thousand, 5 one thousand).

2. Relax your pelvic muscles.

You have just done one Kegel exercise. You should plan to do 10 to 20 Kegel exercises three to four times each day.

Another way to tighten your pelvic floor muscles is to:

1. Squeeze the muscles in your anus (like you are holding a bowel movement).

2. Relax your pelvic floor muscles after each attempt.

3. Repeat this exercise 10 to 20 times.

When you do your Kegel exercises, remember

Do not hold your breath.

Do not push down.

Squeeze your muscles together tightly and imagine that you are trying to lift this muscle up.

Do not tighten the muscles in your stomach, buttocks, or thighs

Relax your pelvic floor muscles between each squeeze.

How Often Should I Do Kegel Exercises?

Your goal should be to do 20 Kegel exercise three to four times each day. The great thing about Kegel exercises is that you can do them anytime you want to do them

Kegel exercises can help both men and women. Some men's partners do the exercises with them. The more you do them, the stronger your pelvic floor muscles will become.

It can take six weeks or longer to strengthen your pelvic floor muscles

B. The Push-Ups

Lower yourself Only halfway down while doing push up, do not touch the ground.

Halfway down push-ups are easier to achieve and enable you to do faster reps, which, as well as increasing your sexual strength, will also increase your sexual fitness and stamina. Do sets of 10 or 20 push ups.

C. Rebound Exercise

It is performed on a device known as a rebounder/mini-trampoline. Rebounding for 10 minutes twice a day will do wonders for your Sexual health. It strengthens your pelvic floor, abdominal, hip and upper leg muscles as well as strengthening your lymphatic system.



How to End Sexual Problem? Is Exercise the Real Solution?

6 Symptoms of Low Testosterone

Testosterone is an important hormone for men and is responsible for male sexual and reproductive health. It begins to spike during the years of puberty, helping in development of primary and secondary sexual characters. In boys, it helps to build muscles, deepens his voice, and boosts the size of their penis and testes. It plays an important role during later years as well, by maintaining mood, libido, emotional and physical health. That’s why low testosterone can cause a variety of problems in men. 

Here is a list of symptoms that will help you understand if you may have lower testosterone levels.

1. Drop in Energy: Sometimes, we all feel full of energy, but sometimes those energy levels are quite low. And then, there are occasions when we feel low on energy, you may feel that you are getting tired easily and frequently. Fatigue is one of the common effects of low testosterone. If this happens with you regularly, if you are tired all the time despite sleeping for 6-8 hours, consider getting yourself checked by a consultant.

2. Changes in Sex Life: A sudden drop in your sex drive or facing problems in erection (erectile dysfunction) can be another  common symptom of low testosterone. But you should get yourself tested for other conditions as well, including heart disease or diabetes, especially if you are over 35 years of age. Ask for online consultation if you want everything to be private and discreet.
 
 3. Fuzzy Thinking: Do you sometimes think that your thoughts are a blur? Low testosterone can also impact your memory. It can make you feel stressed, sad and even depressed, resulting in concentration problems. These  can be a result of low testosterone

4. Mood Changes: Testosterone directly impacts your mood, even leading to extreme sadness or psychological depression. If nothing seems to make you happy, if you are not what you used to be, then visit a doctor.

5. Muscle Changes: Muscle mass and strength reduces over the years. As testosterone helps build muscle, low levels may be the cause if you witness sudden drop in muscle mass. In such a case you should consult a doctor. It can be because of low hormone function.

6. More Body Fat: If you have been enjoying a more fit or healthier weight most of your life but suddenly start gaining weight, it might point towards low testosterone in the body. Also, if you are unable to lose weight even on a healthy diet, consider consulting a doctor.



6 Symptoms of Lower Testosterone - Most Important Male Sex Hormone

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

Contraception is not only restricted to married couples in today's world. Most of the young couples refrain from seeking medical advice for contraception may be because of social concerns or simply because they feel hesitant and shy.

There are many contraceptive pills available over the counter which youngsters are tempted to buy and use as it seems to be the easy way out. Frequent and improper use of such emergency pills can lead to a lot of hormonal disturbances and the menstrual cycle goes topsy turvy. Then the dilemma starts. As it becomes difficult to interpret the cycle dates and erratic bleeding which happens is disturbing.

In my practice I have seen many young girls popping in pills randomly every now and then. Sometimes at weekly intervals as they are unable to manage the stress of their relationship getting disturbed. What youngsters should try and understand is there is nothing wrong in having pills for contraception but it should be done with proper guidance and the selection of the right pill for that particular individual is important which can be done easily by getting into consultation with a doctor. Need not necessarily be a gynecologist always.

Emergency pills are ok for once in a blue moon kind of use. But it should not become a habit.


Misuse Of Emergency Contraceptive Pills

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