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

When Should You Use Viagra?

Viagra is a very common drug prescribed for treating erectile dysfunction. It works by enhancing the flow of blood to the penis during sexual intercourse to bring about erection. Viagra actually contains the active ingredient Sildenafil Citrate which is a selective inhibitor of Cyclic Guanosine Monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE5).

This drug works efficiently with sexual stimulation. Erectile dysfunction is very common among older men whose sexual function tends to fall after they reach their 50s. But these days even younger men in their 30's and 40's are experiencing an increased incidence of erectile dysfunction.

Doctors can even recommend the drug to both younger and elder men who suffer from erection problems.

Solidification of the arteries, the blood vessels that supply blood to the penis, can occur during the teen years. The problem then develops by the time they reach the age of 20-30 years and more, hindering their ability to get and maintain an erection. Men suffering from diabetes and facing the problem of Erectile dysfunction can be assisted by this drug.

The drug should be ideally taken an hour before the sexual intercourse.

On the other hand, you can also take Viagra half an hour to 4 hours before the sexual intercourse. You don't require having food in order to take the drug. But you need to keep in mind that if you take it after a meal high in fats, it can take a little bit longer for you to experience its effects.

Most importantly, the misuse of Viagra should be avoided. It should be taken only under medical supervision. The drug doesn't have the power to help you ejaculate easily if you suffer from problems related to orgasm or even enhance your sexual appetite. It does not enhance sexual timing, so should not be used to treat premature ejaculation. Men also shouldn't expect the drug to take the erections to unexpected heights.

Word of Caution:

One should never take the drug for recreational purposes. One can end up suffering from minor erectile dysfunction due such abuse.



When Should You Use Viagra?

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

Did you know keeping your private parts clean can avoid major health issues?

Private parts not only make or break intimacy but also also affect your overall health. Men and women - both need to keep them clean. Here are 5 things that you need to religiously follow.

1) Wash them everyday - In case you are not washing your private parts every day, let me share with you that it is a must-do! Your private parts are moist and house many bacteria. You can use soap to wash but an unscented or mild one. Wash them with lukewarm and clean water.

2) Clean them up before and after sex - Cleaning your private parts before and after sex is of great importance. Before sex because of etiquette. And, after sex for a healthy sexual life ahead! The body fluids or semen which gather on and near your reproductive organs, if not washed can harbour the growth of bad bacteria and set a stage for infections.

3) Groom them well - Untrimmed hair around the private parts is highly unhygienic. It can lead to too much of itching, increasing the chances of infection.

4) Wear fresh undergarments everyday - Unwashed shirts can do but unwashed boxer or briefs is a big no-no. You need to keep your underwears clean &amp; dry. Wear a fresh and clean undergarment every day. Changing your briefs after masturbation, sex, work-outs in gym is also highly recommended.

5) Don't delay visit to a doctor - If you are experiencing any sort of irritation, itching, redness, odour, swelling or other form of discomfort please do not delay in consulting a doctor. It can be a sign of a serious health problem or a severe infection.

5 Sexual Hygiene Musts For Men And Women

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

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