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 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

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

8 amazing health benefits of masturbation

Masturbation can be extremely beneficial to your health and well-being. It doesn't just feel good, it has other benefits too that can vastly improve your health and life.

Here are some reasons why you should masturbate regularly:

1. It boosts your mood

Masturbating releases the hormones oxytocin and dopamine, which improve your mood and give you a natural high. It helps you relax and decreases your stress and anxiety levels.

2. Helps you sleep

Having an orgasm relaxes you physically and mentally, relieves tension and makes you feel satisfied due to the lowering of blood pressure and the release of endorphins. This helps you fall asleep faster and sleep better.

3. Lesser junk food cravings

The release of oxytocin makes us feel happier, lowering emotionally triggered food cravings, which help you make better food choices and avoid unhealthy and fattening 'comfort' food.

4. Relieves cramps

Masturbation can help relieve menstrual cramps. It increases blood flow to your pelvic region and hence eases pain, cramps and backaches.

5. Helps cure urinary tract infection in women

Those suffering from utis can get relief by masturbating as it flushes out bacteria from the cervix.

6. Prevents prostate cancer

Masturbation flushes out the toxin build-up in the urogenital tract, making men who ejaculate frequently three times less likely to develop prostate cancer.

7. May get rid of restless leg syndrome

People who suffer from restless leg syndrome feel a constant need to move their limb, which may cause leg pain and cramps. A publication in 'sleep medicine', a medical journal suggests that sex and masturbation may help relieve symptoms of rls.

8. Boosts your immunity and general health

Ejaculation in males triggers the release of cortisol, a stress hormone. Although stress inducing, experts believe that small doses of this hormone help build your immunity. In women, masturbation is known to improve cervical and cardiovascular health while also reducing the risk of type-2 diabetes.

If you would like to consult with me privately, please click on 'consult'.
Related Tip: 6 Common Myths on MASTURBATION, Busted!

8 Unbelievable Health Benefits of Masturbation

Some people experience symptoms of erectile dysfunction and think of consuming Viagra. Viagra is the market name of a substance called Sildenafil, which is used for the correction of erectile dysfunction. It creates hypertension in the blood vessels, enabling you to get an enhanced erection. Viagra is quite useful for boosting your sexual performance. However, you may experience several side effects on your health. Before deciding on using a pack of Viagra, it is advised to consult a doctor to know the exact dosage that would work for you.

Dosages

1. 50 mg is the recommended dosage for men in general. The dose can be sometimes increased up to 100 mg. It depends on tolerance and effectiveness. The dose may also be decreased to 25 mg in some cases. It is also advised not to take Viagra more than once a day. The dosage will have to be altered if you take other prescribed medicines.

2. Viagra single packs are also prescribed by doctors. Single packs are available in dosages of 25, 50 and 100 mg.

When should you avoid viagra?

Viagra should be avoided in some cases. 

These include the following:

1. In case you take prescribed nitrates for chest pain or pulmonary disorder, your doctor would advise you not to use Viagra due as it increases the risk of high blood pressure, which can be quite disastrous for your health.

2. Many people are allergic to sildenafil, which is a substance present in Viagra.

Side effects of consuming viagra

Viagra causes several serious side effects on the body. Therefore, it is very important to take a doctor s advice and know about the different adversities. The most common side effects include the following:

1. Priapism: This is a condition where your erection lasts for about four hours or longer and does not end. Permanent damage to the penis is indicated if this condition is not treated.

2. Loss of vision and hearing impairment: Viagra may cause Non-arteritic Anterior Ischemic Optic Neuropathy (NAION). This disorder may lead to loss of vision in one or both the eyes. Tinnitus or hearing impairment is another condition, which may occur as a side effect of consuming Viagra.

You should always consult a doctor before you decide to take as he would know best about the dosage required by your body. He will also advise you about an ideal method of usage.

Should You Get Doctor's Advice Before Taking Viagra?

From a medical standpoint, sex during menstruation is completely fine. Most men have claimed that period sex seems messier when compared to intercourse on normal days, but, other than that, there aren t any risk regarding period sex. In fact, it is advisable to engage in vaginal intercourse during periods for a variety of reasons.

Here are a few things you should know about period sex:

Intercourse during periods isn t harmful: Contrary to the popular myth, period blood doesn t contain impurities which might affect the penis in any way. Instead, menstrual blood is normal blood mixed with disposed off tissues from the lining of the uterus and the penis isn t affected by menstrual blood in any way. The menstrual blood serves as excellent lubricant to make the process of intercourse smoother.
Chances of pregnancy still persist: It is not okay to completely ward off protective measures during periods because even though it is safer than other days, there might be a small chance that the sperm of a man lives on in the female body till early ovulation. Besides, the chance of getting a sexually transmitted disease is the same during period sex.
Can relieve cramps: Some women claim that having sex during their period helps ease their cramps as having an orgasm releases  pain- reducing endorphins  into the bloodstream. Also, some medical practitioners believe that sex provides relief by using up chemicals which are responsible for cramps. Thus, having period sex can prove to be relaxing and less painful than normal days.
Sexual arousal ups during menstruation: Most women feel hornier and more aroused during periods because of the increase in the hormonal levels. Some women feel heavier in the pelvic area which increases the sex drive; precisely the reason why having sex during this time is a good idea. So, for all you know, you might actually have a brilliant intercourse session when she s on her period.

Sex During Periods - What Should You Know About It!

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