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

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.



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

From Lybrate: If you found this tip useful, please thank the doctor by clicking on the heart icon below. Also, spread good health by sharing this tip with your loved ones over WhatsApp, Facebook and other media.


5 Common Causes Of Male Infertility

1. Wash Your Hands Thoroughly - Before having sex, do remember to wash your hands. Maintaining such a basic sexual hygiene habit is important as you will be running your fingers over the tender parts of your partner. Since your hands would have come into contact with germs of all kinds, having sex with dirty hands can bring about infections of those parts. Just as you would wash your hands before having your food, don't skip this habit when it comes to having sex.

2. Communicate - Communication is vital for a healthy sex life, and you'll both feel extremely satisfied if you're on the same page. Whether you need to have conversations about STDs such as HIV, HPV or on different sexual positions and techniques, talking to one another can help you and your partner to understand each other better in between the sheets.

3. Reciprocate - Reciprocity can make or break your sex life. Sex can be satisfying only when you both you and your partner experience the same amount of pleasure. So if your partner focuses on your pleasure spots, make sure to return the favour by turning your attention to his/her erogenous zones.

4. Don't be Afraid to Ask - Good sex is also about letting your partner know what your desires are. By doing so, your partner would be able to respond better to what you want and you'll find your sex life improving for the better.

5. Don't Criticise - In case of any sexual issue that may arise between you and your partner, it's best to solve it together instead of blaming each other. Whatever suggestions you may have for each other, always put them forward in positive terms. Criticism may make your sex life bitter and can also adversely impact your relationship in the long run, so it's best to avoid it.



5 Do's + Don'ts for a Healthy Sex Life

Resuming sex post pregnancy can take some time as the woman has to go through the initial phase of vaginal soreness and perpetual exhaustion before she can think of having sex. Whether a woman gives birth vaginally or through cesarian section, her body will require time to heal itself; and it is advisable to have intercourse six weeks after childbirth. 

Here are some of the common sex problems post-pregnancy.

1) An eager partner - Your partner might be ready for sexual intercourse but you are not. Even if it is six weeks after giving birth, when the wound inside has mostly healed and perhaps you're not sore anymore, you still may not want to have sex. This is because the hormones in your body are drastically changing, and the uterus is gradually shrinking and your episiotomy wound is progressively healing. In such situations, one should take it slow. Cuddling, kissing and spooning are some of the ways closeness can be fostered.

2) Delicate and tender breasts - Breasts may become sore, heavy and leaky due to nursing your baby. And it is natural that after breastfeeding the whole day, one may want them to be left alone at night. Wearing a nursing top or a tank top during sex is advised. Nursing your baby right before sex can also help as your breasts won't be as full and achy.

3) Sex won't feel the same - It is natural that after delivering a baby, sex won't feel exactly the same. This is because the vaginal muscles would be temporarily stretched out. And there is a chance of temporary soreness and inflammation within the vagina. Kegel exercises may help to get back on track.

So, in case you're a woman and felt strange about not being up for sex post your pregnancy, there's absolutely nothing to be stressed about. And men, if you are reading this tip, your woman needs you to understand her even more after her becoming a mother; so, treat her with utmost care.



3 Things You Need to Know about Post-Pregnancy Sex

6 Dangerous Effects of Alcohol on Your Sexual Well-Being

While small amounts of alcohol do not have any effect on your sexual health, moderate amounts of drinking are known to cause problems in both men and women.

Let's take a look at the effect alcohol may have on your body and sex life:

1. It acts as a depressant - Acting as a depressant (a drug that reduces stimulation or arousal in various parts of the brain), alcohol inhibits certain areas of the central nervous system that are important for orgasm and arousal, more specifically - the circulation, respiration, and feeling of nerve endings.

2. It dehydrates your body - Sexual arousal requires an adequate supply of oxygen and flow of blood to the private areas so as enable you to experience the different sensations that accompany a sexual act. Adequate blood flow in the case of women is important for lubrication and in the case of men for developing and sustaining an erection. Less fluid in the body and a depressed nervous system can affect your sexual performance.

3. It's not an aphrodisiac if you go overboard - Several studies show that alcohol can help certain people to overcome feelings of deficiency or sexual reserve. This can only happen if you limit your consumption to only 1-2 drinks. If you go overboard, the depressant action of the drink begins to take effect preventing your body's ability to react sexually.

4. It causes fewer erections - Drinking large amounts of alcohol or even long-term drinking can cause erection problems to develop. Erectile dysfunction is said to occur when too much drinking causes dehydration leading to a decrease in blood volume and an increase in the angiotensin hormone, which is associated with ED. The likelihood of this occurring gets further increased if the body's central nervous system is unable to act in a natural way.

5. It leads to delayed ejaculation and orgasm - A 2004 study reveals that about 11% of alcohol users face difficulty in having an orgasm. While the men faced difficulty in ejaculating, women participants required more stimulation to reach an orgasm, compared to men and women who did not drink or drank little.

6. It causes vaginal dryness - The dehydrating effect that normally occurs if you drink a lot can also cause vaginal dryness. It causes a decrease in your sensations and hampers the production of vaginal secretions for sexual penetration, leading to painful sex.



6 Dangerous Effects of Alcohol on Your Sexual Well Being

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

Don't wait any longer, manage your Small Penis Size online with a Lybrate doctor today

Consult for Small Penis Size - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES