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

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?

There are phases in life when you do not feel energetic enough to engage in sex. It could be due to stress, long work hours or other biological reasons. A healthy, active sexual life helps in reducing a number of health issues, keeps you de-stressed, happier and most importantly, helps in keeping the relationship's spark alive! Certain foods are known to address just that and help in running your libido.

Try these boosters to get the spark back in your life.

1) Black Raspberries - They will get you into mood. Snack on it as it helps in increasing your sexual endurance. Consume at least 10 black raspberries an hour before getting busy.

2) Figs - Figs are considered excellent stimulants of fertility, enhance the secretion of pheromones. Try feasting on a few figs every day to notice a difference.

3) Cloves - Cloves are sex-superfoods. In fact, they have been used as a natural treatment for sexual dysfunction for years. They possess aphrodisiac qualities. Having a few will naturally up your libido.

4) Watermelon - Watermelon is known for boosting serotonin and endorphin levels, both of which are linked to improved sexual performance. Have the fruit regularly.

5) Eggs - Poach them, scramble them, make an omelette or do a sunny side up. There are just so many ways to eat an egg. But no matter how you eat it, the results will be the same - your libido will rocket up. It is used for heart ailments and erectile dysfunction as well.

6) Ginger - A little bit of ginger every day boosts circulation and so enhances your libido.

7) Lettuce - Lettuce is a libido booster for both men and women. Have iceberg lettuce with little salad or just nibble it and you will be good to go!

If you have any questions on improving sexual health, please click on 'Consult.

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Boost Your Sex Drive With These 7 Foods

5 reasons your partner doesn't want to have sex anymore

There are innumerable explanations as to why couples in long-term relationships find themselves in situations when either one of the partner's starts avoiding sex for a reason the other cannot comprehend.

The explanation for your partner's behaviour may be due to an underlying medical issue or various emotional or psychological factors. Following are a few reasons why your partner does not want to have sex anymore:

1. Physical factors: your partner might be experiencing a loss of libido due to physical ailments, particularly ones pertaining to the endocrine and circulatory systems. Disorders such as diabetes, hypothyroidism, heart complications to name a few, affect the hormone levels in the body, which leads to the lack of sexual drive.

2. Psychological factors: Many mental and emotional factors also affect libido in both men and women. Stress and depression, which often cause sleep deprivation, are two of the biggest causes of unwillingness to have sex. Talk to your partner about what the root of the problem is and ascertain what is creating stress and triggering depression. Communication and counselling are the main ways of dealing with such a situation.

3. Excessive masturbation: If a person watches too much pornography and consequently indulges in masturbation frequently, sexual function is automatically lowered when it comes to performing during intercourse. If your partner masturbates too much, simply ask that the practice needs to be put an end to.

4. Lack of affection: When there is a lack of warmth and affection between partners, the desire to engage in sexual intercourse is automatically diminished. Communicate with your companion to determine ways in which you can rekindle love and passion in the relationship.

5. Addiction to narcotics: If your partner has developed an addiction to certain narcotics, such as nicotine, morphine and various anti-depressants that reduce sex drive, it could be the reason for not wanting to have sex.

The reasons for developing an aversion to sex are often extremely subjective and complex. Open and honest communications between partners may unravel the problem but in many cases, therapy and medical assistance provides the solution.



5 Reasons Your Partner Doesn't Want to Have Sex Anymore

In today's time there are various factors, which affects our relation with our partner and among such factors is low libido. Low libido or a decreased sexual activity can affect a relationship in a big way. In some extreme cases, the impact is such that it leads to irreconcilable marital discords. Time and again, an individual, irrespective of their age, sex or occupation can go through periods of low libido. Decreased sexual desire over a longer period of time needs thorough investigation. It could be an indication of something big and serious lying ahead. 
7 critical factors that attribute to low libido: 

1. Hormonal imbalance: women, mostly menopausal and postmenopausal, experience low libido. This is because during menopause, there is a significant drop in the oestrogen level. Reduced oestrogen level can have a huge impact on sexual desires and performance. It can also make the vagina dry, resulting in painful penetration and intercourse. Hormonal imbalance or changes during pregnancy can also result in low libido in females. In males, low libido has been found to be associated with decreased levels of testosterone. 

2. Stress: an individual's mental and emotional state is greatly reflected in their sexual performance. A sound mental health can enhance a performance thousand folds. On the contrary, factors like depression, anxiety and stress, lowers the sexual desires in a person. To enjoy a healthy and normal sexual life, it is important to keep stress and chronically blue moods at bay.

3. Sound sleep to the rescue: the benefits of a sound sleep are beyond imagination. A good 6 - 8 hours of sleep can do your sexual desires or libido a world of good. A sleep deprived soul will be agitated and cranky, both on and off the bed. Continuous sleep deprivation can also lower the testosterone level, resulting in low libido.

4. Medical condition: medical conditions like diabetes, cardiac problems, high blood pressure, or ailments of the coronary artery can rupture an individual's sexual life immensely. Improper functioning of the thyroid glands is another factor contributing to low libido. In such cases, it is best to consult a physician at the earliest. Rest legs syndrome can also contribute to low libido. It is a condition whereby, a male experience an uncontrollable urge to move his legs.

5. Smoking: a killer habit, which affects a person's sexual activity is smoking. Drug abuse and drinking (to some extent) can be equally responsible for a low libido.

6. Change in weight: a sudden change in body weight (gain or loss) can play a significant role in low libido. Take pride in your body structure. There is nothing to be ashamed of.

7. Take a break: boredom can mask your sexual life greatly. Break the monotony, take short breaks, go on vacations and low libido will be a thing of the past.

7 Things That Might Be Causing Your Low Libido

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