Premature Ejaculation
Premature Ejaculation
Definition:
Persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it.
It has been difficult to define 'Premature ejaculation' since there is a great variation in the physiology of ejaculation. International Society for Sexual Medicine (ISSM) has defined (PE) as 'Ejaculation in less than 60 seconds from the start of intercourse.
PE is seen in young men from their first attempt at intercourse. Later they acquire the ability to delay the orgasm after an adequate function. PE can create tension in the relationship. Wife's estimate of the duration of time from the beginning of intercourse until ejaculation , as well as her judgment of whether PE is a problem, can be quite misleading. PE can create tension in the relationship.
Patients may misinterpret secretion from bulbourethral glands as semen and label himself suffering from P.E. Some may see prolonged period of intercourse in blue films and feel it as standard. Some may think that anything short of the ability to prolong till wife's orgasm is PE. Some think duration mentioned by a friend is normal.
Patient tries their own way to prolong the period by diverting attention, pinching self, using a condom during the intercourse, drinking alcohol or masturbating prior to intercourse. All these are found to be unproductive techniques. In attempting to control orgasm, man is distracting himself from stimulation of touch and arousal, and he fails to enjoy his sexual feelings and may lose the erection. Therefore, emphasis should be on increasing penile stimulation and not avoid it.
Causes:
Anxiety.
Hurried sexual experience.
The excessive sensitivity of glans.
Rapid ejaculatory reflex.
Fear of losing an erection.
Prolonged abstinence.
Fear of detection.
Treatment:
Counseling:
Counseling of Couple is done. It is emphasized that problem is not in genitals, the problem is in the brain.
Sex Therapy:
It is based on systemic desensitization to bring about behavioral modification.
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