What is Ejaculation and Premature Ejaculation?

Ejaculation is the expulsion of semen from the body. Premature ejaculation (PE) is when ejaculation happens sooner than a man or his partner would like during sex. PE is also known as rapid ejaculation, premature climax or early ejaculation. PE might not be a cause for worry. It can be frustrating if it makes sex less enjoyable and impacts relationships. If it happens often and causes problems, your health care provider can help.

Ejaculation has 2 phases: emission and expulsion.

Phase 1: Emission

Emission is when sperm moves from the testicles to the prostate and mixes with seminal fluid to make semen. The vasa deferentia are tubes that help move the sperm from the testicles through the prostate to the base of the penis. (When you are talking about just 1 of these tubes, it is called a vas deferens).

Phase 2: Expulsion

Expulsion is when the muscles at the base of the penis contract. This forces semen out of the penis. Mostly, ejaculation and orgasm (climax) happen at the same time. Some men climax without ejaculating. In most cases, erections go away after this step.

Premature Ejaculation

Premature ejaculation (PE) occurs when a man experiences orgasm and expels semen soon after sexual activity and with minimal penile stimulation.  As long as that happens infrequently, it’s not cause for concern. However, if you regularly ejaculate ahead of you and your partner wish — for instance before intercourse begins or shortly afterward it is usually considered premature ejaculation.

The majority of men experience premature ejaculation at least one time in their lives. Often adolescents and teenage boys experience premature ejaculation throughout their first sexual encounters, however eventually learn ejaculatory manage.

Scientists have long suspected a genetic connect to premature ejaculation. In a single study, ninety-one percent of men who suffered with lifelong premature ejaculation additionally had a first-relative having lifelong premature ejaculation. Other researchers have famous that men who experience premature ejaculation have a faster neurological response in the pelvic muscles.

Common causes of Premature Ejaculation

The exact cause of premature ejaculation is yet to be known. While it was once thought to be only psychological, doctors and researchers now know premature ejaculation is more complicated and involves a complex interaction of both psychological and biological factors.

Sometimes PE is a problem for men who have erection problems (erectile dysfunction or ED). This is when men are not able to get or keep an erection that’s firm enough for sex. Since an erection goes away after ejaculation, it can be tough to know if the problem is PE or ED. ED should be treated first. Premature ejaculation may not be a problem once the ED is treated.

However,

Some physical illnesses, such as a prostate infection, Erectile Dysfunction, are also known to induce premature ejaculation. In other instances, premature ejaculation is the consequence of physical injury that affects the nervous system. Specific medications, such as chilly medications containing pseudophedrine, additionally cause premature ejaculation. Sexual dysfunction is a common symptom of psychiatric afflictions between bipolar disorder to post-traumatic strain disorder. In these circumstances, it is best to discuss the issues with your physician.

Some Other causes of premature Ejaculation are:

Erectile dysfunction:

Erectile dysfunction, or ED, is the inability of a man to have an erection hard enough to have sexual intercourse. Men who are anxious about obtaining or maintaining their erection during sexual intercourse may form a pattern of rushing to ejaculate, which can be difficult to change.

Don’t forget to read? Common Causes and Treatment of Erectile dysfunction

Relationship problems:

For those who have had satisfying sexual interactions with other partners through which premature ejaculation happened infrequently or by no means, it’s likely that interpersonal issues between you whilst your current partner are triggering the problem.

Anxiety, Depression particularly about performance:

Many men with premature ejaculation also experience anxiety — either specifically about sexual performance or related to various other issues.

Stress:

Stress and stress-related anxiety induce each one of these problems by stimulating your sympathetic nerves and generating an imbalance of chemicals and hormones. The sympathetic nerves are responsible for a man’s urge to ejaculate.

Normally, this impulse is low and needs to be built up through sensory and mental stimulation till the orgasm is reached. In cases of stress, the sympathetic nerves happen to be excited and overworked. Men will begin sex which has a very strong impulse to ejaculate not to mention climax far too rapidly.

Serotonin

Though the exact cause of PE is not known, serotonin may play a role. Serotonin is a natural substance in your body made by nerves. High amounts of serotonin in the brain increase the time to ejaculation. Low amounts can shorten the time to ejaculation, and lead to PE.

Psychological Issues

Psychological, or mental health, issues can be involved in PE and may include:

• depression
• stress
• guilt
• unrealistic expectations about sexual performance
• history of sexual repression
• lack of confidence
• relationship problems

Taking care of emotional problems often helps.

Other Issues

PE and Age

PE can happen at any age. Aging is not a direct cause of PE, though aging does cause changes in erections and ejaculation. For older men, erections may not be as firm or as large. Erections may not last as long before ejaculation occurs. The feeling that ejaculation is about to happen may be shorter. These changes can lead to an older man ejaculating earlier.

PE and Your Partner

With PE, you may feel you lose some of the closeness shared with a sexual partner. You might feel angry, ashamed or upset, and turn away from your partner. Premature ejaculation may not only affect you, it may also affects your partner. PE can cause partners to feel less connected or feel hurt.

Talking about the problem is an important step. Couples counseling or sex therapy can be helpful. Exercises, such as the squeeze technique, may be helpful for you and your partner to prolong an erection (see the treatment section of this article for details). Most importantly, a couple should learn ways to relax. Worry (such as performance anxiety) can make PE worse

Diagnosis

It is typical for men to be able to have at least some control of if and when they ejaculate during partnered sex and masturbation. If a man does not feel that he has control of when ejaculation occurs, and if there is worry by the man or his sexual partner(s), PE may be present.

When PE gets in the way of your sexual pleasure, you should see your health care provider. The diagnosis is determined by whether ejaculation occurs early, late, or not at all. Most often, your health care provider will diagnose PE after a physical exam and talking with you. Some questions he or she may ask are:

• How often does PE happen?
• How long have you had this problem?
• Does this happen with just one partner, or all partners?
• Does PE happen with each attempt at sex?
• What type of sexual activity (i.e., foreplay, masturbation, intercourse, use of visual cues, etc.) do you take part in and how often?
• How has PE changed your sexual activity?
• How are your personal relationships?
• Is there anything that makes PE worse or better (i.e., drugs, alcohol, etc.)?

Lab testing is only needed if your health care provider finds something during your physical exam.

Treatment

Psychological therapy, behavioral therapy and drugs are the main treatments for PE. You can talk with your health care provider to decide the best choice for you. More than one type of treatment may be used at the same time.

Psychological Therapy

Psychological therapy is a way to work through the feelings and emotions that may lead to problems with sexual relationships. The goal of this type of therapy is to learn the source of problems and find solutions that may help PE. It can also help couples learn to grow closer. Psychological therapy can help you become less nervous about sexual performance. It can also give you greater sexual confidence and understanding to help your partner’s satisfaction. This type of therapy can be used as the only treatment, or it may be used along with medical or behavioral therapy.

Behavioral Therapy

Behavioral therapy uses exercises to help build tolerance to delay ejaculation. The goal is to help you train your body away from PE. Some choices are the squeeze method and the stop-start method. Exercises work well, but they may not be a lasting answer.

• The Squeeze Method
  With this method, you or your partner stimulates your penis until you are close to ejaculation. When you are close, you or your partner firmly squeezes your penis so your erection partly goes away. The goal is for you to become aware of the sensations leading to climax. The squeeze method may help you better control and delay climax on your own.
• The Stop-Start Method
  In this method, you or your partner stimulates your penis until just before ejaculation. When you are about to climax, you or your partner stops until the urge to climax lets up. As you regain control, you and your partner start stimulating your penis again. This process is repeated 3 times. You ejaculate on the fourth time. You repeat this method 3 times a week until you have gained more control.

Medical Therapy

No drugs have been approved in the U.S. to treat PE. Still, there are a number of drugs, numbing creams and numbing sprays that may slow ejaculation in men with PE.

Drugs

Doctors noticed that men and women on antidepressants have delayed orgasms. Drugs such as fluoxetine, paroxetine, sertraline, clomipramine and tramadol affect serotonin levels. Some doctors use these drugs “off-label” (for a different reason than the drug’s original use) to treat PE. If one drug does not work, your doctor may suggest you try a different drug.

For others, α1-Adrenoceptor antagonists are another option for drug therapy. These drugs may induce ejaculatory dysfunction such as retrograde ejaculation and/or failure of emission.

Drugs for PE can be taken each day or only before sex. Your health care provider will suggest when you should take a drug based on your activity level. The best time to take the drug is not clear. Most doctors suggest from 2 to 6 hours before sex. PE can return if you stop taking these drugs. Most men with PE need to take these drugs on an ongoing basis.

Numbing Creams or Sprays

Numbing creams and sprays may be put on the head of the penis about 20 to 30 minutes before sex. If you leave the numbing cream/spray on your penis for longer than suggested, your erection may go away. Also, the numbing cream/spray should not be left on the exposed penis during vaginal sex because it may cause vaginal numbness. Wash the cream off your penis 5 to 10 minutes before sex. Wearing a condom can also help dull sensation.

After Treatment

With the techniques listed here, about 95 out of 100 men will recover from PE. There is no way to promise recovery, but learning how to relax may help. If the problem stays, keep working with your health care provider to find solutions.

More to know?

Premature Ejaculation Causes and Risk Factors

The cause is not really known. But your brain chemistry could be at least partly the reason. Men who have low levels of the chemical serotonin in their brains tend to take a shorter time to ejaculate.

Emotional factors can play a role: Stress, Depression, Anxiety, Guilt, Relationship problems, Lack of confidence or poor body image, Concern over your sexual performance, and negative feelings about the idea of sex (sexual repression).

Some physical conditions may also cause PE, including unusual hormone levels, Irregular levels of neurotransmitters (an imbalance of the chemicals in your brain that pass messages or impulses to the rest of your body, Inflammation, or an infection in your prostate or urethra (the tube that runs from your bladder and sends pee out of the body), and Genetic traits you inherit from your parents.

Sometimes PE can be a problem for men with Erectile Dysfunction (ED). That’s when the penis doesn’t remain firm enough for sex. Men who are worried they could lose their erection may develop a pattern of rushing to ejaculate. It can be a hard habit to break.

Treating erectile dysfunction may make premature ejaculation go away. There are many medication options.

Premature Ejaculation Diagnosis

Your doctor probably will start by asking if you’ve always had the problem or if it’s a new thing. They may ask about your sex life or your relationships. You’ll probably get a physical exam, too.

If your doctor thinks emotional issues are causing your PE, they may refer you to a mental health professional who works with people who have trouble with sex. If a physical problem is causing it, they might recommend that you see a doctor called a urologist, who specializes in conditions that affect your urinary system.

Premature Ejaculation Treatments and Home Remedies

Ninety-five percent of men are helped by behavioral techniques that help control ejaculation.

Stop and start: You or your partner stimulate your penis until you feel like you’re going to have an orgasm. Stop the arousal for about 30 seconds or until the feeling passes. Start the stimulation again and repeat three or four more times before you ejaculate.

The Squeeze: It works the same way as the start and stops method. But, when you feel like you’re reaching orgasm, you or your partner squeezes the head of your penis until you lose the erection. Repeat this a few times before ejaculating.Some men find that if they think of something else during sex they can last longer.

If those don’t work for you, you can try a few other things:Strengthen your muscles: Weak pelvic floor muscles sometimes contribute to PE. Kegel exercises may help strengthen them. Find the right muscles to tighten by stopping your urine in midstream. Hold them tight for 3 seconds and then release them for 3 seconds. Do this ten times, at least three times a day.Wear a condom: It may desensitize you enough so you can last longer.

MASTURBATION

Get busy before you “get busy”: Some men find that masturbating a few hours before sex helps them stay in control during intercourse.

Seek counseling: A Psychologist or Psychiatrist can help you work through problems like depression, anxiety, or stress that may be contributing to your PE.

If none of these help enough, your doctor may talk with you about medication. While there aren’t any drugs specifically approved to treat PE, medicines used to treat other things may help in some cases. This is called off-label use.These include:

Antidepressants: A side effect of some selective serotonin reuptake inhibitors (SSRIs) can cause a delayed orgasm. But these medications also have side effects that include nausea and drowsiness. They also can throw a wet blanket on your desire to have sex. So, it’s possible you’re trading one problem for another. You and your doctor will decide what’s right for you.

Anesthetic creams or sprays: You put these on the head of your penis to make it less sensitive. Leave it on for about 30 minutes. It must be washed off before sex so you don’t lose your erection or cause loss of sensation for your partner.Medications for erectile dysfunction:

These drugs may also help men maintain an erection. They include sildenafil citrate (Viagra) and a host of others.

HERBAL TREATMENT

Herbal treatment using 100% pure herbal food supplements formulations such as AFRO-MOSES AND MEDI-PLUS CAPSULES from Medi-Moses Prostate Centre which serve as daily nourishment for the Penis for BETTER and LONG- LASTING POWER, Surge in Male Drive and Energy and Increased Male Confidence.

Premature Ejaculation Complications

If your relationship is affected by PE, talking about the problem is an important first step. A relationship counselor or sex therapist may be able to help.

Premature ejaculation may also make it hard to start a family because the sperm may not reach an egg to fertilize it or depression related to PE might affect your sex drive or performance. A fertility specialist can talk with you and your partner about some other options.