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What is Premature Ejaculation?

Premature ejaculation occurs in men when semen leave the body (ejaculate) sooner than wanted during sex. Premature ejaculation is a common sexual complaint. As many as 1 out of 3 people say they have it at some time.

Many men feel stressed if they experience PE at any time. Men with PE and their partners may feel unhappy or embarrassed about their sexual relationships. Treatment is available and these feelings can change.

Premature ejaculation isn't cause for concern if it doesn't happen often. But you might be diagnosed with premature ejaculation if you:

• Always or nearly always ejaculate within 1 to 3 minutes of penetration
• Are not able to delay ejaculation during sex all or nearly all the time
• Feel distressed and frustrated, and tend to avoid sexual intimacy as a result

Premature ejaculation is a treatable condition. Medications, counseling, and techniques that delay ejaculation can help make sex better for you and your partner.

Premature ejaculation Symptoms

The main symptom of premature ejaculation is the inability to delay ejaculation for more than three minutes after penetration. But it can happen in all sexual situations, even during masturbation.

Premature ejaculation can be classified as:

• Lifelong. Lifelong premature ejaculation occurs all or nearly all the time beginning with the first sexual encounter.
• Acquired. Acquired premature ejaculation develops after having previous sexual experiences without problems with ejaculation.

Many men think they have symptoms of premature ejaculation, but the symptoms do not meet the criteria for diagnosis. It is normal to experience premature ejaculation occasionally.

How Does Ejaculation Work?

Ejaculation is the sudden, pleasurable release of semen through the penis. It is controlled by your brain (your central nervous system). When you are sexually aroused, signals are sent from your spinal cord to your brain. When you reach a certain level of arousal, your brain tells your reproductive organs to "Go!" This causes semen to be released through the penis (ejaculation).

There are two stages of ejaculation: ejaculation and expulsion.

• Step 1: Emission Ejaculation occurs when sperm moves from the testicles to the prostate. There it combines with seminal fluid to form semen. The vasa deferentia are tubes that help move sperm from the testicles through the prostate to the base of the penis. (When you're talking about just one of these tubes, it's called the vas deferens.)
• Step 2: Removal Withdrawal occurs when the muscles at the base of the penis contract. Due to this the semen comes out of the penis. Often, ejaculation and orgasm occur at the same time. Some men reach climax without ejaculating. In most cases, the erection ends after this phase.

Causes

The exact cause of PE is not known, but there are several reasons why a person may develop PE. There may be biological, chemical or emotional reasons for this. Below are some more specific reasons.

Serotonin

Serotonin is a natural substance produced by nerves in your body. It helps control the way the brain manages mood, emotion, sleep, and sexual desire. Higher amounts of serotonin in the brain increase the time to ejaculation. Lower amounts may reduce ejaculation time, and lead to PE.

Psychological causes

Psychological factors that might play a role include:

• Early sexual experiences
• Sexual abuse
• Poor body image
• Depression
• Worrying about premature ejaculation
• Guilty feelings that can cause you to rush through sex

Psychological Issues

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

• Depression
• Anxiety
• Stress
• Guilt
• Unrealistic expectations about sex
• Lack of confidence
• History of sexual repression (blocked or bottled-up sexual feelings)
• Relationship problems

Diagnosis

It's normal for men to have at least some control over when and how they ejaculate during partner sex and masturbation. If a man does not feel that he has control over when he ejaculates, and if it causes anxiety to the man or his sexual partner, PE may be present.

When PE gets in the way of your sexual enjoyment, you should see a health care provider. Diagnosis is determined by whether ejaculation occurs early, late, or does not occur at all. Often, your health care provider will diagnose PE after a physical examination and talking to you. Some questions he may ask are:

• How often does the PE happen?
• Has the PE been present lifelong, or started recently?
• 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.)?

Treatment

Psychological therapy, behavioral therapy (sexual exercise) and medications are the main treatments for PE. You and your doctor can work together to decide the best option for you. Many people try more than one treatment at the same time.

Behavioral Therapy

Behavioral therapy uses exercise to help increase tolerance to delayed ejaculation. The goal is to help keep your body away from PE. Some options are the squeeze method and the stop-start method. Exercises work well, but they may not be a permanent answer and work for all people now.

Psychological Therapy

Psychological therapy is a way of overcoming emotions and sensations that can cause problems in sexual relationships. The goal of this type of therapy is to know the source of the problems and find solutions that can help with PE. It can also help couples learn to get closer. Psychological therapy can help you be less nervous about sexual performance. It can also give you greater sexual confidence and understanding to help you satisfy your partner. This type of therapy may be used as the sole treatment, or it may be used with medical or behavioral therapy.