Premature ejaculation

What is it?

Premature ejaculation is the inability to delay ejaculation till the man wishes or when ejaculation occurs too early in the sexual act to satisfy both partners. The time to reach the stage of ejaculation is subjective and varies form one man to another. Some men may ejaculate immediately after copulation begins while another may not ejaculate even after 10 minutes. Thus, time is not a criterion for ascertaining whether the ejaculation is premature or not; mutual satisfaction is the benchmark against which this condition is measured.

What are the causes?

Premature ejaculation primarily has a physiological basis. Biologically, men have an orgasm approximately 2-3 minutes after penetrating the vagina. Women, on the other hand, typically take more time to reach the climax. Since in most cases, the partners may not climax together, they are not satisfied and the ejaculation is termed premature. However, premature ejaculation may be caused by a variety of psychological and social reasons. It is seen that it occurs frequently when the man is under mental stress or anxiety. Anxiety may be due to the fear of non-performance, the fear of being discovered (as during premarital or extramarital sex in our society) or anxiety related to contraction of sexually transmitted diseases or an unwanted pregnancy. Though men of all ages may experience the condition, it is more common in adolescents, young adults and inexperienced men. However, it is also true that almost all men experience it at some point in their lives. Premature ejaculation is one of the most common sexual problems for which couples seek advice. The result of treatment is often successful.

What are the symptoms?

Since premature ejaculation is not a disease, it does not have the classic "symptoms". An individual realizes that he is suffering from it when sexual intercourse ends before either partner is completely satisfied. It is diagnosed by a physical examination, in addition to interviews with the couple regarding their relationship.

What is the treatment?

In some cases, the problem can be solved simply by educating an individual about the condition and reassuring him. Counselling is provided by psychologists that helps a man to deal with his fears and anxieties and, thus, eliminate the psychological causes of the condition. The following techniques may be beneficial in delaying ejaculation: The "stop and start" method – in this method, the man learns to recognise the stage after which he cannot control ejaculation. The treatment method trains the person to remove the stimulus just before that stage is reached so that the urge to ejaculate is controlled. For example, when during masturbation, the man reaches a point just before ejaculating, he stops the stimulus until he starts losing the erection. Once the stage is past, he can resume the activity. This process is repeated again and again until the individual is able to delay ejaculation till the time he wishes. This method called the 'Masters and Johnson method', is most effective when the help of the partner is sought during actual intercourse. The squeeze technique – in this method, the partner gently squeezes the tip or base of the penis just before the point of ejaculation thereby "cancelling" the orgasm. This process can be continued until the couple decides mutually to reach the climax. Desensitising creams and gels are available in the market that reduce the sensitivity of the penis and help men reach climax later. Some men also feel that condoms reduce the sensations and, in addition to providing safer sex, help them last longer. The couple can also experiment with sexual positions as some positions offer more control than others and may help to delay ejaculation.

DoctorNDTV Team

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