It is one of the most common sexual problems in men. In the most general sense, premature ejaculation is when a man ejaculates beyond his control during sexual intercourse. Sometimes, ejaculation may occur even before sexual intercourse. Sometimes, ejaculation may occur in the first few movements or first seconds of intercourse. For some men, premature ejaculation may be a problem in every relationship, while for others, it may be a problem from time to time.
Accordingly, premature ejaculation can be defined as the ejaculation of the man during sexual intercourse, before entering the vagina, during or immediately after penetration. The man's voluntary control and control of ejaculation is impaired. A man who cannot ejaculate prematurely has control and control over his ejaculation reflex. Men with premature ejaculation cannot voluntarily control their ejaculation. They do not have the chance to determine the time of ejaculation. Whether they want to or not, they ejaculate rapidly, involuntarily and uncontrollably as soon as they reach the level of arousal.
It is more common in young men. It is seen less frequently in older groups as it tends to slow down with advancing age. According to the diagnostic criteria, premature ejaculation occurs constantly or recurrently with little sexual arousal and before the person wants it; It is the occurrence of ejaculation before, immediately or shortly after penetration into the vagina. The diagnosis is made primarily based on the statements made by the patient or his/her partner that ejaculation occurs quickly during intercourse.
In the evaluation, the frequency of sexual activity, the newness of the sexual partner or environment, age and sexual experience should be taken into account. In order to be diagnosed with premature ejaculation, the man must have a regular and active sexual life for at least six months.
The best definition is that in most sexual intercourse, the man does not have voluntary or conscious control over when to ejaculate.
Premature ejaculation is the lifelong type that we encounter in the clinic, the type that depends on situational factors, the type that depends on psychological factors. , or it may appear as a type due to combined factors resulting from a combination of psychological and medical factors. The majority of cases seen throughout life It is accepted that premature ejaculation is caused by psychological factors.
In the situational (situation-dependent) type, premature ejaculation occurs involuntarily and continuously depending on certain conditions or with a certain partner, whereas premature ejaculation occurs in other conditions or with another partner. ejaculation does not occur. Condition-related premature ejaculation is rarely seen in the clinic.
The most common form is the generalized type, which occurs throughout life and due to psychological reasons. In acquired premature ejaculation that begins later in life, special attention should be paid to organic causes.
Men generally report that they can control their ejaculation more during masturbation than when they attempt intercourse.
Men are most effective in ejaculation control. Their big focus is, “How long is good enough?” It's a matter of Many factors come into play here, such as the man's subjective feelings of control and the duration of coital connection required for the partner to reach orgasm. However, the basic pattern in premature ejaculation is the man's inability to control when he wants to ejaculate.
Men with premature ejaculation are concerned about performance inadequacy due to the concern that their partner will not be able to reach orgasm, and they state that they want to be treated for these reasons. The practice often expressed by men is that ejaculation is completed right at the beginning of the vaginal penetration process or within one to five minutes.
What is certain is that premature ejaculation causes significant distress for many women and men and can affect the couple's relationship. The female partner may not be able to make sense of this situation and may accuse her partner of insensitivity. Men with premature ejaculation are not as insensitive and thoughtless as they think. On the contrary, they feel very ashamed, sad and withdrawn because of their situation. The man may feel shame, fear, humiliation and inadequacy. Sexuality gradually becomes less of a pleasurable activity. Meanwhile, some negative emotions begin to be experienced on the opposite shore. The spouse gets confused and feels responsible, looking for the blame on himself. Disappointment in the future In parallel, he may experience anger, resentment, feeling that he is not valued, and the feeling that something is missing in his life.
In the vast majority of cases, hasty early sexual experiences, e.g. Stories such as experiences in the car, at the parents' house, out of fear of being caught, or having the first sexual intercourse in a brothel are detected. Such adverse conditions have the property of promoting premature ejaculation. As a result, uncontrolled ejaculation can be seen as a habit pattern that is established in the early stages of a man's sexual life and is resistant to change.
Ejaculation control can also be defined as a learned process. During this process, the key is for the man to be aware of the rising levels of sexual arousal leading up to orgasm so that he can control his ejaculation. Men who cannot distinguish the level of arousal just before orgasm due to distraction and excessive concern about their partner's satisfaction cannot learn to control their ejaculation. In this case, sexual sensory awareness is absent or weak.
Regardless of the causal mechanism, most cases of premature ejaculation respond perfectly to sexual therapy. This leads us to the knowledge that psychological reasons play an important role in premature ejaculation.
There is a high probability that subsequent uncontrolled ejaculation is related to medical factors. However, infrequent sexual intercourse, being with a new partner, anxiety focused on sexuality, and problems in the marital relationship can also cause premature ejaculation.
There are very few cases of premature ejaculation that occur in the urinary tract or spinal cord and result in lifelong uncontrolled ejaculation. There is a congenital disorder. The most common is spina bifida. In such rare cases, other neurological disorders should also be expected.
Secondary premature ejaculation is much rarer than the lifelong type of premature ejaculation. Moreover, it is much more likely to be associated with organic factors. Another cause of premature ejaculation that develops later is erectile dysfunction. In the presence of erection problems in men, premature ejaculation, difficulty entering the vagina and ejaculating before losing the erection. It develops in response to the ace. Some spinal cord disorders and surgical procedures can damage the neural structure related to the ejaculation reflex, causing uncontrolled ejaculation. For this reason, importance should be given to a good physical examination if no unusual psychological stress factor or trauma is detected in a man who subsequently complains of uncontrolled ejaculation. In short, care should be taken to evaluate the possibility of an organic erectile dysfunction or an underlying neurological disorder in case of premature ejaculation. is its ejaculation. A normal man first gets excited, then enjoys this excitement (plateau) and then ejaculates. The problem here is not with ejaculation itself, which is a component of the orgasm reflex. This is an orgasmic disorder. The plateau, which is the period during which the couple stays in the relationship for a while, which should normally be experienced after arousal, is not present in those who ejaculate prematurely. In other words, there is no point of voluntary prolongation or postponement.
In normal ejaculation, even at a high level of arousal, a man can control his ejaculation by monitoring it. There is voluntary control over the ejaculation reflex. In the diagnosis of premature ejaculation, attention should be paid to whether ejaculation really comes early or whether it is perceived as premature due to the slow reaction of the female partner. The diagnosis of premature ejaculation should only be made when the ejaculation process is found to be insufficiently controlled by the man or when the partner does not experience orgasm because the man cannot control the ejaculation process. Before diagnosing premature ejaculation, the sexual therapist should take into consideration factors such as age, frequency of sexual intercourse, partner characteristics, foreplay duration and suitability of the environment. Because premature ejaculation is common in men who have sexual intercourse for the first time. Many young men can later develop a control over ejaculation time.
Men with premature ejaculation avoid foreplay with the thought of ejaculating prematurely
As a result, their partners experience a decrease in sexual interest and desire. /p>
Orgasm disorders may occur.
CAUSES OF EARLY EJACULATION
- Sexual incompatibility.
- Subconsciously underlying negative thoughts about sexuality.
- Excessive dependence on the partner.
- Castration anxiety.
- Fear of pregnancy.
- Feeling of sinning or guilt. .
- Fear of contracting a disease.
- A sexually repressed upbringing.
- Sexual myths.
- Excessive importance given to the penis.
- Organic reasons.
- Lack of sexual stimulation.
- Unrealistic information and expectations about sexual life.
- During adolescence, shameful sins are prohibited and harmful. masturbation due to emotions and fear of being caught.
- Rapid sexual intercourse in inappropriate environments.
- Rejection by the partner.
TREATMENT OF PREMATURE EJACULATION
Various medications have been tried to delay ejaculation. Numbing creams and sprays are among these. These only numb the nerve endings on the penis and do not do much good. Premature ejaculation is a condition that concerns the autonomic nervous system. Since these types of drugs have a local numbing effect, they reduce the sensitivity of the penis and reduce sexual pleasure from contact. It has the same effect on the female partner.
Recently, some drugs used in the treatment of depression have also started to be used in the treatment of premature ejaculation. Although these drugs provide some benefit, lifelong drug use does not make drug treatment very attractive. Being able to control ejaculation is ultimately a learning process.
Reasons are important in treatment. While following the treatment path according to the causes, attention should also be paid to sustaining and triggering factors. On the other hand, during treatment, it should be kept in mind that premature ejaculation may have a partner-related, psychological and biological aspect.
If the problem is caused by a medical reason, the client should be ensured to receive appropriate treatment. In such cases, sexual therapy applied in addition to medical treatment provides optimal success in the treatment. Cases due to medical reasons are rare in the clinic. The majority of cases
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