PRIMARY EJACULATION
Commonly used among the public is “premature ejaculation”, ”premature orgasm”, The problem of“uncontrolled ejaculation”or “uncontrolled ejaculation”, also called “rapid ejaculation”, is the most common problem, especially in men under the age of 40. Since it is usually difficult to express. And since it is a relative concept, there is not enough information about its frequency (our clinical experience is that it is seen in almost one in every two men in our country). In fact, almost every man may encounter this problem at some point in his life. Premature ejaculation may occur due to the tension that occurs at least during their first sexual experience, and they may learn to control ejaculation over time. Men who have premature ejaculation problems may also experience erection problems (impotence) and sexual reluctance problems. Men, and especially couples, should not exaggerate this very common problem and should not put too much weight on the man. They should know that premature ejaculation is a problem that is 100% treatable. Ejaculation control is a condition that can definitely be learned.
What is premature ejaculation?
Definition of premature ejaculation; It is the occurrence of involuntary (uncontrolled) ejaculation after the penis remains in the vagina for less than 1 minute during sexual intercourse, and this situation, which is not desired by the person, lasts longer than 6 months. In some books it may be 2 minutes, in others it may be 4-7 minutes or less. Instead of defining premature ejaculation in minutes in this way(Masters and Johnson's definition of premature ejaculation is that both partners are satisfied), they accept it as a problem of uncontrolled ejaculation and as follows: We can define;
• Inability to control stopping at the stage before ejaculation is triggered,
• This problem is recurring and repetitive in every relationship,
• The sexual partner is not satisfied with this situation,
• It should last for 6 months and the person should not be disturbed by this situation.
A person who ejaculates prematurely usually saysthat "when that moment comes, he/she cannot hold back". Therefore, premature ejaculation is actually a sexual incompatibility. There is a plateau phase in the sexual cycle, that is, the phase in which sexual pleasure is obtained. The plateau phase lasts very short in these men; Therefore, his partner may not be able to experience both this plateau phase and ejaculation. As a result, women may develop sexual dissatisfaction, anger and stress towards their partner, while men may experience thoughts such as "Will I not be able to satisfy my partner?", "If I ejaculate early again", etc., fear and fear. causes excitement. As a result, in men who already have premature ejaculation problems, this infertile cycle not only triggers premature ejaculation, but also can cause erection problems (impotence) and sexual reluctance. Anger, unhappiness, concentration problems, depression and loss of self-confidence frequently occur in those who have premature ejaculation problems. These can negatively affect their entire marriage life, social relationships and even business life. On the contrary, some men take their situation for granted, do not care about it, see it as normal, and see sexuality as a score-based encounter rather than pleasure. Because, unfortunately, the social teachings around them and their view of sexuality are like that.
Types of premature ejaculation;
a) Primary (primary) premature ejaculation
It is a condition associated with the existence of a lifelong problem.
b) Secondary (secondary) early ejaculation
It is the occurrence of the problem later when there was no premature ejaculation problem before.
c) Situational (seasonal)premature ejaculation
It is the experience of premature ejaculation towards a certain partner. .
If there is a premature ejaculation problem from the beginning of sexual life, this problem can be called primary (primary, lifelong), and this problem, which occurs at a certain period of a healthy sexual life, can be called secondary (secondary). , acquired) is called premature ejaculation.
Types and causes of premature ejaculation:
There is often a history of masturbation done quickly and with the fear of being caught. A man who is stepped on or caught while masturbating or during his first sexual experience; In subsequent sexual experiences, he directs his attention outside and cannot realize his own arousal and control point. He cannot focus on pleasure and emotions, and his sexual pleasure turns into worry, fear and anxiety. All of these cause stress, activating the sympathetic system and causing the orgasm reflex to work faster and, as a result, premature ejaculation.
•Due to lack of self-confidence:The person is not at peace with himself or his sexual partner. His approach towards her, his critical attitude, etc. may cause loss of self-confidence in men. Men may lose their self-confidence, especially in sexuality, and experience premature ejaculation.
•Due to psychological reasons:Those who have psychological problems such as temporary depression or anxiety. Premature ejaculation or late ejaculation/inability to ejaculate problems may be observed in men.
•Stress-related:Psychosocial stress, such as work problems and economic difficulties, may also be the cause of premature ejaculation.
•Mixed type premature ejaculation:Premature ejaculation, erection problems (impotence), sexual reluctance or curvature and/or pain in the penis during erection It may be accompanied by other sexual disorders such as Peyronie's. (For example, premature ejaculation may occur due to excessive fear of a man who has erection problems. Or a man who has a curvature of the penis and has pain during sexual intercourse should seek medical attention as soon as possible.) may become conditioned to ejaculation and experience premature ejaculation problems.)
•Due to lack of knowledge:It is one of the most common types. About sexuality (sexual physiology) They do not have enough information about it. In fact, they have wrong information. Their awareness about techniques to control premature ejaculation is low. They attach a lot of meaning to their penis and often suffer from performance anxiety. Cultural factors, social roles and behaviors impose an imposition that men should be more dominant and dominant than women in terms of sexuality. This excessive meaning placed on the penis and the man's sexual identity is a very heavy burden for the man. This wrong and unnecessary meaning that society attaches to male sexuality also affects men's sexual life. During sexual intercourse, many men ejaculate prematurely due to "performance anxiety".
•Dependent on the neurological system:In this rare type; They have hypersensitive sympathetic systems. As a result, they have fast functioning ejaculation reflexes. Genital area muscles (bulbocavernosus reflex) are faster.
•Extreme sensitivity of the penis:Especially the glans penis (head of the penis) Being very sensitive to contact can lead to premature ejaculation. This type of patient group benefits greatly from injection treatment at the head of the penis.
•Depends on the psychological system:Bipolar disorder, chronic depression, obsessive-compulsive disorder, schizophrenia. It may be caused by chronic psychological disorders such as post-traumatic stress disorder, attention deficit and hyperactivity, and personality disorders (avoidant personality disorder, dependent personality disorder, narcissistic or borderline personality disorder).
•Due to physical diseases:The physical disorder that most commonly causes premature ejaculation is inflammation of the prostate (prostatitis). Sometimes premature ejaculation can also be seen in urinary tract infections and urethritis. Premature ejaculation may also occur in some systemic diseases (liver failure, heart diseases, severe kidney diseases). Endocrinopathies (especially thyroid, prolactin and testosterone hormone disorders)may cause premature ejaculation. Low magnesium and high calcium may also cause premature ejaculation.
•Due to physical injuries: strong>After lumbar region, spinal cord trauma injury (T12-L1 level), paraplegia, penis injury, pelvic area injuries or surgery, there may be damage to the neurological system in the sexual areas and ejaculation control may decrease or be lost.
•Due to relationship stress:Premature ejaculation may also develop due to emotional conflicts in the relationship, excessive sensitivity towards the partner, misunderstandings, and a response to cheating. Premature ejaculation due to relationship problems is usually acquired later.
•Due to medications:Sudden discontinuation of medications used in psychiatric diseases, intensive use of cold and flu medications, and use of some allergy medications affect the sympathetic system. It may stimulate and cause premature ejaculation.
Sexual Response Cycle:
(men are shown in blue, women are shown in red.)
Premature ejaculation, i.e. uncontrolled ejaculation shawl; As seen in the graph on the side, the plateau phase in the sexual response cycle is short-lived. In order for a woman to orgasm, this plateau phase in the man must last a long time and he must be able to control his sexual partner at least in time to orgasm. After the woman ejaculates, she can ejaculate again and have successive orgasms. Generally, men enter the resolution phase after ejaculating. In other words, the man needs time to get erect again (hardening of the penis). As a result, the man should be able to control his ejaculation and pull the trigger and ejaculate after his sexual partner orgasms.
Spouse (sexual partner) Support in Premature Ejaculation
Sexuality is a two-sided function. Here, women's attitudes towards their husbands are very important. Instead of increasing the stress (anxiety, concern and excitement) that is already on the man by saying accusatory, hurtful and humiliating words; He should always be there for him and be supportive. Premature ejaculation treatment is a process. It takes time for the man to learn techniques to control and delay ejaculation. In this process, the woman should motivate her sexual partner and play an active role during the treatment. However, the sexual partner of a man with premature ejaculation may also experience some sexual problems such as anorgasmia (inability to orgasm) in the future. For this reason, the couple must be patient, compatible with the treatments given and motivate each other. Nowadays, premature ejaculation treatment can be easily performed by experts in this field.
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