Premature ejaculation, or medically known as "Premature Ejaculation", is the most common sexual dysfunction in men. In general, it is an issue that approximately 25% of all men complain about. In 2-3% of men, the event is experienced very severely and can seriously affect the person psychologically. Premature ejaculation is actually a wrong definition. It cannot be clarified according to whom or what it is early. Although it does not fully cover it, the term "Uncontrolled" or "Uncontrolled Ejaculation" may be a more accurate definition. In fact, the diagnosis, cause (etiology) and treatment of premature ejaculation have not been fully determined so far, and it still constitutes one of the darkest issues in medicine. If you want, let's first describe the situation of premature ejaculation as much as possible.
Except for exceptions, in almost every sexual intercourse, despite very little sexual stimulation, before entering the vagina, as soon as it enters, or within 1 minute before the person even wants it. It is the state of ejaculation. A person has no self-control over his body against ejaculation. This disorder causes significant psychological stress in the person and conflicts in couple relationships.
Even this definition, although generally correct, is quite incomplete. It neglects both the physiological and psychogenic background of the work. Men with premature ejaculation problems inevitably experience stress, disappointment, tension, frustration and avoidance of sexual activity. Likewise, similar reflexes and sexual dissatisfaction manifest themselves in the spouse or partner over time. This psychogenic aspect of the event should never be neglected. But basically, premature ejaculation itself is a problem with a psychogenic basis. Physiologically, ejaculation is a reflex. As with all reflexes, it is not easy to control. Most men learn over time to partially control their own ejaculation. In some men, this awareness cannot be realized and no matter what the person does or thinks, he cannot prevent ejaculation.
CLASSIFICATION OF PRIMARY EJACULATION:
1- LIFETIME EARLY EJACULATION: This is the type of premature ejaculation that we find the main and most important. From the first sexual experiences, with every partner, anywhere and everywhere It is the way it is experienced in sexual relations in the situation. The "intravaginal ejaculation latency time" (IELT) is under 1 minute. As age progresses, the problem tends to get worse. Studies have shown that 80% of men with this problem have an IELT time below 30 seconds. It is reported that 40% of men ejaculate within the first 15 seconds.
2- ACQUIRED PRIMARY EJACULATION: It is a situation in which the problem occurs later in men who did not have such a problem before. There may be an underlying cause. Some diseases such as prostate inflammation (chronic prostatitis), thyroid gland diseases (hyperthyroidism), major sexual problems that occur in couples (erection problem in men, dyspareunia (pain during sexual intercourse) in women) can cause premature ejaculation. It often requires medical treatment. In addition, some psychiatric disorders such as anxiety, depression, and relational issues such as marital problems are also conditions that can later cause premature ejaculation.
3- NATURAL VARIABLE PREMEDIATE EJACULATION: It is a very common type and is not considered a problem. Men may ejaculate prematurely in different environments or partner changes. It is situational and considered normal. It does not require treatment or therapy. Especially in the first 6 months of regular sexual life, the man's inability to fully control ejaculation can also be evaluated in this context.
4- EJACULATION DISORDER SIMILAR TO EARLY EJACULATION: Some men complain about having premature ejaculation problems even though it occurs in normal periods (over 4-6 minutes). . Again, it is a problem that cannot be considered a disease. Most of the time, people have the problem of misperceiving sexuality. First of all, the situation is explained to the person. It is stated that there is no condition that requires treatment. However, some cognitive techniques regarding the beautiful art of lovemaking can be taught.
DURATION ISSUE: The duration issue in the premature ejaculation problem is a completely subjective and controversial issue and ignores female sexuality. Studies have shown that 90% of men who say "I have a premature ejaculation problem and I want to be treated", seek treatment or consult a doctor, ejaculate within the first minute (IELT). Therefore, current sexual health science is also based on this period. So the critical time for premature ejaculation is 1 minute. In general, less than 1 minute is premature ejaculation; The limit time is 1-2 minutes; 2 min Above ika is normal. In a comprehensive scientific study, the average IELT time was found to be 5.4 minutes worldwide, while the average in Turkey was 3.7 minutes. It can be seen in the table below that this period is well below the American and European data. (Table2) (Waldinger 2005). 40% of men who are medically accepted to have premature ejaculation problem in the first 15 seconds; It has been determined that 70-80% of them ejaculate within the first 30 seconds. So, what is the average IELT required for a woman to reach sexual satisfaction? Medical guidelines such as DSM-IV, ISSM, EAU cannot clarify this issue and advise the woman to be satisfied with just 1 minute. In our opinion, this issue is an important dilemma. We think that the duration of sexual intercourse should exceed 7 minutes in order for a woman to experience sexuality in a healthy and satisfactory manner. Although this can sometimes be done naturally, it is a skill that many men can acquire later with sexual education.
SELF-CONTROL ISSUE: In our opinion, the ability of a man to control his ejaculation is much more important than the duration. is the discharge criterion. Many men can sense beforehand that they will ejaculate. When this happens, it relaxes the PC muscles (love muscles), slows down its rhythm, regulates its breathing and changes position. Thus, ejaculation is postponed. A man with premature ejaculation problem does not have voluntary self-control over his body. Such a man expresses the issue as follows: "The same thing happens every time and everything happens very quickly. Even though I think about different things, I cannot stop myself from ejaculating." The essence of sexual therapy is for a man with premature ejaculation to first notice the yellow light burning in his body; Once he realizes it, it is essential that he learns how to apply the brakes. Because when the red light turns on, it is too late and it is impossible for anyone to control.
RELATIONAL CONFLICT: In order to say premature ejaculation problem, both men and women have this problem. It is essential to worry. Especially women may even be happy with this situation. She can only approach sexuality with the mentality of "let my husband do his job". In this case, it is a little difficult to call the event premature ejaculation. Of course, this is not the right and healthy thing. A man with premature ejaculation experiences intense stress, tension and shame. lives. He feels incompetent. He is embarrassed towards his wife because he experiences the same thing every time. He constantly feels the need to explain. He initially stays away from the argument to avoid being blamed by his wife. Women, on the other hand, initially think that the problem will get better over time and the situation will improve. Unless it improves, disappointments will increase. They begin to accuse their spouses of selfishness. Relationship conflicts gradually increase with constant apologies, blame, and compensation efforts. As a result, a tense and unhappy sexual life is inevitable for couples. Because it is not surprising that the partner of a man who has premature ejaculation problems also has sexual arousal and orgasm problems.
IS A MAN WHO EJECTS EARLY SELFISH?
A man who ejaculates prematurely is often accused of being selfish by his partner and often has to apologize to his partner. Apologizing does nothing more than making the person feel guilty. Premature ejaculation is not that man's fault, nor is it something within his own control. Moreover, a man who ejaculates prematurely experiences a great feeling of dissatisfaction. He ejaculated but could not reach orgasm. The correct approach should be to put an end to the vicious cycle of blame-apology and take responsibility together as a couple and seek a scientific medical solution.
COMMON PERSONALITY OF MEN WITH PRIMARY EJACULATION PROBLEM. FEATURES
*They generally have a constantly rushing and fussy nature, which we call Type A personality. They eat fast and drive fast. They are pretty good at computer games. Their reflex arcs are developed and fast.
*They are often looking for a fast, permanent and miraculous treatment that will give results as soon as possible.
*They have high sexual libido. In other words, they love sex and do not get bored of sex easily. Even though their interest in their spouse or partner decreases, their sexual energy is generally high.
*They like to have sex a lot in a row. The rest periods between the two relationships, which we call the refractory period, are shorter. They have a score-based understanding of sexuality. This is an effort to both save the situation with their partner and to achieve their own self-satisfaction. However, as age progresses, the refractory period inevitably lengthens and the premature ejaculation period becomes shorter. Do Therefore, relationship conflict may arise in the following years, even if it does not occur at the beginning.
*They are generally a little shy of sexually hot women. Again, they do not want sexually cold women. They are not easily satisfied, and their self-confidence in regular intercourse is quite weak.
*Man with premature ejaculation problem cannot turn off his brain during intercourse. He doesn't make love by feeling; He constantly thinks and counts. It's like a child afraid of needles. They are very afraid of being touched, stimulated, and getting close.
As age increases, the drama of men who ejaculate prematurely increases;
-The duration of premature ejaculation becomes shorter.
-The refractory (rest) period becomes wider
-The lust for the partner decreases
Therefore, compensatory efforts (frequent intercourse, non-coital ways) take years. It starts to decrease in . As relationship conflict emerges, stress and tension at home increases. For this reason, it is not surprising to come across men who have had premature ejaculation problems from the very beginning, but have been married for 10 years and have just started to seek treatment.
PREMACY EJACULATION IS A DISEASE OF PRELIMINARY Ejaculation. .
The sexual cycle has stages of desire-arousal-plateau-ejaculation-resolution. The plateau phase is the stage when the penis becomes fully erect and enters the vagina. The longer the stay inside, the more pleasure both the person and the partner will experience. We all like to eat slowly, little by little, when we have a food we like. Because we enjoy more food this way. Normally, during sex, it is necessary to pass the plateau phase slowly and enjoy it. After reaching a certain saturation, ejaculation-orgasm occurs spontaneously. In men who ejaculate prematurely, the plateau is either absent or very short. Therefore, men who experience premature ejaculation despite ejaculation experience great dissatisfaction. To reiterate, she ejaculated but could not orgasm. Our main goal in diagnosis is to try to understand why the man cannot stay at this plateau. Treatment may sometimes differ depending on the cause of premature ejaculation.
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