Premature ejaculation is defined as a situation in which the person ejaculates involuntarily, with limited sexual stimulation, before or immediately after the penis enters the vagina, and this event causes significant distress in the person. Premature ejaculation is a common condition among men. Although there are differences between estimates, it is thought that approximately one in every three men will encounter this problem during their lifetime. As long as it doesn't happen frequently, it's not something to worry about. Although premature ejaculation cannot be fully defined, premature ejaculation can be diagnosed if the person has the following characteristics:
- Ejaculation that occurs approximately 1 minute after vaginal penetration at all times or in most intercourses
- Ejaculation that is, not being able to delay ejaculation for the period after vaginal penetration or until vaginal penetration
- Avoiding sexual intercourse due to stress and anxiety
Premature ejaculation problem
Premature ejaculation , both physiological and biological factors may play a role. Although premature ejaculation is a subject that men feel ashamed of and avoid talking about, it is a frequently encountered and treatable health problem. In men with premature ejaculation, the problem may be mild at first and worsen over time. In some cases, men try not to make their partners feel their premature ejaculation problems. This may lead to communication problems between the couple and related sexual problems. In heterosexual couples, women may experience sexual reluctance, inability to orgasm, and arousal disorders as a result of the man not spending enough time on foreplay. In heavy forms, union cannot occur. If couples do not approach the problem constructively, they may experience serious problems in their relationships.
Types of premature ejaculation
Before moving on to the causes of premature ejaculation, it is necessary to know that there are types of premature ejaculation. Premature ejaculation is divided into 4 classes.
Premature ejaculation that continues throughout life: This type of premature ejaculation is observed with the first sexual activity and continues throughout life. It is the least frequently observed type of premature ejaculation in the general population. Studies conducted in China and Turkey report that it is observed between 2.3 and 3.2% in the general population. It is clear.
Acquired premature ejaculation: It is a more common problem. It may occur as a result of a physiological or psychological change. It is observed between 3.9% and 4.2% in the general population.
Variable premature ejaculation:It is the most frequently observed type of premature ejaculation problem. It is seen at a rate of 8.5-11.4% in the general population. The person sometimes experiences normal ejaculation and sometimes premature ejaculation.
Sensory (Subjective) premature ejaculation: In this type, the person does not actually have a premature ejaculation problem, but premature ejaculation occurs due to cultural and psychological reasons. He thinks he is experiencing ejaculation. The prevalence rate in the general population is between 5.1-6.4%.
Causes of premature ejaculation
The causes of premature ejaculation are divided into two: psychological and biological.
Psychological causes of premature ejaculation;
- Sexual inexperience
- Negative perception of one's own body image
- Relationship innovation
- Excessive excitement and arousal
- Relationship stress
- Anxiety
- Self-blame and feelings of inadequacy
- Depression
- They can be listed as psychological problems related to control and intimacy.
These psychological factors are frequently observed reasons, especially in men who have previously experienced normal ejaculation and then encounter premature ejaculation problems.
On the other hand, , lifelong premature ejaculation problem is experienced due to earlier traumas. Examples of these are;
- Sexual abuse
- Strong sexual education and upbringing
- Traumatic sexual intercourse experience
- Psychological conditioning Situations such as (young people ejaculate quickly through masturbation due to fear of being caught) may be given.
Biological causes of premature ejaculation:
Premature ejaculation may occur. There are hormone, infection and nervous system diseases that can cause erectile dysfunction.
Diabetes: Although diabetes is a disease that generally causes erectile dysfunction in men, a study published in the journal Translational Andrology and Urology in 2016 found that a significant majority of diabetic patients with erectile dysfunction It seems that he also has a premature ejaculation problem. It is sterile. The biological mechanism why diabetes causes premature ejaculation is not fully known.
Hormone disorders: Testosterone hormone deficiency, thyroid hormone disorder and pituitary gland diseases cause premature ejaculation.
Multiple Sclerosis: Early. Ejaculation is one of many sexual dysfunctions observed in patients with multiple sclerosis.
Prostate gland problems: Research shows a correlation between prostate gland infections and premature ejaculation.
Other causes: Recent studies shows the role of hypersensitivity of the penis and increased neurophysiological excitability of the ejaculation center in premature ejaculation.
Can premature ejaculation be prevented?
Men with premature ejaculation problems use inappropriate strategies when trying to solve this problem on their own. They can improve. Men with this problem may avoid foreplay, as increased stimulation of the penis during foreplay will shorten the duration of sexual pleasure and intercourse. This situation reduces sexual satisfaction and communication in their partners and themselves. It may also cause arousal problems in the female partner. Another wrong strategy is to engage in painful behavior for them (pinching, biting their lip) during intercourse. The purpose of this approach is to try to increase the duration by reducing sexual pleasure. Even if the duration is partially prolonged, the quality of the sexual act will deteriorate. The sexual environment may become anxious for men who ejaculate beforehand by masturbating and aim for the second and third ejaculation.
Providing sexual satisfaction to the partner by prolonging foreplay is the best strategy the individual can take on his own.
Diagnosis of premature ejaculation. How is it diagnosed?
In order to be diagnosed with premature ejaculation, the patient must have an active sexual life. A long interview with the doctor and physical examination are essential in diagnosing premature ejaculation. If premature ejaculation is accompanied by erectile dysfunction, the doctor may order some tests to check hormone levels. During this interview, the patient's medical history is explained in as much detail as possible, which ensures that the treatment strategy is determined correctly. Past and present possessions in medical resume n diseases, accidents, traumas, medications used will be asked, and the patient's sexual life will be listened to.
How is the treatment of premature ejaculation?
Today, the treatment of premature ejaculation is a success. Once the underlying cause of the disease is determined, one or more of the following treatments can be used together, depending on the patient's condition.
Medication: Oral medications are one of the most preferred treatment methods for premature ejaculation. is one. When drugs called SSRI (Selective Seratonin Reuptake Inhibitor) are taken orally as a tablet every day, their effects begin to be observed after 5-10 days. However, the need to use these drugs every day and the emergence of side effects such as fatigue, nausea, sweating and yawning cause the rate of patients to continue treatment to be low.
Exercise and sports: Kegel exercises, which are also used in children, women and men with urinary incontinence, are also used in the treatment of premature ejaculation. This exercise works the pelvic muscles and can be performed at any time of the day. During sexual intercourse, when the person feels that he is going to ejaculate, he will contract the muscles in this area, causing the muscle structure in the bladder neck to contract and control ejaculation. Kegel exercise is one of the effective treatment methods against premature ejaculation. Apart from this, fitness and similar sports that exercise the pelvic floor muscles are also useful in preventing premature ejaculation.
Creams and gels:Another method used in the treatment of premature ejaculation is the use of creams containing local anesthetics. Creams/gels/sprays applied to the penis before intercourse cause loss of sensation in the penis and delay ejaculation. Since these treatments are local, systemic side effects observed in pills are not observed. However, creams and gels can prevent the feeling of orgasm in men and women, depending on the amount of use. Especially the bad smell of the gels used can create an unpleasant environment during intercourse.
Condom: Condoms such as creams and gels are one of the treatment methods used to prevent premature ejaculation as they reduce the sensation during intercourse.
Sex therapies: ; These maneuvers are “stop-start” and “squeeze” techniques. The stop-start technique is a gradual technique and each stage takes an average of 2 weeks and the recommended maneuvers must be performed at least three times each week. These maneuvers aim to reduce penile stimulation and thus delay ejaculation. The squeezing technique is to stop intercourse when ejaculation is felt during intercourse and squeeze the tip of the penis until the feeling of ejaculation passes, thereby delaying ejaculation.
Surgical treatments:This method is an irreversible method and is rarely applied. . The logic of this treatment is based on the assumption that the penis is hypersensitive in patients, and it is aimed to reduce this hypersensitivity by cutting the nerves leading to the penis in various ways.
The most accurate treatment strategy for premature ejaculation is individually programmed treatments together with a specialist physician. If you think you have a premature ejaculation problem, consult your nearest healthcare provider.
Read: 0
