Our readers might be surprised to learn that one of people’s most frequent searches on the internet is about premature ejaculation.
It is one of the most frequent causes of visits to the sexologist, urologist and specialists in sexuality. What’s more, the two most frequently asked questions on search platforms are: what is premature ejaculation and how can I make it last longer?
What is the premature ejaculation?
Premature ejaculation was defined as a disorder that affected people’s sexual health in 1887 by Gross. His study influx was mainly in upper social classes, however it is currently known that at least 43% of Spaniards suffer from premature ejaculation according to him Demographic Study on Premature Ejaculation (DEEP, 2009) by the Spanish Association of Andrology, Sexual and Reproductive Medicine.
In his book Manual of Sexology and Sex Therapy (2010), Francisco Cabello explains that there are two types of criteria to define premature ejaculation: on the one hand, according to the number of intravaginal thrusts or rubbing movements; and on the other hand, according to the temporal terms that oscillate between one and seven minutes. The reality is that, according to specialists, premature ejaculation is a disorder to the extent that it affects one or those involved in sexual practice. So, premature ejaculation is defined as:
“The inability to control the occurrence of ejaculation for the time necessary for both partners to enjoy the relationship.” (ICD-10)
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What Causes Premature Ejaculation?
According to studies based on scientific evidence that have been carried out regarding premature ejaculation, this disorder may be related to three main causes:
There are many hypotheses (without contrast) regarding premature ejaculation, among which are:
- Genetic or hereditary aspects. According to Assalian (2004), there is a 90% family incidence; but according to Jern et al. (200), studying twins, they only attribute 28% of the incidence.
- Neurological aspects.
- For excitability and sensitivity. Premature ejaculation may be related to the apparent inability to distinguish your own level of arousal and the accompanying premonitory sensations. Especially in cases of anteportam ejaculators (people who ejaculate before even penetrating) or who cannot perform more than one or two intravaginal thrusts.
- By electrophysiological aspects. It is suspected that the origin of premature ejaculation may be in the existence of a hyperexcitable bulvocavernous reflex or in the low sensory threshold of the dorsal nerve of the penis.
- By aspects by serotonergic receptors. According to Waldinger et al. (1998), premature ejaculation is due to a hypersensitivity of the 5-HT receptors or a hyposensitivity of the 5-HT receptors.
- Prostate disorders. That is, derived from cervical and prostatic irritants that shorten ejaculatory latency. In fact, it has been postulated that 64% of those who suffer from premature ejaculation have prostatic inflammation; of which 52% a bacterial prostatitis and 12% a non-bacterial prostatitis.
- Hormones It has been shown that ejaculation can be faster when there are low levels of magnesium in the semen.
- Drugs. It has been found that there is a relationship between medications such as cyproheptadine, trifluoperazine, pseudoephedrine, yohimbine, among other anxiolytics and antipsychotics. So too with the abrupt withdrawal of opiates.
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It is important to mention that although there are biological factors and aspects that undoubtedly influence the incidence of premature ejaculation, the psychosocial aspect must also be considered. Let us remember that every aspect of human sexualities involves biopsychosocial factors.
For this reason, it is important to start with identifying that among the psychological aspects that can most influence the incidence of premature ejaculation is education. Considering that much of our sex education comes from a porno mainstream, where the duration of an erection is a myth that covers hours and hours of recording, the panic of “Not last as long as in the movies” it can actually cause some premature ejaculation crises.
Now, according to Masters and Johnson (1970), among the factors that can influence the incidence of premature ejaculation are: “those who masturbate quietly with fantasies, recreating and taking breaks, have a better ejaculatory response with a partner than those who masturbate with photos and compulsively in order to release tension. ” (p. 209) This, according to Metz and Prior (2000), has a correlation with the abilities to regulate anxiety and the specific sexual or sensual physiological ignorance that prevents control ejaculation.
By this we mean that the experience is completely different when the attention is focused on arousal and satisfaction during sexual practice, than when one is “concerned about orgasm control, anxious about possible failure and with thoughts related to maintenance erection ”(p. 210). So before the quantity, the quality of the eroticofestive experience influences a lot in the control of ejaculation. In Caballo’s words:
Quality also influences, clinical experience dictates that when ejaculatory control is poor, the patient spends less time in erotic games, gives less rein to fantasies and has very monotonous relationships. In sum, the frustration subsequent to involuntary rapid intercourse causes the patient to avoid intercourse as much as possible, so the frequency decreases and, as he believes that ejaculation is caused by excess excitability, he reduces erotic games. By reducing playtime, the patient does not get into the habit of relaxing and enjoying contact in general, focusing all response on the genitals.
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What are the treatments related to premature ejaculation?
In the event that premature ejaculation has a more hormonal background or due to medication issues, it is important to consider drug therapy. However, the quality of sexual practices can improve through:
- Sex education based on guaranteeing the sexual health of the person; managing to distinguish between sensual eroticization and genital eroticization.
- Sensory targeting exercises, to learn to focus attention on their own sensations – and not on those of the couple.
- Identify what it is and how does he feel ejaculatory reflex to make use of the “Stop/Star” technique .
- If necessary, physiotherapy sessions to stimulate and strengthen the pelvic floor through electrostimulation and biofeedback.
In order to improve the quality of sexual practices and the perception of this discomfort, it is essential to visit a trusted sexologist with experience in cases of premature ejaculation.
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Premature ejaculation, what is it and what are its causes? – Vibrations Blog
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