General Illness Information
Common Name: Early ejaculation
Medical Term: Premature ejaculation, PE.
Description: premature ejaculation is is a male sexual dysfunction characterized by early ejaculation which always or nearly always occurs prior to or within about one minute of penetration.
Causes: Premature ejaculation can be caused by both psychological and organic causes. Although many men are embarrassed to talk about this disorder, premature ejaculation is an ordinary and curable condition.
The exact cause of premature ejaculation is not known. Earlier the only reasons for early ejaculation were considered psychological, but now it’s known that the causes of premature ejaculation are more complex, and include both psychological and organic factors.
Psychological causes of premature ejaculation:
- Early sexual experience can create a pattern that is then difficult to change, for example, a situation in which the patient may have hastened to reach orgasm in order to avoid “revelation”;
- Erectile disfunction. Men who are worried about achieving and maintaining erection during intercourse, may develop behavioral patterns that lead to premature ejaculation, and these structures can be very difficult to destroy;
- Anxiety. Many men with premature ejaculation may have an anxiety related to both sexual relationships and other related causes;
- Problems in relationships. Often, interpersonal problems contribute to the problem.
Organic causes of premature ejaculation:
- Abnormal hormone levels;
- Abnormal levels of neurotransmitters (biologically active substances in the brain);
- Reflex disorders of the ejaculation;
- Some diseases of the thyroid gland;
- Inflammation and infection of the urethra (urethritis) and / or prostate gland (prostatitis);
- Heredity;
- Violation of the nervous system due to trauma or surgical intervention;
- Quitting certain narcotic drugs or psychotropic drugs used to treat anxiety and other mental health problems.
Classification: Premature ejaculation is divided into:
- Congenital (primary);
- Acquired (secondary).
Congenital premature ejaculation occurs with the first sexual experience and remains a problem throughout life. Ejaculation occurs long before penetration or less than 1-2 minutes after it;
Acquired premature ejaculation is characterized by a gradual or sudden occurrence. The time of ejaculation is very short, but usually not so short as with congenital premature ejaculation.
Risk Factors:
- Health problems: concerns about your own health during intercourse, such as cardiovascular diseases, can lead to accelerated ejaculation;
- Stress. Emotional or mental stress in any area of life can cause premature ejaculation due to the inability to relax and concentrate during sexual intercourse;
- Some drugs: narcotic (psychotropic) drugs can lead to premature ejaculation.
Prevention:
- Use condoms with an anesthetic;
- Think about abstract topics during sex;
- Do special exercises to strengthen the pelvic muscles;
- Masturbate before sexual intercourse;
- Do a circumcision surgery.
Signs & Symptoms:
- Ejaculation is less than a minute after penetration or before penetration in the vagina.
Additional signs of this disease:
- different duration of the sexual act;
- prolonged duration of sexual intercourse when using condoms or anesthetic ointments;
- prolonged sexual intercourse when taking antidepressants or other types of sedatives.
Remember that both the length of the sexual intercourse and other signs are very relative and only a specialist can diagnose the condition and determine its true cause. In addition, one-time cases of early ejaculation can hardly be considered signs of the disease, since they can be caused by non-medical factors (situation, mood, etc.).
Diagnosis:
The greatest importance in the diagnosis of premature ejaculation is the collection of medical and sexual history of the disease. Based on these data, the urologist can identify primary or secondary premature ejaculation. Also, during the conversation, the doctor should find out the duration of the sexual act before ejaculation, whether the problem arises only with a certain partner or under certain circumstances, the influence of premature ejaculation on sexual activity and quality of life, whether the patient takes medications or drugs. It is very important to recognize premature ejaculation in erectile dysfunction.
If the urologist has sufficient grounds, then an additional examination of the vascular, endocrine and neurological system may be suggested. The exclusion of Peyronie’s disease, urethritis and prostatitis may also be necessary in some cases.
Treatment:
Premature ejaculation may be a sign of prostatitis, so treatment should be selected and monitored carefully. There are conservative and operational methods of treatment:
Conservative methods of treatment include:
- Psychotherapy that helps cope with the anxiety of a man about his sexual power;
- Reduce the tempo. Another name for the technique is “stop-start”. When a man feels maximum excitement, stimulation must be stopped until the excitement subsides;
- Condoms that reduce sensitivity;
- Drug treatment (Dapoxetin, Lidocaine, Viagra, Levitra, Cialis);
- Creams that reduce sensivity of the penis;
- Antidepressants. However, due to the many side effects, serotonin reuptake inhibitors are rarely used to eliminate premature ejaculation.
The most effective surgical methods of treatment:
- Denervation of the glans penis;
- Selective denervation.
Activity:
No restrictions.
Possible Complications:
- Problems in relationships. If premature ejaculation affects your relationship, it is desirable to include your sexual partner in the treatment program;
- Fertility problems: Premature ejaculation can sometimes cause troubles for couples who are trying to become pregnant.
Prognosis:
Modern techniques allow to cure premature ejaculation in 98% of cases.
Other:
Nothing specified.
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