Premature Ejaculation: What is it, Causes, Symptoms and Treatment
Sexual dysfunctions are one of the most common health problems today.
Sexual dysfunctions are one of the most common health problems today. Thanks to medical studies conducted today, clearer data has begun to be obtained about why these disorders develop, and significant progress has been made in treatment. One of these problems that seriously negatively affects the sexual lives of couples is the problem of premature ejaculation.
What is Premature Ejaculation?
Ejaculation or ejaculation; It is the ejaculation of seminal fluid containing sperm from the penis during orgasm, which is the highest point of sexual pleasure in men. Premature ejaculation or premature ejaculation is the situation in which the man reaches orgasm and ejaculates before the desired time during sexual intercourse. This is considered an important health problem that causes couples to not reach the level of satisfaction they want during sexual intercourse and to become alienated from sexuality.
Premature ejaculation is a very common problem in society. According to research, one in every three men between the ages of 18 and 59 has a premature ejaculation problem at some point in their life.
Although premature ejaculation is considered among sexual dysfunctions; Contrary to popular belief, it is different from other sexual function problems such as erectile dysfunction. Erectile dysfunction means the inability to maintain or initiate penile erection during sexual intercourse. However, erectile dysfunction and premature ejaculation may occur together or trigger each other.
Premature ejaculation problem has a subjective feature that may differ from patient to patient. Accordingly, the definition of premature ejaculation may vary depending on couples’ expectations and satisfaction points from sexual intercourse. Since premature ejaculation is defined as ejaculation earlier than the person wishes; The perception of premature ejaculation may vary depending on the ideal duration of sexual intercourse determined by the individual.
However, the problem of premature ejaculation has been defined by determining an objective criterion in the clinical approach. In the clinic, premature ejaculation is evaluated according to the following criteria:
- Ejaculation occurs before or within a minute of the penis merging with the vagina.
- It is not possible to delay ejaculation in almost every sexual intercourse.
- There are negative psychological symptoms such as avoidance of sexual intercourse, intense stress, and depression.
What Causes Premature Ejaculation?
Premature ejaculation is basically examined in two separate parts, depending on the initial period of the problem. Accordingly, when talking about primary premature ejaculation in people who have had a persistent premature ejaculation problem since the first sexual experience; Premature ejaculation problem that develops later in an individual with normal sexual experiences is considered as secondary premature ejaculation.
In the primary form, the problem may continue throughout life and underlying organic causes can be detected. In the secondary form, since there is a history of normal sexual experience, it can be inferred that the problem is caused mostly by psychological reasons.
Since premature ejaculation problem is a condition that can develop at certain times in healthy men; It does not pose a significant problem unless it is long-lasting or repetitive. As the man’s sexual experience increases and he learns to control the feeling of ejaculation, the problem of premature ejaculation usually disappears.
However, long-term or recurring premature ejaculation problems may occur in the following situations and in the presence of health problems:
- Intense stress, anxiety or depression: Premature ejaculation is more common in people who are under intense psychological stress, have intense anxiety about their relationship or sexual experience, or have a mood disorder.
- Having bad judgment about oneself: Premature ejaculation may occur in situations such as having bad thoughts about one’s own body, disliking oneself, or making bad judgments about oneself.
- Problems with the partner: Since relationship problems with the sexual partner affect the patient psychologically, they may trigger premature ejaculation.
- History of sexual abuse: Previous sexual abuse is a serious risk factor for sexual dysfunctions such as premature ejaculation.
- Sexual dysfunctions such as erectile dysfunction: Sexual dysfunctions such as the inability to maintain an erection for a long time may accompany premature ejaculation.
- Hormonal irregularities: Changes in blood levels of sex hormones such as testosterone, androgen or estrogen can result in premature ejaculation.
- Inflammatory diseases such as prostatitis or urethritis: Premature ejaculation may be triggered in case of inflammation of the tissues and organs that make up the reproductive system.
- Advanced age: As it becomes more difficult to delay and control ejaculation with age, sexual dysfunctions such as premature ejaculation are more common.
- Chronic diseases: Sexual dysfunctions are more common in people with chronic diseases such as hypertension, diabetes, and heart diseases.
What are the symptoms of premature ejaculation?
Various clinical symptoms may be observed in patients with premature ejaculation problems. Accordingly, the following symptoms are frequently observed in men with premature ejaculation problems:
- Reaching orgasm and ejaculating immediately at the beginning of sexual intercourse or within 1 minute of the start of intercourse
- Failure to control ejaculation during sexual intercourse
- Intense stress, anxiety, guilt or depression before sexual intercourse or after premature ejaculation
- Having relationship problems with a sexual partner
- Decreased desire for sexual intercourse (libido)
- Erectile dysfunction or inability to maintain an erection during sexual intercourse
How to Diagnose Premature Ejaculation?
It is very important that the patient and the physician establish correct communication during the evaluation process of a specialist physician in determining the problem of premature ejaculation. Patients may express that they have a premature ejaculation problem in the context of their expectations from sexual intercourse. However, premature ejaculation problem, which is clinically important, is detected in the presence of the following criteria:
- Ejaculation occurs at the beginning of intercourse or within 1 minute
- Inability to control ejaculation during this period
- Presence of premature ejaculation problem and psychological or organic reasons that predispose this situation
As a result of the detailed disease history taken by the physician and the detailed physical examination, additional imaging and laboratory tests may be required when deemed necessary. However, since the problem of premature ejaculation often arises from a functional disorder, instead of examining organic causes, examining the factors that push the patient to this problem may be on the agenda.
How to Treat Premature Ejaculation?
If a clear organic cause is found during the diagnosis of premature ejaculation problem, specific treatment of the underlying cause is performed. However, since premature ejaculation often occurs due to psychological or functional reasons, various lifestyle changes, some methods and psychotherapeutic methods are recommended or applied to patients.
In this context, the following methods are frequently used to eliminate premature ejaculation problem:
- Masturbating up to an hour before intercourse helps to control ejaculation during intercourse.
- When you meet with your partner, preparing for sexual intercourse by doing foreplay before starting sexual intercourse immediately is useful in eliminating the problem of premature ejaculation.
- The “stop-start” method can be applied to control ejaculation. According to this method; Sexual stimulation is given by the sexual partner to bring the person close to ejaculation. In this case, sexual stimulation is stopped and the feeling of ejaculation disappears. This “stop-start” application is repeated two more times, allowing ejaculation at the fourth stimulation. Applying the method three times a week is very useful in ensuring ejaculation control.
- Another method used to control ejaculation is the “squeezing” method. In this method; After the person is given sexual stimulation and brought close to ejaculation, the tip of the penis is squeezed until the feeling of ejaculation disappears and ejaculation is delayed. With this method, premature ejaculation can be eliminated by learning ejaculation control.
- Another method called Kegel exercises aims to strengthen the pelvic muscles in the penis area with repetitive contractions throughout the day. In this way, when the feeling of ejaculation comes, this feeling can be delayed with the help of the pelvic muscles. Kegel exercises are generally performed as repetitive exercises in which the muscles are contracted for about three seconds and then relaxed for about three seconds.
- It may be useful to use measures that reduce the amount of sexual stimulation of the penis before intercourse. In this context, delay sprays, condoms and anesthetic substances can be used.
- Psychotherapy can be useful in treating sexual disorders with the participation of both the person and his/her partner. Psychotherapy gives positive results, especially in solving psychological problems arising from partner or relationship problems.
- As drug treatment, antidepressants and drugs used for erectile dysfunction such as sildenafil and tadalafil are useful in some patients.
