Premature Ejaculation from A to Z
If there’s one problem a man never wants to talk about in public, even as a couple, it’s premature ejaculation.
It’s a fairly common problem that can have several causes. It affects most men of all ages and physical conditions at some stage in their lives.
But what is it? How does it happen? How do you live with it? What can be done about it? What solutions are on the market, and how do I get them? SpecialHomme is here to help you find out more about the problem.
The taboo of premature ejaculation
Premature ejaculation affects a large number of men. It’s true that the figures vary, but it’s estimated that one man in 3 is a victim of this disorder.
It can be very stressful. Not only for the man primarily affected, but also for the partner in the relationship.
Even though the suffering can be unbearable, very few men and couples consult a specialist about it.
This is because premature ejaculation is considered a taboo subject (as is probably the case for all sexual disorders), preventing couples from discussing it with each other and, above all, with their doctor. And, unfortunately, this can only prolong the suffering, as there are many approaches and solutions for regaining control over one’s ejaculation.
The exact causes of premature ejaculation have not yet been definitively determined. Older theories speak of a mental disorder, or assume that premature ejaculation is the result of certain behaviors (such as early or traumatic sexual experiences).
Currently, it is thought that premature ejaculation is due to an imbalance of certain neurotransmitters in the nervous system that are involved in the release of orgasm.
Premature or premature ejaculation
There is no common measure for premature ejaculation. Many people speak of premature ejaculation when the man cannot control the moment of ejaculation and when orgasm is triggered earlier than desired.
In general, ejaculation is considered premature when it occurs before or within two minutes of penetration!
Most definitions of premature ejaculation take into account three key aspects :
- a short duration between penetration and ejaculation ;
- loss of control over ejaculation;
- a feeling of discomfort experienced by the person concerned or his/her partner.
In men suffering from premature ejaculation, ejaculation occurs 3 times out of 4 before the very moment of penetration. Premature ejaculation after penetration occurs when the time between penetration and ejaculation is very short, or in any case far too short for both the man and his partner.
Men who are not affected by this disorder need an average of 5 minutes to reach orgasm. For men affected by premature ejaculation, in most cases it takes less than two minutes to reach orgasm. In extreme cases, simply thinking or imagining the sexual act is enough to ejaculate.
Premature ejaculation: does it affect women too?
In some definitions of premature ejaculation, the woman’s satisfaction is taken into consideration. For example, premature ejaculation can occur when the man is unable to control his ejaculation, so that intercourse is unsatisfactory for both partners.
Premature ejaculation can be congenital (primary) or acquired (secondary). The primary form is very rapid, affecting around ? of men affected by this disorder, and can persist for life in 70% of cases. The secondary form occurs after a period of normal sexual relations. It is often associated with erectile dysfunction. It can also be the result of a drop in sexual desire (libido).
Treating premature ejaculation
Although premature ejaculation is not one of those health problems that causes physical pain, it can nevertheless cause significant mental suffering.
Treating premature ejaculation involves a number of different approaches, from psychotherapeutic methods to drug treatments, as well as manual techniques to control arousal and ejaculation.
Many men manage to control their ejaculation using one of these methods. However, these methods are only necessary if the man really suffers from premature ejaculation. From a purely medical point of view, in most cases there is no need for treatment.
In short, premature ejaculation is a sexual disorder that does exist. And, since it’s a delicate situation in which the man suffers psychologically because his sex life has deteriorated, it’s imperative to get to grips with it, without delay!
Just like any other dysfunction, premature ejaculation can be treated. You just need to be well-informed about it to be able to choose the best approaches.
That’s why, in this article, we’ll first give you a full explanation of what this sexual disorder is, and then offer you a list of tried-and-tested solutions.
If you think you’re a premature ejaculator and have decided to take charge of your life, you’ve come to the right place.
Do you know how ejaculation occurs? What should you have and do to achieve a good ejaculation?
Let’s discover the ejaculation mechanism together!
How do you ejaculate?
Do you ejaculate? What a question! Of course we ejaculate… But have you ever wondered about the mechanism of ejaculation? How do you manage to produce so much sperm so quickly, and how do you manage to “shoot” it out like that, from the tip of your penis?
Some men ejaculate quite far away, while others ejaculate very close. Some men have plenty of semen, while others have much less.
What exactly happens when we ejaculate? How does the ejaculation mechanism work? And why are there so many differences between men?
The anatomy of the penis
Before we start talking about the mechanism of ejaculation, it’s essential to take a comprehensive look at the subject, so as to fully understand the mechanism of ejaculation. Before we begin, let’s remember that the penis contains :
- Two cavities called corpora cavernosa, arranged along the length of the organ and containing a labyrinth of blood vessels in the shape of cavernous spaces (like a sponge).
- A spongy body also runs along the length of the penis, but from below.
- The urethra, or urine and sperm duct, which runs along the underside of the corpus cavernosum.
- Erectile tissue, which surrounds the urethra, two main arteries and several veins, as well as nerves.
- The head (glans), which is at the end of the trunk (main cylinder of the penis) The meatus, or opening at the tip of the head where urine and semen are discharged.
How is an erection produced?
When the blood vessels of the corpus cavernosum relax and dilate, blood rushes through the arteries of the cavernous muscles to fill them. The blood is then trapped under high pressure, creating an erection.
An erection begins with sensory and mental stimulation. During sexual arousal, nerve messages begin to stimulate the penis. Impulses from the brain and local nerves dilate the muscles of the corpora cavernosa to relax, allowing blood to circulate and fill the open spaces.
The blood creates pressure in the corpora cavernosa, helping to harden the penis and achieve an erection; the tunica albuginea (the membrane surrounding the corpora cavernosa), helps to retain the blood in the corpora cavernosa and thus; maintain the erection. The erection stops when the penis muscles stop the flow of blood into the blood channels, allowing the blood stored in the muscles to be released.
Mechanism of ejaculation: explanations
Sexual stimulation and friction provide the impulses and information that are in turn delivered to the spinal cord and brain. Ejaculation is a reflex controlled by the central nervous system. It is triggered when the sexual act reaches a critical level of arousal.
Ejaculation takes place in two phases. In the first phase, the vas deferens (the tubes that store and transport sperm from the testicles) contract and squeeze the sperm towards the base of the penis and prostate. From there, seminal vesicles release sperm-producing secretions. In the second phase, the muscles at the base of the penis contract every 0.8 seconds, forcing sperm out of the penis in a maximum of five semen-expulsion strokes.
Sperm and ejaculation
The characteristics of healthy sperm can be summed up in three words: Quantity, Quality and Motility.
Sperm quantity, of course, refers to… quantity (!), while quality refers to the physical appearance of the sperm. Motility, on the other hand, refers to sperm movement. Healthy sperm is a good indication of the good health of a man’s reproductive system, which increases the chances of obtaining offspring. You can visit fertility clinics or laboratories to have your sperm tested and analyzed to find out whether or not your spermatozoa are healthy.
When it comes to sperm quantity, doctors will tell you that a man should have at least 20 million sperm per milliliter per ejaculation. Healthy reproductive systems can produce up to 40 million sperm per ejaculation. In test results, certain terms may refer to an “abnormal” sperm count, such as “oligospermia,” which means that the sperm count is less than 20 million sperm per milliliter. Polyzoospermia,” on the other hand, means too many sperm per ejaculation.
In addition to quantity and quality, motility is also an important sperm characteristic, as it determines whether the sperm can move on their own to reach the egg.
The sperm enters the woman’s body in a kind of “wave” that propels the sperm towards the egg. This is the ejaculation mechanism! The sperm must then learn to find their own way to the egg.
If you do tests and they contain terms like “asthenozoospermia”, this means that the sperm aren’t as mobile as they should be. On the other hand, the term “necrozoospermia” means that the sperm is not able to move at all.
At this point, if we’ve done our job properly, you should have a much better understanding of the ejaculation mechanism.
Knowing all this, it’s easy to understand why you need to pay close attention to the quality of your sperm. This goes without saying, since sperm quality is a measure of a man’s overall sexual health.
Precocious sexuality is, of course, synonymous with worry! So what are the causes?
Causes of premature ejaculation
Premature ejaculation can have a number of different causes, which are not yet sufficiently defined. In addition to psychological causes, researchers also point to neurophysiological reasons, i.e. reasons that lie in the transmission of signals between nerve cells.
Here’s an overview of the various factors that may contribute to premature ejaculation.
Rapid ejaculation: physiological causes
Several neurotransmitters in the brain affect ejaculation. The neurotransmitter involved in triggering ejaculation is serotonin. With increased levels of serotonin in the brain, the time required for ejaculation can be prolonged.
To put it simply, scientists suspect that there are physiological reasons for the way the brain works, albeit with the penis apparently intact. This means you can have a healthy penis, with a perfect erection and no apparent deformity… and still be “trigger-happy”! Don’t worry, it’s treatable!
On the other hand, health problems such as urinary tract infections and diabetes can also cause premature ejaculation. The side effects of various medications, such as certain painkillers, also affect the power of ejaculation control. In some patients affected by premature ejaculation, erectile impotence occurs simultaneously (erectile dysfunction). In such cases, treatment is determined primarily for erectile dysfunction.
A variety of factors can also contribute to premature ejaculation. These include, for example, suffering from erectile dysfunction, which can occur as an independent sexual disorder or associated with premature ejaculation.
Premature ejaculation: behavioural causes
Another risk factor for premature ejaculation is sexual inexperience. In fact, it’s the most common! We know that not all men approach their sexuality in the right way. Lack of sexual education, fostered by unsuccessful previous experiences, is a contributing factor to short, quickly ended sexual encounters.
What we’re trying to say here is to make sure you have a clear idea of your sexuality: once you understand what triggers ejaculation, you’ll inevitably know how to improve the situation.
The number and frequency of sexual encounters also influence a man’s ability to control himself at the moment of ejaculation. Sexologists believe that irregular intercourse can lead to premature ejaculation. As with athletes, performance is maintained by regular training and occasional competition.
Psychological causes
It’s not just a man’s physiology that can be at the root of his sexual problems: psychology can also play a part. Here, then, is a brief summary of the various possible psychological causes of premature ejaculation:
- Possible childhood sexual disorders;
- Previous traumatic sexual experiences;
- Lack of sex education (from family and friends or on one’s own);
- (Exaggerated) focus on sexual performance;
- Unrealistic ideas about sexuality (generally accentuated by the pornography industry and the taboo nature of sexuality, which generates many urban legends);
- unexplained fear of failure.
Premature ejaculation may also be linked to anxiety disorders. However, no link has been clearly established. It is not scientifically proven whether anxiety disorders are the consequence or the cause of premature ejaculation.
In any case, the fear of premature ejaculation can considerably affect a couple’s sexual act.
Can premature ejaculation be treated?
Whether its causes are physiological, behavioral or psychological, premature ejaculation remains a completely treatable disorder. As with all human disorders, the starting point is to understand the triggering mechanism.
Now, are we born with premature ejaculation, or do we catch it later? If not, what are the symptoms of this dysfunction?
Symptoms of premature ejaculation
Before thinking about treating premature ejaculation disorder, you should first be sure that you really do suffer from it!
It’s the success of the diagnosis that conditions everything that follows. In other words, a wrong diagnosis could cost you dearly… in terms of money, time and, above all, health! Health, both physical and mental, is a precious commodity that must be safeguarded.
So what are the symptoms of premature ejaculation? When can a man be considered a premature ejaculator? SpecialHomme can help you analyze your situation.
Under normal circumstances, men who are not affected by premature ejaculation disorder need an average of 4 to 5 minutes to reach orgasm and thus achieve a first ejaculation. On the other hand, for those affected by premature ejaculation, the time between penetration and ejaculation is generally less than 1 or 2 minutes. But let’s not be too hasty! You could be normal without even knowing it!
Are you born with premature ejaculation, or do you become one?
Science has identified two types of premature ejaculation. Primary and secondary.
Explanations:
The first type concerns any man who has always had too-fast ejaculation. This means he was practically born with it and has always been a premature ejaculator, from his very first sexual encounter. This type of ejaculation is easier to treat, however, as it is generally the result of a lack of training.
Secondary premature ejaculation, on the other hand, concerns men who had a normal sex life but suddenly began to experience the problem. Treatment is a little more complicated than for primary premature ejaculation.
What are the symptoms?
The main symptom of premature ejaculation is the inability to delay ejaculation for more than one or two minutes after penetration. The problem can occur during any sexual activity, even during masturbation or fellatio.
The following is a list of the most important symptoms of premature ejaculation:
- Ejaculation occurs at or very soon after penetration (less than one to two minutes);
- The man is unable to control the timing of his ejaculation;
- The most important symptom, however, is your dissatisfaction and your partner’s frustration when you reach orgasm long before she can cum.
These symptoms of premature ejaculation must be repeated over a fairly long period before you can conclude that you are suffering from premature ejaculation.
Premature ejaculation is only a problem if one of the partners feels dissatisfied. Indeed, ejaculations can occur after 2 or 3 minutes, or even less, but if both partners feel satisfied, then the problem doesn’t arise.
Premature ejaculation is therefore relative! It only occurs when you ejaculate without being able to control yourself until your partner comes.
Why consult a doctor when you ejaculate too soon?
Talk to your doctor if you ejaculate earlier than you’d like during most sexual encounters. It’s normal for men to feel embarrassed when talking about sexual health issues, but don’t hesitate to talk to a specialist who’s trained to listen. Premature ejaculation is a common and treatable problem.
For some men, a simple conversation with their doctor can help alleviate their worries about premature ejaculation. For example, it may be reassuring to hear that occasional premature ejaculation is normal, and that the average time between the onset of intercourse and ejaculation is around five minutes.
After consulting your doctor, a number of treatments may be recommended. Psychotherapeutic methods, manual techniques or drug treatments are available to combat premature ejaculation. Each man can follow the method that suits him, depending on the type of premature ejaculation he suffers from (primary or secondary), the presence or absence of other sexual disorders (erectile dysfunction in this case) and the interaction with the partner within the couple in general.
What are the right questions to ask your doctor when diagnosing premature ejaculation? Can you handle them?
How is premature ejaculation diagnosed?
Although they suffer seriously from premature ejaculation disorder, few men try to find and follow medical treatment. As specialists in this field, doctors are able to make the right diagnosis, determine the source of the problem and recommend the appropriate treatment. That said, if you think you may be affected by this disorder, a diagnosis of premature ejaculation should be considered.
See a doctor for a diagnosis
By asking specific questions about the patient’s sexual experiences (frequency, context, history…), the doctor can determine whether the fear of premature ejaculation itself can be considered as a possible cause. Otherwise, if you are affected by the problem of premature ejaculation in a more “serious” way, your GP will be able to refer you, if necessary, to a sexologist, or even a urologist, depending on your case.
In general, doctors will only refer to premature ejaculation if it occurs less than two minutes after penetration, and the couple suffers as a result. However, the diagnosis of premature ejaculation can sometimes be very difficult to make, as desire can vary from one man to another. While you may think that 5 minutes’ intercourse is enough for you, other men only talk of satisfactory intercourse after a quarter of an hour.
If, however, you’re not sure whether you’re suffering from premature ejaculation, consider a visit to the doctor. Here are a number of symptoms that may indicate whether you really are suffering from this disorder:
- Your partner constantly complains that you come too quickly.
- If you ejaculate in less than two minutes each time, you probably suffer from premature ejaculation.
- Ejaculation control: No matter how long it lasts, if you notice that you’re losing control of your ejaculation, you should be concerned.
Preparing for an appointment to diagnose premature ejaculation
Because the appointment can be brief, and because there are often a significant number of questions to answer, it’s a good idea to be well prepared.
Here are a few tips to help you prepare before you go to see your doctor.
Follow these steps to prepare for your appointment:
- Know what you need to do in advance. The day before your appointment, be sure to ask if there’s anything you need to do (or not) beforehand. For example, your doctor may ask you not to eat in order to carry out a blood test;
- Note any symptoms you may have noticed, including those that may seem unrelated to premature ejaculation;
- Write down key personal information, such as important constraints or recent changes in your life;
- Make a list of all medications, vitamins, remedies and herbal supplements you are currently taking. This may be the source of the problem;
- Ask your partner to accompany you. His or her presence is very important – it’s a condition that’s best treated by both of you;
- Write down the questions you want to ask your doctor. You certainly have some, and you shouldn’t miss the opportunity to ask them!
The right questions to ask your doctor about ejaculation
Your time with your doctor is limited and, above all, precious! If you don’t want the bill to be large, prepare a list of questions to make the most of your appointment. If you’re wondering about premature ejaculation disorder, there are some essential questions to ask your doctor:
- What is the most likely cause of my ejaculation problems?
- Apart from the most likely cause, are there any other possible causes?
- What kind of tests can I have done?
- Is my problem temporary or chronic?
- What’s the best treatment?
- What alternatives are there to the treatment you propose?
- I have other health problems. How can I manage them at the same time?
- Do I need to see a specialist?
- How much does it cost?
- Does my social security cover the cost of seeing this specialist?
- Is there a generic alternative to the drug you’re prescribing?
- Do you have any brochures or other material I can consult at home?
- What websites can you recommend?
In addition to all these questions, don’t hesitate to ask additional questions at your appointment.
Come on, relax! This is just a medical interview with your doctor, for a possible diagnosis of premature ejaculation. It’s important to get over your embarrassment and talk about your disorder as a couple, to try and understand the cause, because there is a treatment for it anyway.
Once the problem and its causes have been identified, let’s get down to business…
Some treatments for premature ejaculation
Premature ejaculation doesn’t necessarily require medical treatment, as it’s not considered an illness: rather, it’s a sexual disorder that can be cured. However, if the suffering is great and significant, treatment may be useful and strongly recommended.
To delay premature ejaculation, a number of well-known methods have been adopted. These include psychotherapeutic treatments, physical exercises and specific medications.
Psychotherapeutic methods to delay ejaculation
Psychotherapeutic treatment for premature ejaculation includes the following techniques:
- Sex therapy;
- Behavior therapy;
- Couple or family therapy.
It’s best if the partner is involved in the treatment. This is essential, as the problem of premature ejaculation affects the lives of both partners.
In general, psychotherapy is a very important option for reducing stress and anxiety. It’s a good tool for breaking the vicious circle of the problem.
Treatment involves reducing the pressure men feel about their sexual performance, and changing their thinking and behavior patterns. In other words, through psychotherapy, the man reconciles with himself, so to speak, in order to move forward.
Slowing down ejaculation manually
Techniques have long been tried and tested by men throughout history. Some have discovered, for example, that masturbating at a certain frequency, or just before intercourse, saves them a few precious minutes before reaching their second orgasm. In fact, it’s a way of “getting rid” of the first ejaculation, which tends to be premature.
On the other hand, other men have turned to certain techniques which still require regular training, such as the Stop-&Go method and the squeeze technique. These are exercises that help men learn to anticipate and control the moment of ejaculation. It’s not easy enough to stop the sensation of orgasm rising towards the glans, but it becomes possible with habit and, above all, perseverance!
The Stop-and-Go method
With the Stop-and-Go method, a man can learn to better control his arousal and thus delay ejaculation.
To do this, the man masturbates normally, but has to stop just before the point of no return (not easy, is it?), until the excitement wears off.
Then he starts masturbating again. This technique should be repeated until the man can control the moment of ejaculation as well as possible.
Stop-and-go can also be practised during intercourse, but to avoid embarrassing your partner, it’s best to do it alone.
The Squeeze method
The Squeeze method is, in fact, a logical continuation of the Stop-and-Go exercise and also serves to delay the moment of ejaculation.
On the one hand, by interrupting the sexual act just before orgasm, the man anticipates the precise moment of accidental ejaculation and is able to control it afterwards.
Secondly, he applies pressure to the glans with his thumb, index and middle fingers.
The aim is to block the flow of blood to the penis and interrupt the ejaculation mechanism, thereby delaying it.
Medication to delay ejaculation
When psychotherapy and manual techniques prove insufficient to combat premature ejaculation, drug treatment may prove useful.
Serotonin
Selective Serotonin Reuptake Inhibitors (SSRIs) affect neurotransmitters in the male brain. Doctors prescribe them mainly to treat cases of depression, but they can also delay arousal and thus the moment of ejaculation.
However, these drugs are not primarily designed to treat premature ejaculation. Nevertheless, they are sometimes used because of their efficacy.
For several years now, drugs specifically approved for the treatment of premature ejaculation have been on the market.
These drugs should only be taken when necessary. They should not be taken on a daily basis. And, unfortunately, health insurance companies do not cover this type of treatment.
There are also special creams and gels containing a local anesthetic. These formats are sometimes used to treat premature ejaculation. Before intercourse, the man applies the cream or gel to the glans penis, making it less sensitive. However, in addition to delaying ejaculation, these agents can also reduce the partner’s arousal. It is therefore recommended that condoms be used in conjunction with these formats.
Drug treatment can delay ejaculation, but the causes of premature ejaculation are not systematically resolved by these drugs. Medication generally only relieves symptoms.
In the case of primary premature ejaculation, on the other hand, drugs act directly on the origin of the disorder, and can thus effectively cure the problem.
At the end of this presentation, we will have reviewed the different approaches known and used to treat premature ejaculation disorder. You now know (in addition to what you already knew, no doubt) that premature ejaculation is entirely treatable, and that it’s more successful when you get involved and believe in it like… iron!
