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Premature ejaculation Causes and Risks:
The cause of premature ejaculation is primarily biological. The normal physical response is for the man to experience climax, and therefore, ejaculate approximately 2 to 3 minutes after penetrating the vagina . The normal physical response for women is to build to a climax, or orgasm, about 12 to 14 minutes after coitus (intercourse) occurs. However, many women may not experience orgasm at all, particularly if intercourse involves only penetration of the vagina by the penis . Other methods of sexual stimulation may be necessary for the woman to attain orgasm. It is estimated that about 10% of women do not experience orgasm under any circumstances or with any type of stimulation. Premature ejaculation may also be caused or aggravated by psychological factors such as guilt (believing the activity is sinful e.g., premarital or extramarital sex); fear (associated with concerns regarding potential pregnancy , sexually transmitted diseases, or getting caught or discovered); performance anxiety (especially in the inexperienced partner or with partners new to each other); and interpersonal issues affecting the couple.
Premature ejaculation is the most frequently encountered sexual complaint of men and couples. It is most common in adolescents, young adults, and other sexually naive males. Increased risk is associated with lack of sexual experience, lack of knowledge regarding normal male and female sexual responses, and with those individuals who highly associate psychological factors (such as fear, guilt, and anxiety) with sexual activity.
Prevention:
Attaining adequate knowledge regarding normal sexual responses of both males and females prior to engaging in sexual activity may prove useful in preventing this condition.
Premature ejaculation is less likely to occur if the couple engages in sexual activity in these situations: only after they know each other well, feel comfortable with one another, and both partners are consenting, without feeling coerced; in a comfortable, relaxed (not rushed) and private setting; and after contraception issues have been discussed, decided and acted upon by the couple.
Symptoms:
- ejaculation happens before the individual or couple would like. (This may range from before penetration to a point too soon after penetration for the couple to feel fully satisfied.)
Signs and Tests:
A physical examination is usually normal and abnormal finding are unlikely to be associated with the condition. Useful information is more likely to be obtained from interviewing the person or the couple.
Treatment:
It is critical that this issue be addressed with a health care provider with whom the person or couple can feel comfortable and openly discuss sexual behaviors and concerns.
Treatment may involve the provider simply explaining why premature ejaculation occurs, assuring the person or couple that it is a normal part of the male sexual response, and providing techniques that may assist the man in learning to delay ejaculation.
Such techniques may include:
The "stop and start" method: - This involves sexual stimulation until the man recognizes that he is about to ejaculate; the stimulation is then removed for about thirty seconds and then may be resumed. The sequence is repeated until ejaculation is desired, the final time allowing the stimulation to continue until ejaculation occurs.
The "squeeze" method - This involves sexual stimulation until the man recognizes that he is about to ejaculate; at that point, the man or his partner gently squeezes the end of the penis (where the glans meets the shaft) for several seconds, withholding further sexual stimulation for about 30 seconds, and then resuming stimulation. The sequence may be repeated by the person or couple until ejaculation is desired, the final time allowing the stimulation to continue until ejaculation occurs.
If pronounced psychological or interpersonal factors appear to be involved, professional counseling or psychotherapy may be necessary.
Prognosis:
In about 95% of cases, the man is able to learn ejaculatory control through education and practice of the simple techniques outlined.
Complications:
- Very early ejaculation, occurring prior to entry into the vagina , may prohibit a desired pregnancy .
- A continued lack of ejaculatory control may lead to sexual dissatisfaction on the part of either or both members of the couple and be a factor in sexual tension or discord in the relationship in general.
Call Your Healthcare Provider:
Call for an appointment with your health care provider if premature ejaculation is causing a problem and it does not respond to the methods described in the Treatment section.
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