A premature ejaculation it is a problem that affects many men and even their partners and sexual partnerships. Why does it happen? Is it caused by psychological or physical issues?
Learn in this text se Premature ejaculation has a cure?
What is premature ejaculation?
It is very complicated to define how much time is enough for a person to come and if this time is normal. Therefore, ddefining what is premature ejaculation or rapid ejaculation can be somewhat complex.
Usually, in medical publications from a while ago, the problem was explained when a man ejaculated before the time necessary for the couple's satisfaction. However, that's not exactly the point, as people have different times to reach orgasm.
The concept of premature ejaculation has varied a lot over time, however, currently, the International Society of Sexual Medicine considers that a man has premature ejaculation if he cannot control ejaculation, his intercourse time is around 1 to 2 minutes and if this problem causes problems to the couple's quality of life.
Premature ejaculation: symptoms and more and less severe cases
In addition, for a man to consider that he has premature ejaculation, the fact must not be isolated, the situation tends to repeat itself in practically all of his sexual relationships, whether with the same partners or different people.
According to the American Urological Association, about 1 in 3 men between the ages of 18 and 59 have some degree of premature ejaculation. In Brazil, according to data from the Brazilian Society of Urology, the statistics are practically the same: it will affect 1 in 4 men.
According to the American Urological Association:
In many cases, the problem of orgasm time in sexual intercourse is not even the man's, for example, if the partner has anorgasmia, that is, it is difficult to reach climax.
Thus, the man's orgasm time will always be shorter than the woman's, and he may be stigmatized as if he had ejaculation, but, in fact, he doesn't.
Therefore, in order to define a time that characterizes premature ejaculation, many studies were carried out. Still, this time will vary from study to study.
However, in several countries, the duration of sexual intercourse considered normal, with penetration and before ejaculation, can vary from an average of 5 to 15 minutes. Average time 5 to 7 minutes.
How does the ejaculation mechanism work?
Ejaculation is controlled by the central nervous system and is the third stage in the stages of sexual intercourse..
When men are sexually stimulated, signals are sent to the brain in the direction of the reproductive organs.
Firstly, the libido (sexual desire) is activated, then the excitement appears, which activates the erection, and in the sequence, it is the orgasm that, in most cases, coincides with the ejaculation that, in fact, is about a reflection.
Ejaculation is divided into two phases: emission and expulsion of semen.. On emission, the sperm produced moves to mix with seminal fluid, form semen, and then travel to the posterior urethra. The man feels this process taking place within him as the excitement grows.
In the expulsion phase, contraction of the muscular part of the prostate and the bladder neck of the bladder expels the semen upon reaching maximum excitation.
The control of this process is by the central nervous system and is mediated by serotonin which, in high amounts, increase the time until ejaculation, while in low amounts, it shortens the time until ejaculation.
Therefore, in some cases ejaculation without orgasm may occur, for example, in patients with motor impairments (paraplegics).
In these patients, as the sensitivity of the penis is impaired, if it receives some stimuli, it will ejaculate reflexively without having any sexual context.
Categories of patients with premature ejaculation
From the studies, 4 categories of premature ejaculation patients were defined:
- Patient with primary rapid ejaculation, that is, he has always had the problem since he started his sex life. In this case, he may have genetic alterations of serotonin receptors or reuptake mechanisms and is usually the most serious case;
- Patient with secondary or acquired premature ejaculation. Before, he always controlled, but for some reason he didn't know anymore how to prevent premature ejaculation. It could be a symptom of erectile dysfunction. Patients who have prostatitis, hormonal changes (such as hyperthyroidism or are taking high doses of testosterone) or psychogenic variations also enter secondary premature ejaculation;
- Patients with natural variation, in some episodes, due to stress or other problems, they do not know how to control premature ejaculation, but over time, when this phase passes, it will naturally improve;
- Patients who complain about the ejaculatory time itself, don't know how to control ejaculation, but actually, they don't meet the criteria for rapid ejaculation. These patients may have penetration time of 5, 7, 10 minutes or more, however, they want to extend this time longer. There are mechanisms to improve this time. But truly, he does not have what is called premature ejaculation.
What causes premature ejaculation?
Rapid ejaculation has nothing to do with age, although it is quite common in adolescence, it can occur with young people and even mature men.
What causes premature ejaculation are several physical factors, such as those already mentioned above and also others, such as prostate and thyroid diseases, spinal injury, alcohol abuse or even medication.
In addition, premature ejaculation can also be the result of psychological factors, such as:
- Performance anxiety;
- Stress;
- Depression;
- Lack of confidence;
- Fault;
- History of sexual repression;
- Relationship problems, etc.
How to stop premature ejaculation?
This pathology has treatment and there are many ways to know how to control premature ejaculation, either for problems with psychological issues or even those who have receptor problems.
Treatment for premature ejaculation may involve therapy or medication (oral or topical), everything will depend on the cause that led the patient to develop the problem. In cases of erectile dysfunction, when treating impotence, it is also possible to verify that premature ejaculation is curable.
Understand how to treat premature ejaculation with the solutions below:
Psychotherapy
Psychological factors can be the cause of premature ejaculation, but they can be a consequence if the patient has other causes as a basis. The fact of ejaculating quickly can generate psychological mechanisms of low self-esteem, insecurity and anxiety in many men.
When the problem occurs due to anxiety, it is very important to seek psychotherapeutic help.
talk about the problem can help the patient a lot, and therapy can make the man more relaxed, recognizing that he has no serious problem, he just needs to develop more tranquility and emotional stability at the time of sex.
Thus, if he does not have any associated physical problem, in therapy, the man can understand how to avoid premature ejaculation .
But for that, it is important for a psychotherapist to be careful when going into details of the patient's sexual life. The man should know that the questions are not out of curiosity, but to understand the patient's sexual context in order to help and find a solution for him.
This psychological treatment can also be combined with some medication.
oral medication
Serotonin reuptake inhibitors
The only FDA-approved premature ejaculation drug is dapoxetine., which is a selective serotonin reuptake inhibitor.
It increases serotonin in the neural plate and will prolong ejaculatory time. It should be used between 1 to 3 hours before sexual intercourse, that is, use is on demand.
This medication needs a prescription, prescribed by a specialist (andrologist/urologist). In addition, the dosage must also be indicated by the doctor who, in some cases, may associate the use of another type of medication.
Other antidepressant medications are also used for the treatment of early education, but they are not approved by the FDA for the specific purpose of treating this sexual problem. Examples of these medications are paroxetine and clomipramine.
Phosphodiesterase 5 Inhibitors
The main examples are Tadalafil and Sildenafil. These medications generally promote a more potent erection, allowing the man to relieve performance anxiety and have better ejaculatory control.
Alternatively, tramadol hydrochloride, which is a strong analgesic, can be used to delay ejaculation. in exceptional cases.
topical remedy
Another medication that can help the patient understand how to control premature ejaculation is for topical use, it can be a gel or spray.
These medications are a mixture of topical anesthetics and with the right amount of prescriptions, they will cause a decrease in local sensitivity, which will cause a prolongation of the ejaculatory time. For this solution, medical advice is also required.
The only problem with this ointment for premature ejaculation is that it can cause a greater anesthetic effect on the penis — or even anesthetize the partner — and the man may lose the feeling of pleasure and, thus, also lose his erection at the time of intercourse. sexual.
Therefore, the indication is that it be used with condoms, to avoid this problem. Some condoms are also equipped with retardant gel.
injectables
Intracavernous therapy consists of applying medication to the penis to make the organ rigid. It is used as a treatment for erectile dysfunction. However, this treatment should be prescribed as an exception for premature ejaculation.
Many clinics may indicate this treatment as a routine for rapid ejaculation, but great care must be taken with this solution used indiscriminately.
Penis injection should not be used as a cure for premature ejaculation, it is for patients who have already used other methods to try to control the problem that manifests itself in a very serious degree, and have not been successful in other ways.
What will happen is that the injection will delay ejaculation a little, but the patient will still be able to ejaculate earlier than desired, however, the penis will remain erect and give the opportunity to satisfy the partner.
Is premature ejaculation curable with surgery?
Many patients think that circumcision or other types of surgery, such as neurotripsy (burning the nerves to try to delay ejaculation), can cure the problem. These surgeries do not have good results for this purpose.
It is even necessary to be very careful with neurotripsy, which can only be carried out as part of studies, in an experimental way. The surgery will leave the penis with very low and irreversible sensitivity. It is not recommended by medical societies.
Do you have home remedy for premature ejaculation?
There are no home remedies for this problem, but if a man thinks of some exercise for premature ejaculation, he can do the strengthening of the pelvic floor, because the weakness in the muscles in this region can impair the ability to delay orgasm.
For this, you can do a test when trying to interrupt the flow of the urine jet, in this way you will be able to identify exactly the musculature of the pelvic floor. And practice at other times outside of urination, contracting these muscles for 3 seconds, then releasing and relaxing for 3 seconds, and continuing to contract and relax for several times in a row. Do not keep doing the exercises during urination as it can have consequences on the bladder.
Men can do this workout in any position, whether lying down or standing up, three times a day.
Another important tip is that the man should try to know his own body. Thus, when he is masturbating he can try to recognize the signs prior to the moment of orgasm. Thus, he will be able to train to delay the orgasm, interrupting the stimuli.
But to avoid premature orgasm, a man can also masturbate 1 to 2 hours before he knows he can have sexual intercourse.
Another way to try to hold back the moment of climax is to squeeze the penis close to the glans to reduce the excitement.
In addition, condom use can also decrease penis sensitivity and help delay ejaculation a little.
Conclusion
If you have that question: “How do I know if I have premature ejaculation?”, “Is there treatment for premature ejaculation?” , “Is there a cure for premature ejaculation?”, etc., consult a specialist.
The doctor will help you understand premature ejaculation, assess the causes, listen to your problem and indicate how to treat it.
Thus, fruitless internet searches for home remedies for premature ejaculation or other attempts at other controversial methods that will not be effective are avoided. The urologist/andrologist will always research the best solution for each patient.
Dr. Marco Túlio Cavalcanti Urologist and Andrologist. Erectile Dysfunction and Sexual Impotence: put an end to this torment. Penis Prosthesis: the resumption of your sex life. Peyronie's disease: correction of curvature, recovery of the size and caliber of the penis. Hormone Replacement: resume your performance.
Instagram: @dr.mtcavalcanti
Youtube: Dr. Marco Tulio Cavalcanti
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7 comments on “Premature ejaculation: causes, studies and treatments”
Hello doctor! I really like your videos and how you detail the topics you cover.
Very good, helped clarify a lot of doubts
I have premature ejaculation, how can I solve it??
It's worth scheduling a consultation with me or my team, so we can carry out the assessment, follow-up and talk in detail about your case.
The consultation can be in person or online (telemedicine).
To schedule a quote: WhatsApp 📲(011) 2533-6152 or via the website https://www.drmarcotuliourologista.com.br/
Pour résoudre le problème de l'ejaculation precoce, faudra consult un herboriste?
Je vous propose de prendre rendez-vous avec moi ou mon équipe afin que nous puissions procéder à l'évaluation, au suivi et discuss en détail de votre cas.
The consultation can be done in person or online (telémédecine).
Pour planifier un devis: WhatsApp 📲(011) 2533-6152 or via the website https://www.drmarcotuliourologista.com.br/
Hello
Je suis âgée 35 ans,et depuis 2 ans je souffre d'éjaculation précoce. Bien avant ça j'ai été victime des hemorrhoids externales 5ans avant. Depuis j'ai du mal à retrouver mes performances sexuelles malgré different traitements, je n'arrive plus à faire plus de 5mn pendant les rapports et cela me déshonore