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Encyclopedia > Premature ejaculation
Premature ejaculation
Classification and external resources
ICD-10 F52.4
ICD-9 302.75
MedlinePlus 001524
eMedicine med/643 

Premature ejaculation (PE), also known as, rapid ejaculation, rapid climax, premature climax or early ejaculation, is the most common sexual problem in men, affecting 25%-40% of men. It is characterized by a lack of voluntary control over ejaculation. Masters and Johnson stated that a man suffers from premature ejaculation if he ejaculates before his sex partner achieves orgasm in more than fifty percent of their sexual encounters. Other sex researchers have defined premature ejaculation as occurring if the man ejaculates within two minutes of penetration; however, a survey by Alfred Kinsey in the 1950s demonstrated that three quarters of men ejaculate within two minutes of penetration in over half of their sexual encounters. Today, most sex therapists understand premature ejaculation as occurring when a lack of ejaculatory control interferes with sexual or emotional well-being in one or both partners. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // F00-F99 - Mental and behavioural disorders (F00-F09) Organic, including symptomatic, mental disorders (F00) Dementia in Alzheimers disease (F01) Vascular dementia (F011) Multi-infarct dementia (F02) Dementia in other diseases classified elsewhere (F020) Dementia in Picks disease (F021) Dementia in Creutzfeldt-Jakob disease (F022) Dementia in Huntingtons... The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Ejaculation is the ejecting of semen from the penis, and is usually accompanied by orgasm. ... Time magazine, May 25, 1970 The Masters and Johnson research team, made up of William Masters and Virginia E. Johnson, pioneered research into the nature of human sexual response and the diagnosis and treatment of sexual disorders and dysfunctions from 1957 until the 1990s. ... Ejaculation is the ejecting of semen from the penis, and is usually accompanied by orgasm. ... An orgasm (sexual climax) is the conclusion of the plateau phase of the sexual response cycle, and may be experienced by both males and females. ... Sexology is the systematic study of human sexuality. ... Sexual penetration (as opposed to outercourse) typically involves the insertion of the penis into a bodily orifice. ... Alfred Charles Kinsey (June 23, 1894 – August 25, 1956), was an American biologist and professor of entomology and zoology who in 1947 founded the Institute for Research in Sex, Gender and Reproduction at Indiana University, now called the Kinsey Institute for Research in Sex, Gender and Reproduction. ... The 1950s decade refers to the years of 1950 to 1959 inclusive. ...


Most men experience premature ejaculation at least once in their lives. Often adolescents and young men experience premature ejaculation during their first sexual encounters, but eventually learn ejaculatory control. Because there is great variability in both how long it takes men to ejaculate and how long both partners want sex to last, researchers have begun to form a quantitative definition of premature ejaculation. Current evidence supports an average intravaginal ejaculation latency time (IELT) of six and a half minutes in 18-30 year olds.[1][2] If the disorder is defined as an IELT percentile below 2.5, then premature ejaculation could be suggested by an IELT of less than about one and a half minutes.[3] Nevertheless, it is well accepted that men with IELTs below 1.5 minutes could be "happy" with their performance and do not report a lack of control and therefore do not suffer from PE. On the other hand, a man with 2 minutes IELT could present with perception of poor control over his ejaculation, distressed about his condition, has interpersonal difficulties and therefore be diagnosed with PE.

Contents

Possible psychological and environmental factors

Psychological factors commonly contribute to premature ejaculation. While men sometimes underestimate the relationship between sexual performance and emotional well-being[who?], premature ejaculation can be caused by temporary depression, stress over financial matters, unrealistic expectations about performance, a history of sexual repression, or an overall lack of confidence. Interpersonal dynamics strongly contribute to sexual function, and premature ejaculation can be caused by a lack of communication between partners, hurt feelings, or unresolved conflicts that interfere with the ability to achieve emotional intimacy. Neurological premature ejaculation can also lead to other forms of sexual dysfunction, or intensify the existing problem, by creating performance anxiety. In a less pathological context, premature ejaculation could also be simply caused by extreme arousal. On the Threshold of Eternity. ... For other uses, see Emotion (disambiguation). ... Sexual dysfunction or sexual malfunction (see also sexual function) is difficulty during any stage of the sexual act (which includes desire, arousal, orgasm, and resolution) that prevents the individual or couple from enjoying sexual activity. ...


Recent research has also investigated the role of factors involving the female partner. One study of young married couples (Tullberg, 1999) reported that the husband's IELT seems to be affected by the phases of the wife's menstrual cycle, the IELT tending to be shortest during the fertile phase. Other studies suggest that young men with older female partners reach the ejaculatory threshold sooner, on average, than those whose partners are their own age or younger[citation needed]. Menstrual cycle In the female reproductive system, the menstrual cycle is a recurring cycle of physiologic changes that occurs in reproductive-age females. ... Ovulation is the process in the menstrual cycle by which a mature ovarian follicle ruptures and discharges an ovum (also known as an oocyte, female gamete, or casually, an egg) that participates in reproduction. ...


Possible physical factors

Science of mechanism of ejaculation

The physical process of ejaculation requires two sequential actions: emission and expulsion.

Mechanism of Ejaculation

The emission phase is the first one to happen and it involves deposition of seminal fluid from ampullary vasa deferens, seminal vesicles & prostate gland into posterior urethra.[4] Second phase is the expulsion of semen which involves closure of bladder neck followed by the rhythmic contractions of urethra by pelvic-perineal and bulbospongiosus muscle and intermittent relaxation of external Sphincter urethrae.[5] Today it is believed that the neurotransmitor serotonin (5HT) has a central role in modulating ejaculation. Several animal studies have demonstrated its inhibitory effect on ejaculation modulated through the PGI system in the brain. Therefore, it is perceived that low level of serotonin in the synaptic cleft in these specific areas in the brain could cause premature ejaculation. This theory is further supported by the proven effectiveness of SSRIs, which increase serotonin level in the synapse, in treating PE. Image File history File links Size of this preview: 800 × 600 pixelsFull resolution (960 × 720 pixel, file size: 71 KB, MIME type: image/jpeg) Description:Biological Mechanism of Ejaculation Source: own work date: 5/15/07 Author: Dchance I, the creator of this work, hereby release it into the public... Image File history File links Size of this preview: 800 × 600 pixelsFull resolution (960 × 720 pixel, file size: 71 KB, MIME type: image/jpeg) Description:Biological Mechanism of Ejaculation Source: own work date: 5/15/07 Author: Dchance I, the creator of this work, hereby release it into the public... Horse semen being collected for breeding purposes. ... In anatomy, the urethra (from Greek ουρήθρα - ourethra) is a tube which connects the urinary bladder to the outside of the body. ... Bulbospongiosus is one of the superficial muscles of the perineum. ... The urethral sphincter is a collective name for the muscles used to control the flow of urine from the urinary bladder. ... For the professional wrestling stable, see Ravens Nest#Serotonin. ...


Sympathetic motor neurons control the emission phase of ejaculation reflex and expulsion phase is executed by somatic and autonomic motor neurons. These motor neurons are located in the thoracolumbar and lumbosacral spinal cord and are activated in a coordinated manner when sufficient sensory input to reach the ejaculatory threshold has entered the central nervous system.[6][7] Ejaculation is the ejecting of semen from the penis, and is usually accompanied by orgasm. ... The Spinal cord nested in the vertebral column. ... A diagram showing the CNS: 1. ...


Several areas in the brain, and especially the nucleus paragigantocellularis, have been identified to be involved in ejaculatory control.[8] Scientists have long suspected a genetic link to certain forms of premature ejaculation. In one study, ninety-one percent of men who suffered from lifelong premature ejaculation also had a first-relative with lifelong premature ejaculation. Other researchers have noted that men who suffer from premature ejaculation have a faster neurological response in the pelvic muscles. Simple exercises commonly suggested by sex therapists can significantly improve ejaculatory control for men with premature ejaculation caused by neurological factors[citation needed]. Often, these men may benefit from anti-anxiety medication or selective serotonin reuptake inhibitors (SSRIs), such as sertraline or paroxetine, as these slow down ejaculation times[1]. Some men prefer using anaesthetic creams, however, these creams may also deaden sensations in the man's partner, and are not generally recommended by sex therapists. This article is about the general scientific term. ... Anxiety is a physiological state characterized by cognitive, somatic, emotional, and behavioral components[1]. These components combine to create the feelings that we typically recognize as anger and known as fear, apprehension, or worry. ... Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressants. ... Zoloft bottles, with blue and green tablets Sertraline hydrochloride (also sold under brand names Zoloft, Lustral, Apo-Sertral, Asentra, Gladem, Serlift, Stimuloton, Xydep, Serlain, Concorz) is an antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. ... Paroxetine (Paxil, Seroxat, Pexeva) is a selective serotonin reuptake inhibitor (SSRI) antidepressant. ...


Diagnosis

Diagnostic criteria for Premature Ejaculation DSM-IV-TR (American Psychiatric Association)


A. Persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it. The clinician must take into account factors that affect duration of the excitement phase, such as age, novelty of the sexual partner or situation, and recent frequency of sexual activity. The frequency of sexual activity of humans is determined by several parameters, and varies greatly from person to person, and within a persons lifetime. ...


B. The disturbance causes marked distress or interpersonal difficulty.


C. The premature ejaculation is not due exclusively to the direct effects of a substance (e.g., withdrawal from opioids).


Differential diagnosis

Premature ejaculation should be distinguished from erectile dysfunction related to the development of a general medical condition. Some individuals with erectile dysfunction may omit their usual strategies for delaying orgasm. Others require prolonged noncoital stimulation to develop a degree of erection sufficient for intromission. In such individuals, sexual arousal may be so high that ejaculation occurs immediately. Occasional problems with premature ejaculation that are not persistent or recurrent or are not accompanied by marked distress or interpersonal difficulty do not qualify for the diagnosis of premature ejaculation. The clinician should also take into account the individual's age, overall sexual experience, recent sexual activity, and the novelty of the partner. When problems with premature ejaculation are due exclusively to substance use (e.g., opioid withdrawal), a substance-induced sexual dysfunction can be diagnosed.


Ejaculation disorder types

  • Premature ejaculation -Ejaculation occurs very early
  • Retarded ejaculation -Ejaculation takes a long time
  • Retrograde ejaculation -Semen flows from the prostate gland into the bladder rather than spurting out of the penis
  • Inhibited orgasm in males[9]

Treatment

In mundane cases, treatments are focused on gradually training and improving mental habituation to sex and physical development of stimulation control. In clinical cases, various medications are being tested to help slow down the speed of the arousal response.


Masters and Johnson recommended a start and stop technique to increase the time till ejaculation. This requires a great deal of couple cooperation and communication and may be difficult for some.


Medications

Serotonergic medications, such as SSRIs can delay ejaculation.[10][11] SSRIs are commonly used as anti-depressants. Examples include Prozac, Zoloft, Celexa, Effexor, and Lexapro.


William Francis Ganong (physiologist), cited dietary 5-HTP as an alternative source to raising serotonin levels. Many supplements are available that contain 5-HTP, such as Detain X. William Francis Ganong (b. ... 5-HTP (5-Hydroxy-tryptophan) is decarboxylated to the neurotransmitter serotonin (5-HT) by the enzyme aromatic-L-amino-acid decarboxylase. ...


Devices

External latex rigid sheathes fastened to the body have been developed that cover all part of the penis during penetration so that the penis is protected from all the stimulation of the vagina. These help to gain control and to provide satisfaction to the partner. Masters and Johnson recommended the use of the Lateral coital position to help alleviate premature ejaculation. Time magazine, May 25, 1970 The Masters and Johnson research team, made up of William Masters and Virginia E. Johnson, pioneered research into the nature of human sexual response and the diagnosis and treatment of sexual disorders and dysfunctions from 1957 until the 1990s. ... The lateral coital position The lateral coital position is a sex position described by Masters and Johnson in their Human Sexual Response. ...


Natural Method

Successful premature ejaculation treatment is possible without pharmaceuticals using exercises concentrating on reconditioning the ejaculatory reflex and the patients ability to deal with sexual stimulation. Source Paul Lain cure premature ejaculation


See also

Delayed ejaculation, also known as retarded ejaculation and ejaculation incompetence, is the inability to ejaculate or persistent difficulty in achieving orgasm despite the presence of normal sexual desire and sexual stimulation. ...

References

  1. ^ Ejaculation delay: what's normal? [July 2005; 137-4]. Retrieved on 2007-10-21.
  2. ^ Waldinger MD, Quinn P, Dilleen M, Mundayat R, Schweitzer DH, Boolell M (2005). "A multinational population survey of intravaginal ejaculation latency time". The journal of sexual medicine 2 (4): 492-7. doi:10.1111/j.1743-6109.2005.00070.x. PMID 16422843. 
  3. ^ Waldinger MD, Zwinderman AH, Olivier B, Schweitzer DH (2005). "Proposal for a definition of lifelong premature ejaculation based on epidemiological stopwatch data". The journal of sexual medicine 2 (4): 498-507. doi:10.1111/j.1743-6109.2005.00069.x. PMID 16422844. 
  4. ^ Böhlen D, Hugonnet CL, Mills RD, Weise ES, Schmid HP (2000). "Five meters of H(2)O: the pressure at the urinary bladder neck during human ejaculation". Prostate 44 (4): 339-41. doi:10.1002/1097-0045(20000901)44:4<339::AID-PROS12>3.0.CO;2-Z. PMID 10951500. 
  5. ^ Master VA, Turek PJ (2001). "Ejaculatory physiology and dysfunction". Urol. Clin. North Am. 28 (2): 363-75, x. doi:10.1016/S0094-0143(05)70145-2. PMID 11402588. 
  6. ^ deGroat WC, Booth AM (1980). "Physiology of male sexual function". Ann. Intern. Med. 92 (2 Pt 2): 329-31. PMID 7356224. 
  7. ^ Truitt WA, Coolen LM (2002). "Identification of a potential ejaculation generator in the spinal cord". Science 297 (5586): 1566-9. doi:10.1126/science.1073885. PMID 12202834. 
  8. ^ Coolen LM, Olivier B, Peters HJ, Veening JG (1997). "Demonstration of ejaculation-induced neural activity in the male rat brain using 5-HT1A agonist 8-OH-DPAT". Physiol. Behav. 62 (4): 881-91. PMID 9284512. 
  9. ^ Premature Ejaculation. Premature Ejaculation and Male Orgasmic Disorder. Armenian Medical Network (2006). Retrieved on 2007-09-19.
  10. ^ Safarinejad, M. R., & Hosseini, S. Y. (2006). Pharmacotherapy for premature ejaculation. Current Drug Therapy, 1, 37-46.
  11. ^ SadeghiNejad, H., & Watson, R. (2008). Premature ejaculation: Current medical treatment and new directions. Journal of Sexual Medicine, 5, 1037-1050.
Postnatal Depression (also called Postpartum Depression and referred throughout this article by the acronym PPD) is a form of clinical depression which can affect women, and less frequently men, after childbirth. ... Wikinews has related news: Dr. Joseph Merlino on sexuality, insanity, Freud, fetishes and apathy Personality disorder, formerly referred to as a Character Disorder is a class of mental disorders characterized by rigid and on-going patterns of thought and action (Cognitive modules). ... Passive-aggressive behavior refers to passive, sometimes obstructionist resistance to following authoritative instructions in interpersonal or occupational situations. ... Kleptomania (Greek: κλέπτειν, kleptein, to steal, μανία, mania) is an inability or great difficulty in resisting impulses of stealing. ... Trichotillomania (TTM), or trich as it is commonly known, is an impulse control disorder characterized by the repeated urge to pull out scalp hair, eyelashes, facial hair, nose hair, pubic hair, eyebrows or other body hair. ... “Voyeur” redirects here. ... A factitious disorder or FD is a mental disorder where the ill individuals symptoms are either self-induced or falsified by the patient. ... This page refers to the self-inflicted factitious disorder. ... Egodystonic sexual orientation is an egodystonic condition. ... Two women in handcuffs and latex miniskirts and tops - Latex and PVC fetishism Wikinews has related news: Dr. Joseph Merlino on sexuality, insanity, Freud, fetishes and apathy Sexual fetishism is the sexual attraction for material and terrestrial objects while in reality the essence of the object is inanimate and sexless. ... Half-wit redirects here. ... Developmental disorders are disorders that occur at some stage in a childs development, often retarding the development. ... Specific developmental disorders categorizes specific learning disabilities and developmental disorders affecting coordination. ... Speech disorders or speech impediments, as they are also called, are a type of communication disorders where normal speech is disrupted. ... Expressive language disorder (DSM 315. ... For other uses, see Aphasia (disambiguation). ... Expressive aphasia, known as Brocas aphasia in clinical neuropsychology and agrammatic aphasia in cognitive neuropsychology, is an aphasia caused by damage to Brocas area in the brain. ... Receptive aphasia, also known as Wernickes aphasia, Fluent aphasia or sensory aphasia in clinical neuropsychology and cognitive neuropsychology, is a type of aphasia often (but not always) caused by neurological damage to Wernickes area in the brain. ... Landau-Kleffner syndrome (LKS), also called progressive epileptic aphasia, is a rare, childhood neurological syndrome characterized by the sudden or gradual development of aphasia (the inability to understand or express language) and an abnormal electroencephalogram (EEG). ... For the programming language, see Lisp (programming language). ... This article is about developmental dyslexia. ... Dysgraphia (or agraphia) is a deficiency in the ability to write, regardless of the ability to read, not due to intellectual impairment. ... Gerstmann syndrome is a neurological disorder. ... Developmental Dyspraxia is one or all of a heterogeneous range of psychological development disorders affecting the initiation, organization and performance of action[1]. It entails the partial loss of the ability to coordinate and perform certain purposeful movements and gestures in the absence of motor or sensory impairments. ... The diagnostic category pervasive developmental disorders (PDD), as opposed to specific developmental disorders (SDD), refers to a group of disorders characterized by delays in the development of multiple basic functions including socialization and communication. ... Autism is a brain development disorder characterized by impairments in social interaction and communication, and restricted and repetitive behavior, all exhibited before a child is three years old. ... Rett syndrome/ disorder is a neurodevelopmental disorder that is classified as a pervasive developmental disorder by the DSM-IV. Many[1] argue that this is a misclassification just as it would be to include such disorders as fragile X syndrome, tuberous sclerosis, or Down syndrome where one can see autistic... Asperger syndrome (also Aspergers syndrome, Aspergers disorder, Aspergers, or AS) is one of several autism spectrum disorders (ASD) characterized by difficulties in social interaction and by restricted and stereotyped interests and activities. ... Attention-Deficit Hyperactivity Disorder (ADHD), is a neurobehavioural developmental disorder[1] [2] [3] affecting about 3-5% of the worlds population under the age of 19[4]. It typically presents itself during childhood, and is characterized by a persistent pattern of inattention and/or hyperactivity, as well as forgetfulness... Conduct disorder is a psychiatric category to describe a pattern of repetitive behavior where the rights of others or the social norms are violated. ... Oppositional defiant disorder is a controversial psychiatric category listed in the Diagnostic and Statistical Manual of Mental Disorders where it is described as an ongoing pattern of disobedient, hostile, and defiant behavior toward authority figures that goes beyond the bounds of normal childhood behavior. ... Separation Anxiety redirects here. ... Selective mutism is a social anxiety disorder in which a person who is normally capable of speech is unable to speak in given situations. ... Reactive attachment disorder (RAD) is the diagnostic term for severe and relatively uncommon disorders of attachment that can affect children. ... A tic is a repeated, impulsive action, almost reflexive in nature, which the actor feels powerless to control or avoid. ... Tourette redirects here. ... Speech disorders or speech impediments, as they are also called, are a type of communication disorders where normal speech is disrupted. ... “Stutter” redirects here. ... Cluttering (also called tachyphemia) is a communicative disorder characterized by speech that is difficult for listeners to understand due to rapid speaking rate, erratic rhythm, poor syntax or grammar, and words or groups of words unrelated to the sentence. ...

  Results from FactBites:
 
PREMATURE EJACULATION (1943 words)
Premature ejaculation, according to Bancroft, is typically a younger man's problem, with the majority of cases involving men under the age of 30.
Rather, premature ejaculation seems to be typical of young, sexually inexperienced males who simply have not learned to slow down and modulate their arousal and to prolong the pleasurable process of making love.
It may be that premature ejaculators, who because of their problem keep their attention focused on how close they are to ejaculation during sexual activity, have trained themselves to be unusually accurate self-observers of arousal.
Lifespan's A - Z Health Information Library - Premature ejaculation (576 words)
Premature ejaculation occurs when a man orgasms during intercourse sooner than he or his partner wishes.
Premature ejaculation early in a relationship is most often caused by anxiety and overstimulation.
Chronic premature ejaculation may be a sign of anxiety or depression, both of which could be helped by psychiatric intervention.
  More results at FactBites »


 

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