What Is Premature Ejaculation?

Premature ejaculation, is a fairly common sexual health problem in which men ejaculates too soon during the act of sexual intercourse (1). Although, actual statistics are not known, but it is believed that approximately 1 of 3 men suffers from premature ejaculation. According to another study reported in the European Urology journal (2), investigators suggested that approximately 20-30% males experience premature ejaculation, warranting some form of therapy.

It is imperative to mention that occasional episodes of premature ejaculation (PE) does not demand any type of treatment or management; however, if you are continuously experiencing PE, you should see a doctor for prompt management.

What Are Some Classic Symptoms Of Premature Ejaculation?

As the name suggests, the classic symptom or clinical presentation of premature ejaculation is specific for ‘ejaculating in under one minute of vaginal penetration’.  Premature ejaculation is classified into two types, primary (lifelong) or secondary (acquired) premature ejaculation (3).

• Lifelong premature ejaculation means that you have been facing this problem since your very first sexual intercourse.
• Acquired premature ejaculation suggests that previously there were no ejaculatory issues (suggesting a recent injury or ailment).

Clinical studies indicates that males who experience premature ejaculation also complaints of other sexual disorders such as poor libido, low sex drive, anorgasmia and erectile dysfunction (2).

What Are Some Common Causes Of Premature Ejaculation (PE)?

Male ejaculatory function are complex and involves an interplay of physiological and psychological factors. Various clinical and research studies indicates that misalignment or an imbalance between psychological and physical factors can lead to premature ejaculation. Some common causes include:

Psychological Factors:

• Anxiety: Men who are anxious are more likely to experience premature ejaculation, according to a new study. This is regardless of the nature of anxiety (i.e. sexual performance related anxiety or work/ professional life related anxiety). For example, according to a new study reported in European Urology (2), investigators suggested that men who suffers from erectile dysfunction are very anxious about maintaining an erection for longer periods of time. The fear to lose erection often makes them ejaculate too soon, consciously or unconsciously; thereby presenting as PE.
• Relationship issues: If you are experiencing frequent episodes of premature ejaculation after entering in a new relationship (and had fewer/ occasional episodes in your previous relationship) then there is great deal of possibility that issues between you and your current partner are causing premature ejaculation. Knowing what is causing/ triggering PE can help in devising reliable solutions for optimal management.
• Feeling of guilt: Pattern of rushing to ejaculate increases when you are guilty about something; for example an extramarital affair, engaging in intercourse at a public place etc.

Physiological Factors:

Besides the above listed psychological factors, physiological factors can also play a major role in the pathogenesis of PE; classic ones are:

• An imbalance of hormones and neurotransmitters
• Abnormality in reflex activity of the ejaculatory system
• Inflammation or infection involving prostate and urethra
• Chronic thyroid dysfunction
• Hereditary factors
• Significant damage or injury to a major nerve during a surgery or trauma

Learn More About The Pathophysiology Of Premature Ejaculation

It is very important to learn about pathophysiology and risk factors of premature ejaculation in order to address this problem appropriately.

Certain risk factors that are strongly linked to PE are:

• Chronic mental Stress: Mental strain contribute to premature ejaculation because anxiety or psychological stress limits the ability to focus on the sexual encounter and may interferes with the ability to control sensations.
• Other Sexual disorders: Certain sexual problems (such as erectile dysfunction, orgasmic dysfunction etc.) can also aggravate the risk of premature ejaculation; partly due to an ongoing underlying issue and partly due to added stress and anxiety caused by PE.
• Associated health problems: Several medical and chronic health issues like heart disease, uncontrolled diabetes etc. can also lead to anxiety during sexual intercourse, which may result in PE (4).

You must keep in mind that quick ejaculation on occasional basis doesn’t mean that you have sexual problem. Premature ejaculation can be due to naturally occurring variations, and is characterized by periods of premature ejections in between normal ejaculations.

References

1. Malavige, L. S., & Jayawickrema, S. (2015). Premature ejaculation and its management. Sri Lanka Journal of Diabetes Endocrinology and Metabolism, 5(1).

2. Porst, H., Montorsi, F., Rosen, R. C., Gaynor, L., Grupe, S., & Alexander, J. (2007). The Premature Ejaculation Prevalence and Attitudes (PEPA) survey: prevalence, comorbidities, and professional help-seeking. European Urology, 51(3), 816-824.

3. Hatzimouratidis, K., Amar, E., Eardley, I., Giuliano, F., Hatzichristou, D., Montorsi, F., … & Wespes, E. (2010). Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. European urology, 57(5), 804-814.

4. Patrick, D. L., Althof, S. E., Pryor, J. L., Rosen, R., Rowland, D. L., Ho, K. F., … & Jamieson, C. (2005). ORIGINAL RESEARCH—EJACULATORY DISORDERS: Premature Ejaculation: An Observational Study of Men and Their Partners. The journal of sexual medicine, 2(3), 358-367.