Cause[ edit ] The causes of premature ejaculation are unclear. Many theories have been suggested, including that PE was the result of masturbating quickly during adolescence to avoid being caught, performance anxiety , an unresolved Oedipal conflict , passive-aggressiveness or having too little sex; but there is little evidence to support any of these theories.
However, studies have been inconclusive in isolating the gene responsible for Lifelong PE. Mechanism[ edit ] The physical process of ejaculation requires two actions: The emission is the first phase. It involves deposition of fluid from the ampullary vas deferens , seminal vesicles and prostate gland into the posterior urethra.
It involves closure of bladder neck, followed by the rhythmic contractions of the urethra by pelvic-perineal and bulbospongiosus muscle and intermittent relaxation of external urethral sphincters.
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.
Likewise, those with higher IELTs may consider themselves premature ejaculators, suffer from detrimental side effects normally associated with premature ejaculation, and even benefit from treatment. Diagnosis[ edit ] Premature ejaculation as a medical problem under evidence-based criteria generated by the International Society for Sexual Medicine in as being not the result of a nonsexual mental illness , a problem in a given relationship, or caused by medication, by the person ejaculating around a minute after penetration and before the person wants to ejaculate, occurring for a duration longer than 6 months and happening almost every time, and causing significant distress for person.
A combination of medication and non-medication treatments is often the most effective method. There is little evidence to indicate that it is effective and it tends to detract from the sexual fulfilment of both partners.
Other self-treatments include thrusting more slowly, withdrawing the penis altogether, purposefully ejaculating before sexual intercourse, and using more than one condom. Using more than one condom is not recommended as the friction will often lead to breakage. Some men report these to have been helpful.
It stated that the man suffers unconscious hostility toward women, so he ejaculates rapidly, which satisfies him but frustrates his lover, who is unlikely to experience orgasm that quickly. But even years of psychoanalysis accomplished little, if anything, in curing premature ejaculation. James Semans in Sensing it, they were to signal their partner, who squeezed the head of the penis between thumb and index finger, suppressing the ejaculatory reflex and allowing the man to last longer.
From the s to the s, sex therapists refined the Masters and Johnson approach, largely abandoning the squeeze technique and focused on a simpler and more effective technique called the "stop-start" technique. During intercourse, as the man senses he is approaching climax, both partners stop moving and remain still until the man's feelings of ejaculatory inevitability subside, at which point, they are free to resume active intercourse.
These include selective serotonin reuptake inhibitors SSRIs , such as paroxetine or dapoxetine , as well as clomipramine. Ejaculatory delay typically begins within a week of beginning medication. The treatments increase the ejaculatory delay to 6—20 times greater than before medication. Men often report satisfaction with treatment by medication, and many discontinue it within a year.
These are applied "as needed", 10—15 minutes before sexual activity and have fewer potential systemic side effects as compared to pills. Both treatments were developed in South Korea and are fairly common in this country, with Prevalence studies have indicated, however, that rates of PE are constant across age groups. The Kamasutra , the 4th century Indian sex handbook, declares: