Controlling Premature Ejaculation

I have seen many explanations of premature ejaculation in my time as a sex therapist, but never any explanation which relates to the concept of archetypal energies. We see the Lover as the archetype which determines how a man or woman expresses themselves in bed.

A man who has premature ejaculation could therefore be said to be in his inflated Lover energy. Premature ejaculation (PE) is a sexual problem the effect of which is that a man reaches climax in coitus too soon – before either he or his partner would wish him to do so.

Premature ejaculation is also called rapid ejaculation and tends to be shortened to PE. Sex experts Dr Masters & Virginia Johnston said PE was a male sexual dysfunction if a male achieves climax prior to his lover in more than 51% of the occasions they have intercourse.

Nowadays the most typical way to define early orgasm is when the male comes inside of two minutes after the moment of intromission – i.e. penetration, when many men with premature ejaculation actually ejaculate.

In fact, research by Dr Kinsey even in the mid part of the last century showed that almost 80% of men climax in less than two minutes after insertion of the penis in over 50% of all sex.

Quick climax may be separated into 2 or more forms. An example would be primary PE, which starts when a man first has makes love, and secondary PE, which is acquired somewhat later in life.

Early ejaculation might be sometimes also separated into “global PE”, a problem that happens with all partners, each time a man has sexual intercourse, and situational premature ejaculation – which occurs only with certain partners.

The majority of men starting their sexual exploration will most likely shoot their load very quickly. And, as you probably know, most men climax too soon occasionally during their sexual “career” -for example, when having illicit sex.

As there’s loads of variability in how long sex lasts before men ejaculate, and because the pleasures different lovers really want from sex are so personal, it’s probably almost impossible to even attempt to guess the level of this annoying dysfunction in the population at large.

Opinions vary from an unbelievably low 6% up to as much as 81%. As a result therapists have begun to work on a statistical and clear definition of early ejaculation. Current research supports a median time between penetration and ejaculation or intravaginal latency time of about 6.5 minutes in 18-30 year olds.

If rapid ejaculation is defined with reference to an IELT percentile below 2.5, then the term “premature orgasm” could indeed be applied to an ejaculation that happens within 2 minutes of sex starting.

However, it is entirely likely for men and their partners with extraordinarily limited self-control to be very comfortable about their lovemaking ability or be indifferent to their inadequate self-control. This seems hardly likely to give much pleasure to a woman who’s kindly agreed to make love to a man! (See this for advice on how to really please a woman in bed!)

Similarly males with much better ability to sustain intercourse may see themselves as fast comers, enduring annoying premature release and needing a good treatment program to control ejaculation even if the facts do not bear this out.

The physical mechanism of ejaculation needs two independent physical actions: they are known as emission and expulsion. Emission is the trigger for the release of semen. Emission includes the deposition of seminal fluid from the ampullary vas deferens and also the seminal vesicles. It is accompanied by an unmistakable sensation which announces imminent orgasm.

The prostate also secretes supportive fluids for sperm into the rear part of the urethral tube. Expulsion is the second phase of ejaculation. It includes sealing of the bladder neck, after which come the regular muscular contractions of the PC and pelvic muscles and intermittent contractions and relaxing of the exterior urethral sphincters.

Scientists believe that the neurotransmitter serotonin has a major role in controlling emission and ejaculation. Several studies on animals appear to have shown its inhibitory effect on the function of ejaculation. Due to this fact, it is acknowledged that lower than normal amounts of serotonin in the synaptic cleft in certain parts of the brain structure could cause rapid ejaculation.

This idea is further given credence by the confirmed efficacy of selective serotonin reuptake inhibitors (SSRIs) (which enhance serotonin levels in the synapse), in curing PE. Motor neurons of the sympathetic nervous system control the first phase of ejaculation, but the second phase is under the control of parasympathetic motor nerve cells.

These motor neurons are situated within the lumbosacral spinal cord and are activated in a highly co-ordinated way when sensory stimulation reaches the ejaculatory trigger.

Several areas in the brain structure, especially the nucleus paragigantocellularis, have conclusively been shown to be linked to control of ejaculation. Scientists have always suspected some kind of genetic link in specific types of premature ejaculation. Some evidence exists for this: In a single study, 91 percent of sexually active men who had global premature ejaculation had a first relative with global PE.

Other workers have shown that men with a rapid climax have a faster nervous system reaction in the pelvic muscles. Simple muscular workout routines can significantly help men learn how to control premature ejaculation if they have little control during intercourse.

Many psychotherapists feel premature ejaculation is attributable to psychological variable like lack of confidence and so forth. Sometimes these men could be helped by taking anxiolytic remedies like or SSRIs such as sertraline. These compounds can decrease the speed of ejaculation. An alternative is to use numbing (anesthetic) lotions on the genitals.

Desensitizing lotions made of Lidocaine may be applied the glans of the penis and may delay ejaculation. Such creams are applied on an “as wanted” basis and have  fewer bodily side effects. Nevertheless, use of those creams could lead to insensitivity within the penis, and reduction feelings for the man’s lover resulting from the lotion getting in her vagina.

PE and Erectile Dysfunction

Premature ejaculation must be addressed before any erectile dysfunction. To identify corrective treatment for premature ejaculation a diagnosis should be devised using the man’s entire sexual history, in search of indicators of IELT, and signs of inadequate control of ejaculation, sexual issues in man and sexual partners and misery in either the man or his lover.

Rapid orgasm and erectile dysfunction occur in about half of males suffering from premature ejaculation. To decide the appropriate treatment, it is important for the doctor to distinguish between PE as “a partner’s criticism” and PE as a so-called “syndrome”.

This male sexual dysfunction may be categorized into lifelong and acquired. Just lately, a functional classification was suggested based mostly on controlled scientific stopwatch research.

Other syndromes were suggested: natural variable PE and premature-like ejaculatory dysfunction. Only PE which has existed for years showing time to ejaculation of below 1 to 1.5 minutes ought to be regarded as a probable candidate for medication as the first strategy, along with psychotherapy.

Priligy

Priligy is authorized in several European countries, including Germany. Dapoxetine, as it is also known, is said to considerably better all elements of premature ejaculation and typically is well tolerated. Prior to Priligy Anafranil tended to be used to deal with PE.

Some more medications used for PE: Ultram, an FDA authorized by-mouth painkiller for moderate pain. It is much like an opioid, works at the sensory receptors, but additionally is just like an anti-depressant in that it increases levels of serotonin and norepinephrine. It also has almost no unintended effects, has low abuse potential, and will increase the IELT by several times better than 90 % of men.

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