Premature ejaculation

At a premature ejaculation or. Ejaculatio praecox it is a common ejaculation disorder in men. From a medical point of view, this is not a painful disease, but the disorder can seriously affect the sex life of the person concerned and their partner. The phenomenon is widespread and the suffering of those affected is sometimes considerable.

What is premature ejaculation?

For one premature ejaculation there is no single definition. When a man cannot control the timing of ejaculation and the orgasm is triggered earlier than desired, this is commonly known as premature ejaculation.

Ejaculation (ejaculation) occurs either shortly before or shortly after penetration into the vagina. In some definitions, the ability to sexually satisfy a woman also plays a role. This is referred to as premature ejaculation when the man is not able to control his ejaculation in such a way that both partners are satisfied during sexual intercourse.

The phenomenon distinguishes between a congenital and an acquired disorder. The congenital form can have physical causes, the acquired form is often due to psychological causes. Premature ejaculation is always a major psychological burden.

causes

For one premature ejaculation there can be different causes. However, these have not yet been finally clarified. The scientists are still debating whether, in addition to psychological and physical causes, neurophysiological reasons can also be responsible for premature ejaculation.

There can be a wide variety of triggers for the psychological causes. For example, early childhood sexual disorders, sexual performance thinking, restricted sex education or even fear of failure can lead to premature ejaculation. In the case of physical illnesses, urinary tract infections or diabetes mellitus are often responsible for the phenomenon. The use of certain medications can also lead to premature ejaculation.

Ejaculation is influenced by various messenger substances in the brain. The messenger substance serotonin is also involved. An increased serotonin level in the brain can increase the time it takes to ejaculate. Premature ejaculation can occur as a congenital or acquired phenomenon.

In the congenital form, physical illnesses are usually responsible for this. The acquired form can usually be traced back to psychological causes. Premature ejaculation can be a lifelong complaint. However, premature ejaculation can only occur for a temporary period of time.

Diagnosis & course

Only a few men affected by premature ejaculation seek medical treatment. In order to make a diagnosis, the questioning and discussion with the person affected are primarily important. The doctor can come to a diagnosis by asking precise questions about the symptoms, but also about sexual experiences and development, as well as any fears that may exist.

If he suspects physical causes as well, appropriate further examinations can be carried out. The doctor will particularly consider the medical history. This gives the doctor important information about the patient's sex life and can thus make an important contribution to further treatment.

When should you go to the doctor?

Premature ejaculation can naturally only occur in sexually mature boys or men. Therefore they belong to the risk group. Normally, however, there is no further need for action. In most cases, this phenomenon is a lack of experience in the area of ​​sexual experiences. Therefore, premature ejaculation occurs mostly in people of the male sex at a young age. With increasing sexual activity in the course of life, the symptoms subside in almost all cases. Tips from the area of ​​self-help are often sufficient to be able to regulate premature ejaculation independently.

A doctor therefore only needs to be consulted in exceptional cases. These are given as soon as there is emotional suffering. In addition, consultation with a doctor should be sought in the event of persistent disorders of the libido or irregularities in sexual behavior. Pain during the sexual act, severe emotional stress or irregularities in the erection should be examined more closely by a doctor. In a large number of cases, premature ejaculation can be prevented if successful masturbation has taken place before the actual sexual act. Ejaculating several times in a short time leads to an alleviation of existing symptoms and can already initiate freedom from symptoms. However, permanent irregularities that already lead to disturbances in the partnership should be discussed with a doctor.

Treatment & Therapy

A premature ejaculation can be treated with the help of medicinal, psychotherapeutic or physical measures. The triggering causes are always decisive for the choice of treatment method. Various therapies are used in psychotherapeutic methods. For example, sex therapy, couples therapy, behavior therapy or family therapy can be used.

Fears can be reduced with the help of appropriate psychotherapy. But also ways of thinking and behavior can be changed, and an existing pressure to perform can be increased. Treatment with medication is usually used when psychotherapeutic therapy has not been successful. So-called serotonin reuptake inhibitors are often used, which can delay the orgasm reflex. Creams and gels that reduce the sensitivity of the penis are also used.

The drug methods can resolve the symptoms, but the causes remain. In addition, special methods have been developed that can help the affected men cope with the problem. This includes, for example, the so-called stop-start method, in which those affected learn to control their arousal and thus prevent premature ejaculation. A continuation of this method is the squeeze method, in which the ejaculation reflex is interrupted by applying pressure to the penis.

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prevention

Since premature ejaculation is an orgasmic disorder, there are no direct preventive measures against the occurrence of the symptom. However, through various therapies or methods, it is possible for those affected to better perceive their own excitability and thus prevent premature ejaculation. In addition, it is important to counteract sexual pressure to perform, as this can be a triggering factor for premature ejaculation.

Aftercare

Premature ejaculation, like many other erectile dysfunction, can be treated. Follow-up care follows immediately after the treatment. In most cases, follow-up care consists of a medical history and a physical examination. As part of the patient consultation, the patient is advised on how to deal with potency problems.

The urologist is usually responsible, who also asks about unusual symptoms during the anamnesis in order to be able to treat the premature ejaculation effectively. If the symptoms persist, permanent treatment takes place. The ongoing follow-up care is adapted to the needs of the patient and usually takes place in cooperation with the family doctor or another specialist who has an eye on the medical history.

It will continue until the erectile dysfunction has been resolved or the patient wishes to stop treatment. In general, however, follow-up care is based on the cause of the erectile dysfunction. For example, if a tumor is the cause, follow-up care is much more complex. In the case of emotional causes, a therapist is usually also involved in the treatment. Follow-up care then takes place shortly after the end of the treatment and must be continued over a longer period of time.

You can do that yourself

Men who ejaculate prematurely can take several steps to delay ejaculation. Training the pelvic muscles, for example using the Kegel method, is effective. Here, the sphincter muscles and pelvic floor are trained, so that the ejaculation can be better controlled. The start-stop method has also proven itself. The penis is regulated until shortly before the so-called "Point Of No Return" and then the stimulation is stopped. The targeted stimulation improves control over the ejaculation. In addition, sexual tension can be relieved in this way.

The so-called squeeze grip can be used shortly before the ejaculation. Here, the thumb is pressed on the glans until the pressure subsides. The emergency method is particularly useful if an unexpected premature ejaculation is imminent. The doctor can also prescribe anesthetic creams, which make the penis insensitive to stimuli. Condoms with appropriate active ingredients are now also available.

Communication with the partner is just as important in achieving a fulfilling love life. When practicing together with the partner, the timing of the ejaculation can be trained. If the symptoms persist, a visit to a urologist or a sexologist is recommended. Occasionally, premature ejaculation is also based on mental illnesses that need to be dealt with.