ALL ABOUT PREMATURE EJACULATION

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Goodmorning to the world. Saying that makes me feel so good you bet. Hope y’all had a frenzy nightrest.. First amongst many things is my unreserved apology for skipping some editions on Scentmarlcs media forum. You can be rest assured that those missing days were used to better the content and structure of Scentmarlc’s Blog as opposed to its current standard. So once again, am so sorry. Yea, today will just an emphasy on a special topic or let’s call it issue that’s been troubling the male folks for quite some decades. #i don’t know if it exist during my grandfather’s time sha#. So, have taken the pain to bring materials on premature ejaculation closer to you for the purpose of self awareness, and motivation for tratment.

Premature ejaculation (PE) occurs when a man experiences orgasm and expels semen soon after sexual activity and with minimal penile stimulation. It has also been called early ejaculation, rapid ejaculation, rapid climax, premature climax, and (historically) ejaculation praecox. There is no uniform cut-off defining “premature,” but a consensus of experts at the International Society for Sexual Medicine endorsed a definition including “ejaculation which always or nearly always occurs prior to or within about one minute.”The International Classification of Diseases (ICD-10) applies a cut-off of 15 seconds from the beginning of sexual intercourse. Although men with premature ejaculation describe feeling that they have less control over ejaculating, it is not clear if that is true, and many or most average men also report that they wish they could last longer. Men’s typical ejaculatory latency is approximately 4–8 minutes. Men with PE often report emotional and relationship distress, and some avoid pursuing sexual relationships because of PE- related embarrassment. Compared with men, women consider PE less of a problem, but several studies show that the condition also causes female partners distress.

CAUSE :
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 by an adult, of performance anxiety, of an unresolved
Oedipal conflict, of passive-aggressiveness, and having too
little sex—but there is little evidence to support any of these
theories.
Several physiological mechanisms have been hypothesized to
contribute to causing premature ejaculation including
serotonin receptors, a genetic predisposition, elevated penile
sensitivity, and nerve conduction atypicalities.
The nucleus paragigantocellularis of the brain has been
identified as involved in ejaculatory control. Scientists have
long suspected a genetic link to certain forms of premature
ejaculation. In one study, 91 percent of men who have had
premature ejaculation for their entire lives also had a first-
relative with lifelong premature ejaculation. Other
researchers have noted that men who have premature
ejaculation have a faster neurological response in the pelvic
muscles.
PE may be caused by prostatitis or as a drug side effect.

MECHANISM :

The physical process of ejaculation requires two actions:
emission and expulsion. The emission is the first phase. It
involves deposition fluid from the ampullary vas deferens,
seminal vesicles, and prostate gland into the posterior
urethra. The second phase is the expulsion phase. 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.
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. The 1948 Kinsey Report suggested that three-quarters of men
ejaculate within two minutes of penetration in over half of
their sexual encounters.
Current evidence supports an average intravaginal ejaculation
latency time (IELT) of six and a half minutes in 18–30 year
olds. 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 two minutes. Nevertheless, it is
possible that men with abnormally low IELTs could be
“happy” with their performance and do not report a lack of
control. 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 :

When deciding the appropriate treatment, it is important for
physician to distinguish PE as a “complaint” versus PE as a
“syndrome”. About 20 years ago, PE was classified into
“lifelong PE” and “acquired PE”.[20] Recently, a new
classification of PE was proposed based on controlled clinical
and epidemiological stopwatch studies, and it included 2
other PE syndromes: “natural variable PE” and “premature-
like ejaculatory dysfunction”. Only individuals with lifelong PE
with IELT shorter than 1–1.5 minutes should require
medication as a first option, along with or without therapy.
For those who fall into one of the other categories, treatment
should consist of patient reassurance, behavior therapy, and/
or psychoeducation to explain that irregular early ejaculation
is a normal variation.
Several possible sub-classifications have been discussed, but
none is in universal usage. Primary premature ejaculation
refers to lifelong experience of the problem (since puberty),
and secondary premature ejaculation reference to the
problem beginning later in life. It has also been subdivided
into global premature ejaculation, when it occurs with all
partners and contexts, and situational premature ejaculation,
when it occurs in some situations or with specific partners.

TREATMENT :

Several treatments have been tested for treating premature
ejaculation. A combination of medication and non-
medication treatments is often the most effective method.

Many men attempt to treat themselves for premature
ejaculation by trying to distract themselves, such as by trying
to focus their attention away from the sexual stimulation.
There is little evidence to indicate that it is effective, however.
Other self-treatments include during the act 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.
By the 21st century, most men with premature ejaculation
could cure themselves, either on their own or with a partner,
using self-help resources, and only those with unusually
severe problems had to consult sex therapists, who cured 75
to 80 percent.
Freudian theory postulated that rapid ejaculation was a
symptom of underlying neurosis. 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. Freudians
claimed that premature ejaculation could be cured using
psychoanalysis. But even years of psychoanalysis
accomplished little, if anything, in curing premature
ejaculation.
There is no evidence that men with premature ejaculation
harbor unusual hostility toward women, however.
Several techniques have been developed and applied by sex
therapists, including Kegel exercises (to strengthen the
muscles of the pelvic floor) and Masters and Johnson’s “stop-
start technique” (to desensitize the man’s responses) and
“squeeze technique” (to reduce excessive arousal).
To treat premature ejaculation, Masters and Johnson
developed the “squeeze technique”. Men were instructed to
pay close attention to their arousal pattern and learn to
recognize how they felt shortly before their “point of no
return”, the moment ejaculation felt imminent and inevitable.
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.

The squeeze technique worked, but many couples found it
cumbersome. From the 1970s to the 1990s, 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. To help the man increase
awareness of his sexual experience, he is encouraged to
create an excitement scale of 1-100. Successful completion of
this scale will include paying attention to his heart rate, when
(and if) he squeezes his inner thighs, and sensations in all
parts of his body. By creating this scale, he will be more able
to pace himself as he uses the “stop-start” technique.
In addition to the stop-start technique, other sexual
adjustments help men develop and maintain ejaculatory
control, among them: masturbation exercises, deep
breathing, and whole-body massage. Sex therapists estimate
that the refined last-longer program teaches effective
ejaculatory control to 90 percent of men.
The authors of one study concluded that sex therapy
“has a remarkable therapeutic effect on premature
ejaculation.”
Drugs that increase serotonin signalling in the brain slow
ejaculation and have been used successfully to treat PE. These
include selective serotonin reuptake inhibitors (SSRIs), such
as paroxetine, 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, many discontinue it within a
year. SSRIs can cause various types of sexual dysfunction
such as anorgasmia, erectile dysfunction, and diminished
libido. It can last for months, years, or sometimes
permanently after the discontinuation of SSRIs.
Dapoxetine is a short-acting SSRI which appears to work
when taken as needed for PE. It is generally well tolerated.

Tramadol, an atypical oral analgesic, appears to be
effective.
Desensitizing topical medications that are applied to the tip
and shaft of the penis can also be used. These are applied “as
needed,” 10–15 minutes before sexual activity and have
fewer potential systemic side effects as compared to pills.
Use of topicals is sometimes disliked due to the reduction of
sensation in the penis as well as for the partner (due to the
medication rubbing onto the partner). Penis insensitivity
and transference to the partner are practically eliminated
when using topical anesthetic sprays based on absorption
technology which enable the active ingredient to
penetrate through the surface skin of the penis (stratum
corneum) to the sensory nerves which reside in the dermis.

EPIDEMORLOGY :

Premature ejaculation is a prevalent sexual dysfunction in
men; however, because of the variability in time required
to ejaculate and in partners’ desired duration of sex, exact
prevalence rates of PE are difficult to determine. In the “Sex
in America” surveys (1999 and 2008), University of Chicago
researchers found that between adolescence and age 59,
approximately 30% of men reported having experienced PE
at least once during the previous 12 months, whereas about
10 percent reported erectile dysfunction (ED). Although
ED is men’s most prevalent sex problem after age 60, and
may be more prevalent than PE overall according to some
estimates, premature ejaculation remains a significant
issue that, according to the survey, affects 28 percent of men
age 65–74, and 22 percent of men age 75–85. Other
studies report PE prevalence ranging from 3 percent to 41
percent of men over 18, but the great majority estimate a
prevalence of 20 to 30 percent—making PE a very common
sex problem.
There is a common misconception that younger men are
more likely to suffer premature ejaculation and that its
frequency decreases with age. Prevalence studies have
indicated, however, that rates of PE are constant across age
groups.

HISTORY :

Other mammals ejaculate quickly during intercourse,
prompting biologists to declare that rapid ejaculation had
evolved into men’s genetic makeup to increase their chances
of passing their genes.
Ejaculatory control issues have been documented for more
than 1,500 years.[citation needed] The Kamasutra, the 4th
century Indian sex handbook, declares: “Women love the
man whose sexual energy lasts a long time, but they resent a
man whose energy ends quickly because he stops before they
reach a climax.”[non-primary source needed]
Sex researcher Alfred Kinsey did not consider rapid
ejaculation a problem, but viewed it as a sign of “masculine
vigor”.

So much for a male disorder you would say right !!!!. For more exposition, knowledge and answers, kindliy visit http://en.m.wikipedia.org/wiki/Premature_ejaculation/ . Have a blessed week.

Credit: wikiSource
By: Scentmarlc

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