Premature Ejaculation Definition, Reason, Symptoms, Treatment & Prevention
Understanding
Premature ejaculation or premature ejaculation is a sexual disorder, which causes ejaculation to occur prematurely. This makes the penis flaccid, making penetration more difficult.
About 1 in 3 men aged 18 and over will experience premature ejaculation at some point in their lives. This condition can cause stress, both in men and in their female partners.
Symptoms
Symptoms of premature ejaculation are not specifically seen, except for subjective opinions about the release of semen or semen which is considered too fast. People who experience premature ejaculation usually seek help based on personal or partner complaints, related to sexual or erectile dysfunction, as well as problems with intercourse.
Complaints submitted include personal assumptions about premature ejaculation. Starting from the time of penetration to the release of semen, the steps that have been tried to delay ejaculation, to the impact on interpersonal relationships and quality of life.
Reason
Physically, ejaculation is controlled by a chemical in the brain, namely serotonin. If serotonin levels or functions are not normal, premature ejaculation is very likely to occur.
Other physical factors that play a role in premature ejaculation are:
- Chronic prostatitis, namely chronic inflammation of the prostate.
- Thyroid disorders, namely the thyroid gland is overactive or underactive.
- Diabetes and hypertension.
- Excessive alcohol consumption, smoking, and use of illegal drugs.
- Erectile dysfunction. Men with erectile dysfunction tend to ejaculate prematurely before the erection ends.
- The penis is too sensitive or there is abnormal reflex activity in the ejaculatory system.
Meanwhile, psychological factors that cause premature ejaculation are generally associated with:
- Stress and depression.
- Problems in the relationship with the partner.
- Anxiety about sexual performance, especially at the start of a new relationship, or when a man already has a history of problems with sexual performance.
- Sexual trauma in the past.
Diagnosis
Based on the consensus of the International Society of Sexual Medicine in 2014, men are considered to experience premature ejaculation if:
- Ejaculation always or almost always occurs less than a minute after vaginal penetration from the first time you have sex. This condition is known as primary or congenital premature ejaculation.
- Shorter ejaculation, which is less than three minutes after vaginal penetration. This condition is known as secondary premature ejaculation.
Inability to resist ejaculation on all or most vaginal penetrations. - Causing negative personal consequences, such as stress, anxiety, frustration, and avoidance of intimate relationships.
- The definition above only applies to actual intimate relationships, which are carried out between men and women. In other words, the definition above cannot be used to describe ejaculation due to self-stimulation, such as masturbation or masturbation.
In the process of diagnosing premature ejaculation, the doctor will conduct an in-depth medical interview regarding complaints, sexual and psychosocial history, and past medical history.
Physical examination in premature ejaculation is usually observed normally, in the sense that it does not show certain anatomical abnormalities. The physical examination primarily assesses the abdomen, nerve function, lower limbs, and genitals.
Until now there is no specific examination to confirm premature ejaculation. Laboratory or supporting tests are only carried out if premature ejaculation is suspected as a result of physical abnormalities, not psychological factors.
Treatment
Treatment of premature ejaculation must involve sexual partners from the start of treatment. The choice of therapy depends on the severity of symptoms, possible correctable causes, psychosocial impact, side effects of medication, and patient preference.
Treatment for premature ejaculation includes:
- Psychotherapy
Psychotherapy is psychological therapy in the form of counseling and reassurance (strengthening). This type of therapy is the main therapy for premature ejaculation. However, it takes quite a long time and costs a lot. Compliance and consistency of couples to therapy is also very necessary.Psychotherapy can be effective if premature ejaculation is subjective and there are clear psychological factors as the main cause. This therapy can also be combined with special drugs for premature ejaculation. - Drugs
- Topical anesthesia. The use of topical anesthetics (lidocaine cream) applied to the head of the penis can reduce sensation due to sexual stimulation. Because this cream can also be absorbed by the vagina, women can experience decreased sexual sensation. The use of topical anesthetic creams will be more effective when combined with the use of condoms.
- Antidepressants. Antidepressants are the most effective in dealing with premature ejaculation. Antidepressants can lengthen the time from when a man is aroused until he ejaculates. The most commonly used antidepressants are the selective serotonin reuptake inhibitors (SSRIs), such as citalopram, sertraline, paroxetine, and fluoxetine. Because these drugs work in the brain, their use is very limited and must be accompanied by a doctor’s prescription. These drugs are only given if other therapies are not successful.
- Sildenafil. Sildenafil or better known as Viagra® helps with erections by increasing blood flow to the penis. This drug does not inhibit ejaculation, so it cannot be used to treat premature ejaculation. However, these drugs can help if a man has erectile dysfunction and premature ejaculation at the same time.
Treatment At Your Home
Some actions that can be taken to deal with premature ejaculation before seeking medical help include:
- Masturbate one to two hours before intercourse.
- Using thick condoms to reduce sensation in the penis.
- Take a few deep breaths to stop the ejaculatory reflex.
- When having sex, stop for a moment and divert your mind to boring things so that the sensation of the penis is reduced.
- Having sex with the position of the woman above.
- Practice self-control with the following techniques:
- Squeeze. You or your partner stimulate the penis until you feel like you are about to ejaculate, then stop immediately. Press the head of the penis for about 10-20 seconds. Then release and wait up to 30 seconds before repeating the stimulation. This process is done several times, before finally ejaculating.
- Stop-start. This technique is almost similar to the squeeze technique, but there is no emphasis on the head of the penis.
When to see a doctor
Immediately seek help if premature ejaculation causes excessive stress or frustration, interferes with interpersonal relationships with partners, and makes you avoid intimate relationships.
Prevention
Most cases of premature ejaculation can be prevented by improving interpersonal communication and being open with your partner. This action lets both parties know what is expected of each other in an intimate relationship. The men will be more confident in doing so.
Another way to prevent premature ejaculation is to train the pelvic floor muscles, through Kegel exercises, and have an adequate and quality night’s sleep. Lack of sleep can reduce brain serotonin levels so that ejaculation can occur more quickly.