PREMATURE EJACULATION

Did you know?

Hell does not have as much fury as has a woman whose male ejaculates before she wants him to ejaculate!

And

Heaven does not have those pleasures that she feels like unleashing on him who ejaculates after she begs him to ejaculate!

Definition of Premature ejaculation!

1- “A person who ejaculates before his partner wants him to ejaculate or he himself wants to ejaculate.

2-“Persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it.”

Causes of premature ejaculation.

•After effects of excessive masturbation.
•Becoming overwhelmed by sexual feelings.
•Hypersensitivity of prostate gland.
• “Not-good” first sexual encounter.
•Hypersensitive Glans.
•Sexual artlessness.
•Vaginal tightness.
•Hypersensitivity.
•Alcoholism.
•Anxiety.

Bad effects of premature ejaculation on Male

•Resorts to temporary relief.
•Aggravates his problem.
•Remains anxious.
•Hurries from bad to worse.
•Loses self-esteem.
•Avoids sexual contacts.
•becomes temporarily impotent
•Loses harmony with his female.

Bad effects of Premature Ejaculation on female

•Suffers emotional trauma.
•Feels ditched.
•Remains depressed.
•Becomes quarrelsome.
•Makes issues of small things.
•Avoids sex.
•Destroys harmony with her male.
•Becomes non-serious about relationship.

Medical case records on premature ejaculation show following dismal figures

•-Males who ejaculate before penis-vaginal contact, are            15 %
•-Males who ejaculate in the first minute of penetration, are      53%
•-Males who ejaculate after two minutes of penetration, are      25%
•-Males who ejaculate after three minutes of penetration, are   17%
•-Males who ejaculate after five minutes of penetration , are     13%
•-Males who ejaculate after ten minutes of penetration, are        7%
•-Males who ejaculate after fifteen minutes of penetration, are   3%
•-Males who ejaculate at their will, are                                        0.1%
•-Males who do not like to ejaculate at all                                 0.01%

Many Malaysians men suffer from premature ejaculation woes

Many Malaysians men aged 19 to 60 have confessed in a Universiti Sains Malaysia survey that they ejaculate even before having sexual intercourse with their partner.

The study/survey recorded case of a married couple who never had a fulfilled intercourse for four years because the husband was unable to control his excitement and would often ejaculate before penetration said USM Men’s Health Clinic head Assoc Prof Shaiful Bahari Ismail who did the study on premature ejaculation.

Some men hardly last a minute after intra-vaginal activity, adding that this caused distress and sexual boredom that might lead to divorce if the wife had a high sex drive.

According to his Premature Ejaculation Perception and Attitude study, about 29% of Malaysians aged between 19 and 60 suffer from some sort of premature ejaculation.

The percentage could be higher, considering many are unable to practise healthy and regular intercourse and also because they lead very stressful lives, he said in an interview here.

A World Health Organisation report said early ejaculation was the most common of all sexual difficulties among men and it was estimated that between 25% and 33% of men ejaculated “before they want to”.

Based on the studies, women who experienced problems of sexual fulfilment were more open to talk about the issue when interviewed without the presence of their husband or partner.

This is in contrast to men who would rather be in a denial mode even in one-to-one interviews.

When the denial is allowed to fester, it would lead to other problems like unnecessary stress.

This could lead to psychological problems and, if not controlled, would eventually affect their manhood and self-esteem.

The premature ejaculation was becoming a threat to Malaysians and might be one of the causes of the increasing divorce rate.

Malaysian men felt that it was taboo to speak about the condition and preferred to “sweep the problem under the carpet”.

Married women also preferred to be silent because it could affect their husbands’ self-esteem.

The family medicine specialist said there was no cure for premature ejaculation because it was “all in the mind”.

Source: The Star @ 18/07/2010.

1 in 3 men suffers from premature ejaculation

As many as one in three men in Malaysia and and nine other countries in Asia Pacific could be suffering from premature ejaculation (PE), according to a study.

PE, a devastating condition for a man, is defined as a lack of control on a man’s part during intercourse, resulting in ejaculation prior to or within one minute of penetration, said Associate Professor George Lee Eng Geap from the University of Malaya and Monash University.

Singapore’s MyPaper quoted Prof Lee, who is part of the study’s steering committee, as saying that PE is a problem that cuts across ethnicity and age groups.”

The Asia-Pacific Premature Ejaculation Prevalence And Attitude Study surveyed nearly 5,000 men, aged 18 to 65, from 10 Asia-Pacific countries, including Australia, China, Malaysia, New Zealand, Singapore, South Korea and Thailand.

The causes of the problem are complex, ranging from the psychological to the physiological, said Prof Lee.

A person who secretly had intercourse at home, and was anxious of being found out by his parents, for instance, could develop PE later in life, he said.

The problem could also be genetic in nature, he added.

There may be a solution: Dapoxetine.

According to MyPaper, American company Janssen-Cilag had recently submitted the pill  to the health authorities in Singapore for review.

The pill is the only known medication that can treat the condition and is currently available in seven European Union countries, including Sweden, Austria and Italy.

Outside of Europe, the medicine is available only in New Zealand and South Korea.

Dapoxetine is supposed to boost the ejaculation-delaying hormone serotonin, by preventing or delaying the breakdown of serotonin in the body.

In effect, this would help maintain higher levels of the hormone in the body, which would in turn help to delay ejaculation.

Other treatments for PE include behavioural therapy like counselling, or topical treatments like sprays, numbing gels or condoms. However, there are drawbacks to some of these treatments.

For example, numbing gel or sprays can desensitise the penis, causing a loss of sexual enjoyment, said Prof Lee.

The condition can seriously injure a man’s relationship with his partner. “PE can have a devastating impact on the relationship between men and their partners,” said Prof Lee.

” The impact extends not just to a man’s self-esteem, but also to a woman’s fulfillment and, ultimately, to the entire relationship.”

Stay the course

A new drug is on the way that can help men to beat premature ejaculation.

JOKES. That’s what you usually get when you talk about premature ejaculation with anyone.

Certainly in our Asian culture, where men often pride themselves on their virility and the number of children they father, premature ejaculation (PE) is naturally a scary and humiliating subject deemed to affect the manhood of those who suffer from it. The social stigma and jokes only worsen the sufferers’ perception that they are the odd ones out. So, they suffer in silence rather than seek help.

But how many of us know that 30% of the male population suffer from PE?

That’s right, that’s one in every three men aged 19 to 80. The percentage in South-East Asia differs little from that in the West, which is 28%. With this in mind, PE doesn’t seem that uncommon a condition anymore.

However, the number of men who come forward (to report the condition) is miniscule. Nobody wants to. People who come to see me talk about something else, about their prostate or something like that. You can see that they are undecided on whether they want to tell you. And when they’re about to walk out the door, they come back and want to say it. They need time. Embarrassment is a big issue.

Lack of awareness also contributes to their hesitation, as there are still those who do not know the difference between premature ejaculation and erectile dysfunction (ED). Unsure of whether their predicament is pathological or physiological, the men might avoid intimacy altogether.

Lee says the International Society of Sexual Medicine defines PE as “ejaculating shortly after penetration” or “ejaculating before one desires to”. All studies of PE have shown that ejaculation happens within a minute or less. When it affects the relationship between partners, then it becomes a problem.

But things are about to change.

We are gradually moving towards recognising PE as a medical condition. Before this, PE was thought to be psychological, that the person may be too anxious during intercourse. All sorts of methods were then recommended, such as certain physical manipulations and even anaesthetic creams and sprays, which were largely ineffective. Now, opinion has shifted to recognising the cause as a neuro-biological one.

We increasingly understand that there are people who suffer from primary PE.They are born that way and it’s because of their central nervous system. There are certain components in there that lower the threshold of climax. And the whole system is controlled by the seratonin system, which controls our mood, appetite, anger, pain and sexual pleasure.

This is where therapeutic intervention comes into the picture, where seratonin inhibitors can be manipulated so that the threshold can be elevated. Anti-depressants are usually used, but there are actually no anti-depressants licensed for PE.

Prozac, probably the most common anti-depressant, is used for this. But a majority of them are long-acting. So, technically that is not a suitable medication to treat PE. You want to treat PE during sexual intercourse, but not beyond that especially if the person suffers from side-effects.

But now there is a new medication that is short-acting. It has already been tested, and is being marketed in seven countries.

I’m predicting that it should be released (in Malaysia) by next year. It is a prescription drug because it carries the side-effects of nausea, headache and vomiting, so it needs to be handled with care.

Even though treatment is within reach, the biggest obstacle is still to get men to come forward for help.

I guess there will always be jokes about the condition. But if you notice, impotency jokes are no longer around. But there are a lot of jokes about Viagra now. So the jokes are no longer on the men but on the success of the treatment. That’s the key to it – do not humiliate the men who suffer from this. It’s already bad enough that they suffer in silence, so there’s no need to humiliate them. Cultural change takes time.

With more education and awareness about PE. and in recognising PE as a medical condition, hopefully embarrassment will diminish and more men will come forward to talk about it.

Lee adds that PE is not solely a man’s problem; it is also a condition from which women suffer, as they might not find satisfaction in their sexual relationship. Communication is important, as usually the man recognises that he has a problem and tells his wife. Then she would suggest that they see a doctor about it.

Let draws a parallel between what is happening now in the treatment of PE and the advent of Viagra which the first sexual revolution for men.Previously, ED was known as impotence, which was very demeaning. But now it is recognised as a medical condition and is treated with medical respect.

If you look at the pre-Viagra era, the jokes were always about impotent men.At the time, before there was a treatment, men were suffering in silence. Now, 10 years on, it has helped millions, about 233 million men. Every second, six tablets are consumed. That has improved men’s sexual experiences, and also improved the relationship between many husbands and wives.

Hopefully, (with the treatment for PE) we will have a second sexual revolution that will change many men’s relationships with their wives.

Premature ejaculation

Premature ejaculation is the most common of all male sexual complaints. Most men are loath to talk about it, but it can be effectively treated.

If you asked a typical group of  men what their most common sexual complaint is, it’s bound to be something like ‘not getting enough’.

But if you asked a group of those  men who are ‘getting enough’ what their problem is, you’ll probably hear ‘shooting my load off too early’.

Indeed, premature ejaculation, sometimes abbreviated by medical specialists to PE, is the most common sexual complaint amongst men and couples.

It’s a consistent problem for about one in three men, although two in three men may be affected at some time in their lives. It’s less common in older men, and most common in adolescents (because stimulation, erection and ejaculation rely on a complex pathway of nerves and blood vessels; these pathways become less responsive with age).

Little good comes of PE. It may lead to criticism of a man from his partner, often causing anxiety, loss of self-esteem, erectile dysfunction (impotence) and diminished libido. It doesn’t do much for the partner either, leading to diminished orgasm and in some cases inability to achieve orgasm at all.

But what is PE exactly? The definitions are a bit vague. It’s usually defined along the lines of ‘ejaculation happening sooner than the man or his partner would want’. But that means different things to different people.

So this month, the International Society for Sexual Medicine (ISSM), after consulting the world’s leading sexual health experts, came up with an evidence-based definition of premature ejaculation.

Here’s how they define it: “Premature ejaculation is a male sexual dysfunction characterised by ejaculation which always or nearly always occurs prior to or within about one minute of vaginal penetration; and, inability to delay ejaculation on all or nearly all vaginal penetrations; and, negative personal consequences, such as distress, bother, frustration, and/or the avoidance of sexual intimacy.”

They also point out that this definition can encompass sex that doesn’t necessarily involve vaginal penetration, but some other form of sexual stimulation.

When to seek help?

The ISSM says this definition is important, because it gives a man (and his partner) a clearer idea of when something is wrong, and when to seek help.

Going by this definition, a man may not need help; there may be nothing wrong. According to this definition PE is where early ejaculation “always or nearly always occurs”. In other words, PE is only a problem if it happens repeatedly.

In fact most men occasionally reach orgasm sooner than they’d like. It’s normal for a man to ejaculate quickly the first time he has sex, for example. It is also normal in those men who haven’t ejaculated for a long time.

But if it does happen frequently, what then?

Psychological causes

Sex therapists say PE is usually caused by a man’s circumstances or mental state, and is not due to any physical problem. These circumstances might be:

• performance anxiety (the main cause), especially anxiety related to beginning a new relationship;
• conflict within an existing relationship (leading to fear of rejection or sexual failure);
• generalised anxiety or stress;
• a childhood anxiety about sex, a religious belief, or a fear of contracting disease or experiencing some physical harm.

The treatment for PE due to these causes is counselling and behavioural therapy from an experienced sex therapist, counsellor, or GP. These techniques help most men with PE. But they rely on a man being open and honest with his partner and with the therapist, and may include:

• techniques in which a man distracts himself in the early stages of arousal, to prolong ejaculation;
• the ‘stop-and-start’ technique, in which the man’s partner stimulates his penis until he feels he is about to ejaculate, then stops, waits for 20 or 30 seconds and then begins again;
• the ‘squeeze’ technique, which involves withdrawing the penis (or stopping foreplay) prior to orgasm and squeezing the end of the penis, where the head joins the shaft, for several seconds until the urge to ejaculate passes;
• psychotherapy directed at correcting underlying anxieties.

Medical causes

Sometimes PE doesn’t have a psychological cause, but is due to underlying disease, says a group of medical specialists writing in this month’s Medical Journal of Australia.

Some men have a condition known as primary (lifelong) premature ejaculation. For them, PE is a continual problem, regardless of their circumstances and who they’re with.

These men have increased sensitivity in the nerve, brain and blood vessel pathways that control orgasm and ejaculation. The pathways are hyperactive and easily triggered following sexual stimulation. The cause isn’t known, but it’s thought to have a genetic basis, as it tends to run in families.

Counselling and sex therapy doesn’t usually help these men. They often have relationship problems – but these are the effects of their condition, not the cause of it.

Drug treatment will help in about 75 per cent of cases. The most effective medications are the SSRI antidepressants, which increase levels of serotonin. Paroxetine (brand name Aropax) and sertraline (Zoloft) work best. Serotonin elevates mood (which is why these drugs are used as antidepressants), but also has the effect of inhibiting ejaculation. But the drugs take up to five hours to work and so need to be given in small doses on a daily basis – they don’t work if taken just before planned sexual activity.

Topical anaesthetics such as lignocaine cream or ointment applied to the penis 20 to 30 minutes before sex (and removed just before sex begins) have also been shown to work.

Other (non-drug) approaches include using condoms (they reduce sensitivity of the head of the penis and delay ejaculation), and masturbation prior to sex – ejaculation is usually delayed if it follows an earlier ejaculation.

The important thing, whatever the cause, is that a man recognises the problem and seeks help, rather than letting resentment and anxiety bubble away. This week is International Men’s Health Week – a good a time as any.