Overall, there is no generally accepted definition for premature ejaculation. It usually means that the man no longer has control over the exact time of ejaculation.
This triggers the orgasm reflex earlier. In most characterizations of premature ejaculation, three main aspects come into play:
- Short duration from the onset of vaginal penetration to ejaculation
- Loss of voluntary ejaculatory control
- Suffering of the affected person and/or partner
It is important to note that the estimated duration until orgasm is subjective. Men often overestimate this.
Men who do not suffer from premature ejaculation need an average of around 5.4 minutes to reach climax.
For those affected, this latency period is less than one to two minutes. Sometimes just thinking about a sexual act can be enough to trigger premature ejaculation.
It is estimated that around four percent of menare affected by premature ejaculation @ megaflopp /AdobeStock
The exact triggers for premature ejaculation have not yet been sufficiently clarified.
Possible causes are:
- Psychological triggers
- Neurophysiological triggers
Neurophysiological causes mean that the trigger lies somewhere in the signal transmission between the nerve cells.
There are various factors that can contribute to premature ejaculation. For example, erectile dysfunction and premature ejaculation sometimes occur at the same time.
The frequency of sexual intercourse can also have an influence. For example, irregular sexual intercourse and inexperience promote premature ejaculation.
There are also a number of psychological causes that may be responsible for premature ejaculation:
- Early childhood sexual disorders
- Restrictive sex education
- Sexual performance thinking
- Unrealistic ideas about sexuality
- Fear of failure
- Anxiety disorders
Physical causes and the use of certain medications can also be triggers:
- Urinary tract infections
- Diabetes mellitus (diabetes)
- Taking painkillers
- Sympathomimetics (drugs that influence the sympathetic nervous system, a part of the autonomic nervous system)
- Impaired serotonin balance
There are many causes of premature ejaculation @ Wasan /AdobeStock
The right contact person for premature ejaculation is a urologist. They will first take the patient's medical history and ask certain questions about the man's sex life.
These include, for example
- Sexual development
- Experiences and
- Course of the sexual response
The answers often say a lot about the triggers, as they reflect the patient's inner attitude. This is particularly important with regard to treatment.
Premature ejaculation is diagnosed if there is less than two minutes between penetration and ejaculation.
From a medical point of view, treatment for premature ejaculation is not absolutely necessary. It is necessary if the person affected or their partner suffers from it.
Depending on the trigger, the therapy can use the following approaches:
- Physical methods
- Medication methods or
- Psychotherapeutic methods
For some men, frequent masturbation or an orgasm before intercourse can already help. In addition, there are certain methods to better perceive and control the timing of ejaculation.
These include, for example:
- The stop-start method and
- The squeeze method
- Psychotherapeutic measures
Psychotherapy as part of the treatment of premature ejaculation is carried out using various methods:
It can be helpful if the partner also takes part in the therapy. Psychotherapy can help to alleviate anxiety and thus break the vicious circle of fear and premature ejaculation.
Psychotherapy is also useful for changing ingrained behavior and thought patterns and relieving sexual pressure.
Affected men usually suffer a great deal, psychotherapy can help @ Prostock-studio /AdobeStock
With the stop-start method, men learn to better control their arousal. The aim is to delay ejaculation. To do this, the man masturbates until he is close to the critical threshold.
He then waits until the arousal subsides. He then begins to masturbate again. He continues this procedure until he is able to control his ejaculation better.
This method is a further development of the stop-start method and is also intended to delay the time of ejaculation. The man interrupts sexual intercourse shortly before climax.
This helps the man to perceive the time of the unwanted climax more precisely and thus to be able to influence it better. He also presses on the penis with his thumb in the area of the glans.
This reduces the amount of blood in the penis. This interrupts the ejaculation reflex. This also leads to delayed ejaculation.
In general, premature ejaculation should be treated by a urologist. The therapy is usually multimodal.
This means that in addition to drug therapy options, behavioral therapy approaches and psychosexual support are also used.
