What is premature ejaculation?
Premature ejaculation is called Premature Ejaculation in English, and it is a condition of male sexual dysfunction that ejaculates quickly against the will before or immediately after insertion into the female genitalia (vagina). It refers to. You can’t control the timing of your ejaculation, and ejaculating early can put stress on you and your partner.
It has been reported that 21% of men aged 18 to 59 years in the United States have premature ejaculation, and other studies indicate that 5 to 30% of men in the world are affected. The ecological factors of premature ejaculation are unknown, and many are considered psychogenic, as they often have no problems with physical function.
Medical definition of premature ejaculation
There were various theories about the definition of premature ejaculation, but now it is a definition based on objective facts and grounds (generally called “evidence”) based on the research results made by the International Society for Sexual Medicine (ISSM). Is used.
The definition is the clinical guidelines for premature ejaculation (published in 2004, revised in 2010) presented at the American Urological Association (AUA) in 2008.
In this guideline, premature ejaculation is the most frequent disorder in male sexual dysfunction, and almost every sexual activity ejaculates earlier than one’s will before or within 1 minute after insertion into the female genitalia. It is defined as a condition that can cause psychological damage due to uncontrolled ejaculation and avoid sexual activity itself .
Treatment criteria for premature ejaculation
ISSM generally states that premature ejaculation is a sexual dysfunction on the male side that ejaculates earlier than the will of self-confidence, the time from vaginal insertion to ejaculation is short, the male side has no power to control ejaculation, and men Makes that a stressful state. By the way, it is said that the time required for general ejaculation is 5 to 7 minutes .
Time of onset, time from intravaginal insertion to ejaculation, how much the man feels he can control ejaculation, how stressful the man is in the premature ejaculation situation, how stressful the male partner is in premature ejaculation After hearing if there are any concerns about psychological, emotional or relationship, premature ejaculation is diagnosed and treatment is started.
Basically, premature ejaculation develops in most of sexual activity (75-100%), and it is very short, within 1 minute from vaginal insertion to ejaculation, or ejaculation continues before vaginal insertion for at least 6 months. One criterion is what you are doing and the fact that no organic factors can be found and that mental stress is thought to be the cause.
In addition, there is a tool called “premature ejaculation diagnosis tool” as a tool to quantify how much mental stress the patient is feeling, and each question item is answered in 5 stages and scored, and it is used as an aid in diagnosis and treatment.
Classification of premature ejaculation
Premature ejaculation can be classified as primary or secondary, and as the name implies, premature ejaculation is a condition that suffers from premature ejaculation from the early stages of sexual experience.
In every or most sexual activity, ejaculation occurs before or immediately after vaginal insertion (within 1 minute), and ejaculation cannot be delayed, resulting in mental damage such as stress and frustration. It is said that they tend to avoid sexual activity.
On the other hand, secondary cases are premature ejaculation that develops after a period of normal sexual activity. The time from vaginal insertion to ejaculation becomes problematic and is usually said to be as short as 3 minutes or less. As a result, it is said that they may also have stress and frustration and avoid sexual activity.
Premature ejaculation, which is the most severe of both primary and secondary symptoms, is a condition in which ejaculation occurs before vaginal insertion.
In addition, premature ejaculation that occurs regardless of the degree, situation, and partner of the stimulus is classified as general type, hypersensitive to a certain stimulus, only in a certain situation, and if premature ejaculation occurs only in a certain partner, it is classified as a situation type. increase.
“Inexperience” is not the only cause of premature ejaculation
The cause of premature ejaculation is not clearly known. However, premature ejaculation is known to be associated with physical conditions such as prostatitis, psychological and psychological factors such as worries, and, rarely, hyperthyroidism, and men with erectile dysfunction have an erection. It is said that he experienced premature ejaculation before his ability was completely lost.
Some researchers believe that there may be genetic factors, while others believe that one of the causes may be a chemical imbalance in the brain or a change in receptor sensitivity. It used to be said that lack of sexual experience hastened ejaculation, but now it is thought that most of the onset is due to anxiety about sexual activity or some kind of stress .
Lack of sexual experience
Due to lack of sexual experience, it may react sensitively to the stimulus applied to the penis during sexual activity, resulting in premature ejaculation. This case is more common among young people and often improves as the penis becomes accustomed to the stimulus of sexual activity.
The stimulation to the penis is maximum immediately before and after insertion into the vagina, and the glans penis, which is the largest erogenous zone of men, reacts hypersensitively to this stimulation, and many young people are in a premature ejaculation state. Will be. The erogenous zone is different for each person, and it is quite possible that something other than the glans is reacting.
It is very effective for premature ejaculation to find out where the most sensitive part of your penis is and to get used to the stimulus by massaging the skin of that part. Erogenous zones other than the glans include the back streaks of the glans, potash, the upper glans, and the scrotum.
Knowing what kind of stimulus you are vulnerable to is also very effective as a measure against premature ejaculation. Is it vulnerable to slimy stimuli such as saliva, semen, and lotions of women, or is it vulnerable to stimuli caused by friction between the skin and skin, or is it vulnerable to stimuli that are rubbed? Find out what kind of stimulus you are sensitive to, whether it is vulnerable to pulling stimuli.
If you can grasp it, give the stimulus to the penis and get used to the stimulus, it will be a measure against premature ejaculation.
Anxiety about sexuality
Psychological factors such as sexual anxiety cause stressful premature ejaculation.
Premature ejaculation caused by psychological factors such as busy work, poor relationships with partners, and tired relationships in the workplace, this time premature ejaculation reduces self-esteem as a man and satisfies the partner. In many cases, people become stressed by feelings of guilt that they cannot give up, fear of being abandoned by their partners, and worsening relationships with their partners, leading to a vicious cycle.
Stress causes a deficiency of the neurotransmitter serotonin in the brain. As a result, it causes excessive suppression of noradrenaline secretion, resulting in an hyperactive state of sympathetic nerves and hypersensitivity to sexual stimulation.
First of all, it is necessary to aim at relieving stress at work and at home, and to think about how to deal with it after accurately grasping the current situation. Even if it is difficult to change the current situation, changing your mind and perspective may reduce your mental burden.
Don’t hold it alone, talk to people and experts around you, talk honestly with your partner, and try to improve together.
Effects of organic diseases
Premature ejaculation may occur due to some organ in the body, and phimosis may be one of the causes. The glans is said to be the largest erogenous zone of men, but if the glans is always wrapped in phimosis, it will react hypersensitively when stimulated.
To improve premature ejaculation, you must first strip the phimosis and strengthen the glans skin.
Authentic phimosis is always wrapped in phimosis, so start by healing the phimosis. In the case of phimosis, the glans is completely covered with the foreskin in normal times, and the glans is exposed only when it ejaculates. The waves of the rush will rush and ejaculate.
Phimosis does not require surgery, but if you are very suffering from premature ejaculation, it is a good idea to cure it. Try to strengthen the glans skin by peeling off the phimosis and massaging it.
When the phimosis is treated by surgery, the glans always rubs against the underwear, so it is possible to naturally strengthen the skin. Premature ejaculation may also occur due to chronic urethritis or chronic inflammation of the prostate, so be sure to check with a medical institution for organic diseases .
Muscle decline
Weakness premature ejaculation caused by muscle weakness is said to occur due to the weakening of the muscle strength related to ejaculation, which is mainly caused by the weakening of the “ejaculatory duct obturator muscle”, which is the muscle that suppresses ejaculation. Most of the main causes of muscle weakness are due to aging, and other causes include a decrease in physical strength due to lack of exercise.
When the penis is hard and erected, it is strong against sexual stimulation, but when the muscle strength is weakened, the hardness of the penis at the time of erection becomes insufficient, and when the hardness becomes weak, the sexual stimulation is the penis. It is easy to reach the internal erogenous zone, resulting in premature ejaculation.
Therefore, it is necessary to train the “ejaculatory duct obturator muscle”, but this muscle is very difficult to train, and the ejaculatory duct obturator muscle is located next to the PC muscle that works during erection, and it trains the PC muscle. It is said that training can also train the ejaculatory duct obturator muscle to some extent.
It is difficult for humans to resist aging, but it is possible to slow down their progress depending on training.
To train your PC muscles, tighten your anus slowly, hold it tight for 10 seconds, loosen it all at once, take a 5 second break, and then repeat the same action to train it. It’s a simple training, so please try it during your free time.
Treatment to overcome premature ejaculation
Treatments for premature ejaculation include drug therapy, sex therapy, a combination of both, or training to control premature ejaculation.
There are various types of drug therapy, such as oral drugs and drugs that apply the drug directly to the penis, and the drugs that are applied directly to the penis include ointments, spray types, lotions, and types in which the drug is applied to the inside of the condom. Exists.
Improving premature ejaculation plays a major role in building good relationships with partners and maintaining relationships, and it is not just a problem for men, but a problem that can be overcome together with partners. It can be difficult, but be sure to work with your partner for treatment. It will surely result in deepening the bond with your partner.
Treatment with oral medicine
Oral medications that are indicated for premature ejaculation are not approved in Japan, but a drug called Priligy is approved worldwide and is being marketed in Europe and other Asian countries. The active ingredient is daboxetine, an SSRI (selective serotonin reuptake inhibitor).
It has the effect of inhibiting the reuptake of serotonin at nerve endings, and by increasing the concentration of serotonin in the brain, it promotes the suppression of excessive secretion of noradrenaline, and by suppressing the hyperactive state of the sympathetic nerve, it is hypersensitive to sexual stimulation. Improves condition and prevents premature ejaculation.
It is said that if you take Priligy about 1 hour before sexual activity, the effect will appear in about 30 minutes, the time to ejaculation will be 3 to 4 times longer, and the effect will last for about 3 to 5 hours.
In addition, generic drugs already exist in Priligy, but they are not approved in Japan, so please import them individually before using them.
Tricyclic antidepressants have the effect of inhibiting both serotonin and noradrenaline reuptake at nerve endings, and are said to be effective against premature ejaculation by increasing the brain concentration of serotonin and suppressing the excessive secretion of noradrenaline. increase.
Treatment with a coating
One of the causes of premature ejaculation is that the penis is sensitive to irritation. Therefore, it is a treatment method that can be expected to improve premature ejaculation by paralyzing the nerves of the penis, making it insensitive to stimuli, and prolonging the time until ejaculation.
In general, by applying a drug containing active ingredients such as xylocaine , lidocaine , and benzogine , which are local anesthetics , directly to the penis, the sensitivity to genital irritation decreases and premature ejaculation can be prevented.
There are a wide variety of premature ejaculation medicines that contain local anesthetics as active ingredients, and the spray type is used by spraying directly on the penis before sexual activity.
How many minutes before sexual activity is sprayed depends on the time when the effect of the drug appears, and there is an advantage that it can be easily sprayed in the toilet.
The lotion type is a type that is applied to the penis while massaging, and you may ask your partner to apply it. In addition, some products have a local anesthetic applied to the inside of the condom, which is recommended for those who do not want to be known to their partners. Please choose a dosage form that suits your lifestyle and is not burdensome.
Sex therapy
It is an effective therapy for primary premature ejaculation, which is thought to be caused by premature ejaculation because the penis is unfamiliar with stimulation due to little experience of sexual activity. As the name implies, it is a therapy that gives you experience of sex and makes your penis accustomed to the stimulus of sex.
It is said that ejaculation is directly related to the stimulation around the glans and the glans crown . Therefore, people with premature ejaculation cannot withstand the stimulus when inserting it into the vagina and often ejaculate, so it is first necessary to get used to the stimulus when inserting it. Once you get used to the stimulation of the glans penis, you will get used to the stimulation of the entire penis during piston movement.
Normally, we will proceed with treatment while receiving counseling with a specialist 6 to 10 times with a partner, but in the treatment, there are several ways to deal with ejaculation while accumulating experience of sexual activity. There is a way.
The squeeze method involves removing the penis from the vagina immediately after insertion, pressing the glans for a few seconds, waiting for the waves of pleasure to pass, resuming sexual activity, and repeating each time it is about to ejaculate. The start / stop method is to stop moving when you are about to ejaculate and start moving again when the waves of pleasure have passed. Experience sexual activity and try the method that suits you best.
Premature ejaculation training
It is a training aimed at being able to control ejaculation, and there are various types of training. Glans masturbation is a masturbation that stimulates the exposed glans by peeling the foreskin, and is a training that aims to strengthen the skin of the glans and to withstand the irritation when inserting the vagina.
If you masturbate with the glans foreskin on, you will not be able to train the glans skin, so be sure to peel off the foreskin. In addition, by reproducing the environment close to the vagina of a woman with a cup, covering the penis with a cup, starting training from a weak stimulus, and gradually giving a strong stimulus, the penis can withstand the strong stimulus. There is also a training method.
As an example, a 6-week period is set twice a week with the goal of being able to withstand masturbation stimulation for 10 minutes at each stimulation stage.
It has been reported that premature ejaculation training takes a little longer, but it has been reported that the time it can actually be inserted into the vagina has been extended . Recommended for those who want to have it.
Premature ejaculation summary
Sexual activity is a healthy and natural activity and is the most important activity that forms affection. There is also data that premature ejaculation makes sexual activity unsatisfactory, and there is a risk of self-esteem and partner relationships breaking down, and about 30% of men are worried about some kind of premature ejaculation.
It is not uncommon, and the factors range from psychogenic to organic, and there are large individual differences, so it is necessary to provide treatment that suits each individual. Getting professional treatment is very effective for improvement. Please face your partner and find a way to improve together.