Premature ejaculation (PE), often also called rapid ejaculation, is among the most widespread sexual dysfunction in men below 40 years. Broadly, premature ejaculation may be described as the occurrence of ejaculation before the desires of both sexual partners are fulfilled. This definition, however, does not exactly specify the duration of the sexual intercourse and reaching an orgasm, both being variable and relies on several aspects characteristic to the individuals involved in the sexual activity. In fact, every male have experienced premature ejaculation at some point or the other in his life, and, hence, an occasional happening is not a matter of worry. However, if premature ejaculation occurs over 50 per cent of ventured sexual intercourse, it may be said that there is an ineffectual relationship necessitating medical treatment. Making the issue more comprehensible, let’s suppose that a male reaches orgasm after eight minutes of sexual intercourse. This cannot be called a case of premature ejaculation provided his partner frequently climaxes in five minutes and both are content with their timings. On the other hand, another male may prolong his ejaculation to 20 minutes, but this may still be regarded as premature ejaculation provided his partner requires 35 minutes of stimulation before reaching her orgasm. Thus, it is apparent from the second instance that premature ejaculation is a relative issue depending on the partners engaged in the sexual act. Premature Ejaculation StatisticsAccording to the National Health and Social Life Survey (NHSLS), around 30 per cent of all males in the United States suffer from premature ejaculation. In fact, many professionals treating premature ejaculation in the U.S. put the figure at 70 per cent saying that most men are not willing to admit the problem owing to embarrassment. On the other hand, the American Urological Association says that premature ejaculation affects between 27 per cent and 34 per cent of males of all age groups. In fact, premature ejaculation has been found to happen at any age in a male's life, but is more common in younger males – aged between 18 and 30 years. It has also been noted to occur as a secondary condition to impotence in men aged between 45 and 65 years. Although there are no available data for Asia, Australia or Africa, the European nations and India report statistics comparable to their American counterparts. Premature Ejaculation Categorization The condition of premature ejaculation may be divided into three categories – constant and regular ejaculation with minimal sexual stimula
tion before, on or shortly after penetration before the person wants to, distinct suffering or owing to problems in the relations between two persons and not entirely due to any express consequences. On the other hand, the human sexual reaction too may be categorized into three segments – libido or sexual desire, excitement or sexual arousal, and orgasm or climax. Moreover, premature ejaculation may be primary or secondary. Primary premature ejaculation is applicable in the case of men who have had the disorder ever since they were competent of functioning sexually, i.e. after the puberty period. On the other hand, secondary premature ejaculation refers to the sexual dysfunction in a man who had earlier enjoyed a satisfactory stage of ejaculatory control and for causes unidentified, the individual endured premature ejaculation later. In fact, premature ejaculation is considered to be a psychological crisis and does not manifest any identified organic disease relating to the male reproductive tract or any recognized abrasions in the brain or the nervous system. The organs that are expressly affected by premature ejaculation comprise the male reproductive tract – penis, prostrate, seminal vesicles, testicles and their limbs, segment of the central nervous system, the peripheral nervous system regulating the male reproductive tract as well as the reproductive tract of the female sex partner that may not be effectually aroused for an orgasm. Premature Ejaculation Grades There are basically four grades of premature ejaculation. The hazard of this male sexual dysfunction is that it develops rapidly going from one grade to another in a matter of few months. Grade 1 This is the most docile grade of premature ejaculation and is believed to be the beginning of the sexual dysfunction. This grade is mainly related to ‘primary ejaculators’ or those who had control over ejaculation in the past. In this grade, premature ejaculation occurs sporadically in moment's emotional tension. Grade 2 This grade is common in secondary premature ejaculation or those who have never had control over their ejaculation. In this grade, premature ejaculation occurs more or less every time and the duration of the sexual act is between 1 to 5 minutes. Grade 3
Those who don't overcome premature ejaculation on grades 1 or 2 develop grade 3 fairly fast. Psychological aspects like performance anxiety are attached to the dysfunction making it chronic. In this grade premature ejaculation occurs always and the subject ejaculates instantly after penetration. Grade 4 Grade 4 is when the sexual dysfunction becomes a disorder. Men who suffer from grade 4 premature ejaculation are inclined to avoid sexual encounters and could even develop into a psychological impotence ‘erectile dysfunction’ where the mind refuses any kind of sexual activity to avoid more frustration and suffering. In this grade premature ejaculation occurs every time and the man ejaculates directly before or right on penetration.
Premature Ejaculation Reasons Historically, premature ejaculation problems has been believed to be a psychological disorder. One theory is that males are conditioned by societal pressures to reach climax quickly because of fear of discovery when masturbating as teenagers or during early sexual experiences "in the back seat of the car" or with a prostitute. This pattern of quick realization of sexual release is difficult to change in marital or longterm relationships. The fact that female arousal and orgasm require more time than male arousal is being increasingly recognized, and this may result in increased recognition and definition of premature ejaculation as a problem. Many have doubted whether premature ejaculation is purely psychological. A number of investigators have found differences in nerve conduction/latency times and hormonal differences in men who experience premature ejaculation compared with individuals who do not. The conjecture is that some men have oversensitivity of their genitalia, thus preventing down-regulation of their sympathetic conduits and delay of orgasm. Lately a certain group of nerves in the lumbar spinal cord has been identified as the possible originator of ejaculation. This nerve site is thought to be linked to excitatory and inhibitory dopamine pathways in the brain, which play significant roles in sexual behavior. This information is providing the basis for development of medications like Dapoxetine or Priligy specifically targeting delay of ejaculation. Premature Ejaculation Impact
In case premature ejaculation happens too early prior to the sexual intercourse and the couple is attempting a pregnancy, it is impossible to achieve pregnancy unless the partner (female) uses simulated insemination. In addition, premature ejaculation is likely to leave both the partners emotionally and physically frustrated. Premature ejaculation is prone to have a direct impact on self-respect, marital function, and may also result in depression or other anxiety issues. Nevertheless, studies have not taken into consideration the link between premature ejaculation and sexual satisfaction or relationship satisfaction in couples who have not sought sex therapy. Hence, there is no evidence that premature ejaculation is an obstacle to a satisfying sexual relationship. Interestingly, observations made by men and women on men's ejaculatory behavior often don't correspond. In general, women see premature ejaculation as less of a problem than the men do. And how women see men's ejaculation, i.e. as a problem or not, seem to be largely influenced by whether they perceive the man as having premature ejaculation.