New consensus on premature ejaculation points to psychological aspects as cause of the problem
Premature ejaculation is characterized by extremely rapid ejaculation that can occur even before vaginal penetration, or 1 to 2 minutes after penetration. It is one of the most common male sexual dysfunctions, affecting about 20 to 30 percent of men of all ages.
In December 2014 the International Society of Sexual Medicine released a consensus on this problem, which is currently ranked in two types: premature ejaculation, primary and secondary. Primary premature ejaculation already manifests with the first sexual experience and remains so throughout life. Because of its characteristic, this type affects young men who are in sexual initiation. On the other hand, secondary or acquired premature ejaculation is characterized by a gradual or sudden onset that occurs after sexual experiences in men with normal ejaculation time but who for some reason have become more anxious. Unlike the primary, the time for ejaculation is usually higher in the secondary form. So the basic difference between the two forms is at the time of the onset of the problem (before or after the onset of sexual activity) and in the time to ejaculation.
Although premature ejaculation is not a purely psychological disorder, most studies show that psychogenic factors play a significant role in their genesis. One explanation is that men, culturally, are conditioned to reach climax quickly, for fear of being discovered when sexual activity begins, either through sexual intercourse itself or through masturbation. This pattern of rapid attainment of sexual liberation is difficult to change in long-term marital relationships.
Psychological therapy can be used as a single treatment or in conjunction with the other treatments. The focus of psychological therapy is to identify psychological difficulties that may contribute to premature ejaculation and also resolve problems in relationships that may have contributed to the cause. This therapy can be done individually or with the couple in order to discuss problems with intimacy. At the same time, psychological therapy can also help man control anxiety about sexual performance and thus increase sexual confidence.
The exact cause of premature ejaculation is not yet known. Although no theory on organic causes has been proven, studies suggest that serotonin, the natural substance produced by nerves, is important. A breakdown of serotonin actions in the brain may be a cause. Studies suggest that high amounts of serotonin in the brain slow ejaculation time while low amounts of serotonin may produce premature ejaculation.
Other risk factors for premature ejaculation include a genetic predisposition, obesity, inflammation of the prostate, hormone changes thyroid, stress, and traumatic sexual experiences.
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