Advice for men from the International Society of Sexual Medicine
Sexual fears are a general condition that all people feel from time to time. Concerns about premature ejaculation have been reported in approximately one-third of men, although only one in ten people experience distress to the point of seeking professional advice or treatment. This leaflet is intended to provide men with information with evidence of premature ejaculation so that they can then choose the appropriate alternatives available to them to improve their sexual health. If you are concerned that you may be experiencing premature ejaculation, it will be helpful to complete a self-assessment survey at the end of this leaflet and discuss the results with your doctor.
What is premature ejaculation?
There is a great degree of misunderstanding regarding the definition and treatment of premature ejaculation. This problem is not only related to young men who do not have experience with sex, but it may also affect older men who have not had this problem before, especially those with concurrent problems with erections. The problem is always humorous, making it difficult for men with it to seek help. Premature ejaculation is best described as a man’s inability to delay orgasm and ejaculation so that both partners can enjoy a satisfying sexual experience, in the absence of other sexual problems. A man who finds it difficult to maintain an erection may arouse himself so much while trying to maintain an erection that he is unable to delay an orgasm. The man’s partner may have arousal or other problems, where she is not able to reach orgasm. The man may then think that he suffers from premature ejaculation and that he cannot.”
Television and pornographic films are usually unhelpful in their portrayal of sex. Beautiful couples are shown having fifteen minutes of sex at a time, men seem very self-confident and women reach orgasms with multiple orgasms. Usually, it doesn’t look like that at all. Most couples are surprised to learn that the average duration of intercourse, from penetration to orgasm, is about one to five minutes. The duration of intercourse can vary greatly over time in a single sexual relationship. Sometimes an orgasm occurs within seconds, sometimes minutes later, and other times it can take much longer. If the duration of sexual intercourse is mutually satisfactory – and often is – the duration of orgasm should not be viewed as a problem. Ten seconds and ten minutes can both be considered a “great sexual experience”. Duration of more than ten minutes is not always the best, as ten seconds of intense and intimate arousal is better than ten minutes of routine and boredom. If premature ejaculation is a problem, seek professional help, and treatment results are usually very good.
Definition of premature ejaculation
Premature ejaculation is a term used to describe an experience in which a man feels (1) the time from penetration to ejaculation is too short, (2) both partners are unable to control when they ejaculate, and (3) distress, personal problems, and problems Between spouses may arise from this experience. Although premature ejaculation is a fairly common sexual complaint, to date, it has not been the subject of adequate scientific research and it lacks a broadly accepted, evidence-based definition. This leaflet discusses premature ejaculation concerning vaginal intercourse.
Premature ejaculation can be divided into two main subtypes, ‘permanent’ in which premature ejaculation symptoms appear from the first sexual intercourse, and ‘acquired’ in which early ejaculation symptoms appear after a period of previously satisfactory ejaculation experience. In multinational studies, the most common duration from penetration to ejaculation was 2-5 minutes, and this value may vary between countries although current research suggests that these differences are unlikely to be significant. Despite many speculations, the cause of premature ejaculation is unknown. There is evidence that genetic factors are responsible for this in some men, and evidence of some other factors such as lack of sexual exercise increased sensitivity of the genitals or the presence of infections in the prostate or seminal ducts.
- ISS M Definition of Persistent Premature Ejaculation: A sexual disorder in men characterized by (i) ejaculation always or often occurring before (or within) one minute of vaginal penetration and (ii) the inability to delay ejaculation for all (or nearly all) vaginal penetration, and (iii) negative personal consequences such as sadness, annoyance, frustration and/or avoidance of sexual intercourse.
- Definition of Acquired Premature Ejaculation: A sexual disorder in men characterized by the symptoms of premature ejaculation beginning after a period of normal ejaculation. There is not enough data to suggest an evidence-based definition, but it is believed that the proposed standard for persistent premature ejaculation can also be applied to acquired premature ejaculation.
- Ejaculation before penetration: Ante Portas (Latin: “before penetration”) is a term used to describe ejaculation that occurs before penetration into the vagina, and is the most severe type of premature ejaculation.
- Other Sexual Concerns Similar to Premature Ejaculation: Two sexual experiences related to ejaculation have been described that are sometimes confused with premature ejaculation, called variable normal premature ejaculation and premature ejaculation-like disorder, both of which are not sexual disorders. Variable normal premature ejaculation is characterized by premature ejaculation occurring infrequently and not coinciding with the subjective feeling of uncontrollable ejaculation. This subtype is a variant of the normal sexual experience. The premature ejaculation-like disorder is characterized by fantasies about premature ejaculation or loss of ejaculation control when in reality the duration from vaginal penetration to ejaculation is five minutes or more.
Who suffers from premature ejaculation?
There is a lack of reliable information on the proportion of men with premature ejaculation in the general population, and the experience of premature ejaculation may vary according to relationship and cultural, social, and political influences. Premature ejaculation is often described as the most common sexual problem in men, affecting 3% to 30% of men. If men who ejaculate after about one minute of penetration are excluded, the proportion of men with premature ejaculation becomes less than 3%. Men who ejaculate between one and five minutes of penetration may experience negative psychological consequences characteristic of premature ejaculation. Men should have the right to have their concerns evaluated with empathy and respect by a healthcare professional and to choose to receive treatment when needed.
What is the effect of premature ejaculation on men and their partners?
Research suggests that men with premature ejaculation and their partners have concerns about ejaculation control, satisfaction with sexual encounters, emotional distress and grief, relationship problems, and the partner’s reactions. The feeling of lack of control over ejaculation is usually the main problem identified by men and their partners. In addition to the short duration of intercourse, the time between penetration and ejaculation is accompanied by this feeling of loss of control. These problems relate to the lack of satisfaction with the sexual encounter and the personal sadness associated with the sexual encounter. These problems result in personal embarrassment and intimacy problems between the man and his partner, as well as emotional distress in men.
Men and their partners frequently reported having personal problems, and they also reported more relationship problems and an overall decrease in quality of life as a result of premature ejaculation. The negative impact on the single man may be greater than the effect on the common man in a relationship, as it may form a barrier between him and the search for and enter into new relationships.
Premature ejaculation is a two-sided problem
Men and women usually have different attitudes towards sexual relations, and although generalizations are not always helpful, the following information may help us understand each other better.
- Sex experiences for men: For many men, sex means penetration, intercourse, and orgasm, which is the preference of both partners. Sex means “doing” something either with or for the partner, both of which release sexual tension. The sensations, which are triggered by kisses, hugs, and stroking (massage), are often not enough on their own, and men with premature ejaculation may especially avoid them because they fear that they will ejaculate faster than usual after penetration. Men with premature ejaculation usually focus on the duration of intercourse to the exclusion of all else, assuming that their partners focus on the same thing. Men should remember that their partners may not understand their preoccupation with this and that they are more interested in other aspects of sex. If this is not internalized, then men’s problems are understood as selfish and self-centered.
- Sexual experiences of women: For many women, sex means sharing intimacy and closeness to a partner and having an emotional and physical connection with one another. It does not just mean romantic love, but it also means sharing one’s physical and emotional autism. The reward that women seek from sex is more than just the physical pleasure associated with intercourse, as the benefits of long-term sexual intercourse for both partners may be more valuable than the immediate action itself. Both partners value the improvement in mood and feelings of happiness that may persist for hours, days, or weeks after a positive, participatory sexual experience. Kissing, cuddling, holding, and stroking each other’s partners are important things for women to enjoy without intercourse. Many women find foreplay to be more enjoyable and important than intercourse. Women may feel frustrated if foreplay is avoided by a partner who is only interested in sexual intercourse. Penetration and intercourse may be pleasant, but they are not always necessary for women to enjoy the sexual experience. The unspoken pressure of a man to allow penetration without any form of physical intimacy is deeply distressing and leads to an emotional hiatus and a woman’s avoidance of physical contact.
- Conversation and Sharing: These two points of view can be understood throughout the relationship, but misunderstandings about the partner’s needs may further reduce the enjoyment of sex, lead to feelings of illness, and may even lead to conflict and conflict. Talking about sexual interests with your partner helps both of you to understand each other’s needs and interests, and to agree on what needs to be done to change the situation for the better. This usually includes a consultation with a health professional. Your family doctor may be able to offer advice and treatment and should refer you to the appropriate specialist.
Premature ejaculation treatment
Premature ejaculation can be treated with sex therapy, drug therapy, or a combination of both. Whichever treatment method is selected, it is important to give proper attention to emotional and relationship factors rather than just focusing on extending the time before ejaculation. Since treatments for premature ejaculation affect both partners, they should be involved in the choice of treatment.
1- Sexual therapy: Sex therapy can be provided by a psychiatrist or a physician with appropriate experience. A range of techniques have been used to treat premature ejaculation but the most common approach is a type of cognitive-behavioral therapy. This treatment includes ejaculation education, exploration of how the experience of premature ejaculation in affected men compares to that of other men, and an exercise program (commonly called “start and stop”) designed to help control ejaculation and enjoy sexual intimacy. It usually requires six to ten consultations with a therapist, with regular practice of the prescribed exercises with the partner.
2- Drug therapy: Medication should only be prescribed by a doctor after medical evaluation. Medicines bought online without medical evaluation by a doctor or through other unregulated sources can be very dangerous. There are two types of drug therapy recommended by the International Society for Sexual Medicine in the Clinical Guide to Premature Ejaculation, local anesthetics, and serotonergic drugs.
Prescribing these medications should be accompanied by education about premature ejaculation and improving sexual health, as well as instructions regarding the use of the medication. Not all medications for premature ejaculation are approved by national regulatory authorities. Before prescribing a medication, your doctor should discuss with you that this medication has not been approved. Topical anesthetics are applied to the penis immediately before sex, and their purpose is to reduce sensitivity to a point where it can delay ejaculation without disturbing the pleasure of sexual sensations. Serotonin-acting drugs affect nerve signals in the brain and nervous system, and their purpose is to delay ejaculation.
Treating premature ejaculation can help extend the duration of intercourse and improve self-esteem and self-confidence. However, this alone is not sufficient to allow the couple to enjoy a satisfying sexual relationship. Paying attention to each other’s feelings and pleasure, sharing intimacy (physical and emotional), and feeling happy and comfortable about other aspects of a relationship are usually necessary for a couple to enjoy good sex.
The environment plays a role, and privacy, warmth, comfort and time are very important. The time of day could be another matter. Having sex late at night when both partners are tired is not the best option. Some couples prefer to have sex in the morning or during the day, which is especially good for retired couples who do not have children at home.
Feeling relaxed is also beneficial. Taking a shower or bathing together before sex can be both physically relaxing and sexually arousing. Take some time to cuddle and enjoy each other before attempting penetration. Whatever form of fun is acceptable to both of you is fine. Talk to your partner about what you like and don’t like, don’t make her try and guess! Also, ask your partner what she likes and what she doesn’t like. Do not rush, it may take longer for a man to have an erection and for a woman to have secretions and sensitivity to arousal as they get older, so take the time and build your sexual arousal gradually.
It’s not a good idea to try to have sex without both parties in the mood for it, but try and make the frequency of sex work for both of you. This is especially important when you are still recovering from a sexual problem. If you haven’t been able to enjoy sex for a long time, you should relearn the things you discovered at the beginning of your relationship. It is good if the frequency of sex is consistent with the desire of both parties. If you’re on medication, it may be helpful to have sex two or three times a week.
Don’t worry if things aren’t perfect at first, things get better as you get more experience with medication and learn what both of you find exciting and fun – some of these things may have changed since the first time you had sex!
Be adventurous, try something new – defy convention!
With time, patience, support, and a partner’s help (and possibly the helpful help of a healthcare professional), you’ll rediscover the pleasure and fulfillment of sexual intimacy.
Sex is a healthy, normal, and central activity for most relationships. It is important for men and women of any age, race, creed, color, and sexual orientation. Our cultural or religious background may influence the way we have sex, but it always remains an important part of the human experience. Sexual health is just as important as other aspects of health, and if you have a problem, you shouldn’t be afraid or ashamed to seek professional help.