It is often said that there are no such sexual problems that could not be created. This statement is based on our commonplace ignorance due to the lack of sexual education and sexual illiteracy of people. Although in any wise saying there is a bit of truth. In order for someone not to crush every person he rolls on, and there are more answers to intimate questions than patients from medical sexologists, the girl’s burning question should be answered. And for starters buy dapoxetine online, it is worthwhile to deal with the terminology that creates the prerequisites for an illiterate interpretation of the topic itself. We will talk about such vulnerable for men concepts as premature ejaculation, accelerated ejaculation and short sexual intercourse.
The terminological dilemma in the names – “premature ejaculation” or “accelerated ejaculation” – is resolved quite simply. These are synonymous designations of the same phenomenon, which the International Academy of Sexological Research (IAIS), the leading public organization of sexologists, devotes its annual meetings to. And this is not accidental, since premature ejaculation is one of the most common conditions that reduce the quality of sex life of men and their partners. Premature ejaculation is a term common in Europe and America.
This is a kind of symptom complex in which ejaculation occurs with minimal sexual stimulation, or occurs before, or immediately after the intromission (insertion of the penis into the vagina), without giving both partners the desired sexual satisfaction. Premature ejaculation leads to problems in communication with the sexual partner and is not associated with the direct action of drugs.
When they talk about premature ejaculation, it most often means the inability of a man to control the moment of his orgasm. This problem gives the man a deep disappointment, aggravated with each such contact and captures almost every man, given that the estimates of various authors premature ejaculation occurs from 25 to 60% of cases. Moreover, most men quickly ejaculate during their first sexual intercourse, and approximately 29% of men experience premature ejaculation regularly (Laumann, 1994). According to surveys of R. Crookes and K. Baur, 75% of male students reported that rapid ejaculation, at least sometimes, is a problem for them, 25% said that this problem accompanies them all the time.
According to different authors, the frequency of premature ejaculation in men ranges from 1 to 77% of cases. The most representative scientific research to determine the prevalence of premature ejaculation among medical sexologists called the work of E. Lauman with co-authors, performed in the United States. During the examination of 1422 men aged 18 to 58 years, it was found that the frequency of premature ejaculation is 29%. According to the same research, premature ejaculation is a complaint in 35-40% of men who applied to a sexologist. It has been established that ejaculatory function disorders are more common in men of young and middle age with higher education, where premature ejaculation is the most common sexual problem in men younger than 40 years old (Noble, 2002). And before it was believed that only the elderly are subject to this disorder.
W. Master and V. Johnson (1970) describe premature ejaculation as a specific fear of sexual intercourse, stress of affective (“fear of action”) and cognitive (“spectator”) components. At one time (until 1979), premature ejaculation was considered as a form of impotence. There were definitions when the duration of copulation was determined by the number of fixed frictions or a specific time. Sometimes it was argued that if a woman does not experience an orgasm in half of coital intercourse, it means that a man leaves his seed prematurely. Today, however, the American Psychiatric Association is determined to determine premature ejaculation from the point of view of “reasonable arbitrary control.” Well-known psychologist Joseph Lo Piccolo believes that there will be no premature ejaculation if both partners “agreed that the quality of their sexual contact would not depend on efforts to delay ejaculation.»
In the International Classification of Diseases of the 10th revision, premature ejaculation is defined as sexual dysfunction, not caused by organic disorders or diseases and consisting in the inability to control ejaculation to the extent that would be sufficient for both partners to enjoy sexual intercourse. In this case, the time of the friction period is not taken into account, which can lead to diagnostic errors in the case of anorgasmia and other pathological conditions of the partner. But, despite the apparent subjectivity, this definition fully reflects the psychological and social aspects of this problem.
Controlled Reflex Process
Ejaculation is the process of excretion of the products of the activity of the testes and accessory gonads, with a specific role of the paracentral lobules of the brain. The moment of inevitability of secretion ejection occurs approximately 2-4 seconds before the eruption from the external opening of the urethra. As soon as a man reaches a critical level of arousal, ejaculation occurs in him reflexively, and the center of this reflex act is located in the lumbar spinal cord.
Through powerful nerve impulses, contraction of the muscle walls of the vas deferens and pelvic floor musculature, the ejaculate ejection reaches such strength that some men ejaculate erupts a meter forward! Moreover, men are capable of a series of ejaculations, following one after another with various breaks: short or long. True, they are far from the golden hamster, according to the observations of biologists able to spend up to 50 ejaculations for an hour.
The volume of a man’s ejaculate in one shot reaches a teaspoonful in 5 ml (about 120–600 million spermatozoa), while the concentration of sperm in it depends on the frequency of eruption. The presence of 40–120 million spermatozoa per ml is considered normal. And each subsequent ejaculation occurs only after a relatively short reflex period – relaxation. An orgasm with or without ejaculation with a subsequent decline in erection and the onset of a reflex period marks the end of intercourse. From when, after what time ejaculation will occur with a decline in erection, we can talk about premature ejaculation, normal intercourse or delayed ejaculation.
Many researchers of sexuality claim that a person is normally capable of delaying an orgasm or “letting go” of it at will. According to these surveys of the last decades, the effect on ejaculation and control over it in most cases is possible under certain conditions, availability of knowledge, skills and experience. That is, the man is able to control his orgasm and ejaculation. If so, then the main problem of accelerated ejaculation is most often seen in the field of control over PE.
This statement is not indisputable. The well-known European expert in the field of sexology Helen Kaplan premature ejaculation, on the contrary, connects with the inability to control the inevitability of this reflex process. A man is simply able to endure a high degree of sexual arousal only until a certain moment, and then reflex ejaculation occurs.
Some researchers are convinced that there are people who are unable to exercise such control for a number of reasons (for example, if PE is the result of a functional impairment of the nervous regulation at its various levels). Those of men who cannot control this reflex process without some help, correction, treatment, become patients of sexologists diagnosed with “premature ejaculation”.
Men with premature ejaculation often underestimate the level of their physical arousal during penile stimulation, and ejaculation occurs even before reaching the maximum sexual arousal. The ejaculatory control of such men is not fruitful enough, so many of them have been struggling with the problem for decades and do not find its solution.
The point here, firstly, is that if there is such a problem, a man begins to pay attention only to the ejaculation process itself, being in constant tension and waiting for premature ejaculation, which, as a rule, leads to it. Such a focus on the ejaculation process often negatively affects erections. And as a result – the possibility of developing erectile dysfunction.
And secondly, the modern view of sex, created by the sociocultural situation in the country, presupposes a mechanistic attitude that prevails in sexual relations. This approach is fixed in the minds of men by means of mass communication, video production, the Internet, where fantastic ideas about sexual intercourse as a working process in a cylinder – a vagina – a powerful metal piston – a phallus that produces energy, heat, enjoying strong shocks for a long time, are shown to be an absolute norm ! Convinced of the uniqueness of this approach, men reject or reject all that does not correspond to this view of sex.
In the men’s company there are legends and myths that “a strong man is one who can saw and saw for hours without stopping.” Men brag to each other in huge time intervals before ejaculation, and the rapid onset of ejaculation is considered as a sign of weakness. But more often it is a look at young sex. Patients of sexologists with delayed ejaculation do not think so. The truth is that the younger and sexier a man is, the faster he ejaculates. In nature, during the period of sexual intercourse, animals are relatively defenseless. Individuals that could not quickly have sexual intercourse were easy prey for predators. This social development, changing attitudes to sexual relations with the development of sexual culture, changed norms, formed behavioral stereotypes, suggested new values.
According to the followers of Taoism, for example, the words “ejaculating prematurely” are not an exact term and cannot be used without restrictions. Suffice it to recall the young men who begin their sex life with fast, uncontrollable ejaculations, with female partners virgins. For an inexperienced man, making love to a young woman who has a close vaginal entrance makes it very difficult to control ejaculation.
Types of Ejaculation
1. The relative acceleration when ejaculation occurs before the appearance of an orgasm in a woman, although it takes at least a minute from the moment of immission to ejaculation and the man produces at least 20–25 frictions.
2. The absolute acceleration of ejaculation, when the duration of the copulative stage is less than 20 frictions.
3. The onset of ejaculation in the setting of sexual intercourse, but before the introduction of the penis into the vagina.
4. Delayed ejaculation, when sexual intercourse is protracted, sometimes debilitating; The extreme degree of delayed ejaculation is an anejaculatory phenomenon, in which ejaculation does not occur at all.
Some researchers of sexuality identify persistent and episodic forms of premature ejaculation and the various variations associated with the onset of ejaculation relative to the onset of the vaginal phase of sex. For example, in sexological dictionaries, this spectrum expands:
– Ejaculation ante portas – involuntary ejaculation, occurring before or at the time of introitus (penetration) of the penis (into the vagina).
– Painful ejaculation – ejaculation, accompanied by painful sensations at the moment of sperm release.
– Ejaculation delayed – ejaculation that occurs as a result of sexual intercourse, which is protracted, sometimes painful.
– Ejaculation delayed involuntary (obstructed), which is understood as a long-lasting ejaculation, regardless of the desire of the man. It is also called late. The systematic appearance of such ejaculation suggests the possibility of treating it as a sexual disorder.
– Ejaculation delayed arbitrary (same as ejaculation delayed conscious) – a conscious increase in the duration of sexual intercourse beyond the physiological norm.
– Ejaculation is premature (accelerated) – ejaculation, which occurs when the duration of the friction stage of the copulative cycle is from 1.5 to 3.5 minutes.
– Ejaculation is premature absolute – that ejaculation that occurs when the duration of the friction stage of the copulative cycle is less than 1 minute or after 20-25 frictions.
– Ejaculation premature relative occurs when the duration of the friction stage of the copulative cycle is from 1.5 to 3.5 minutes or even more, but before reaching the partner orgasm.
– Retrograde ejaculation (same as ejaculatory reflux). With this type of ejaculation, sperm eruption occurs in the bladder, and not from the external opening of the urethra. Such a dysfunction manifests itself by the absence of an outward discharge of sperm during ejaculation and a preserved (or somewhat altered) sense of orgasm.
In case of premature ejaculation, it is possible to distinguish the so-called asthenic form, in which we are talking about irritable weakness, often associated with impaired erection. Ejaculation with this form of the disorder sometimes occurs with incomplete erection, or even unexpectedly, without prior sexual arousal.
Most authors share the premature ejaculation on the primary and secondary.
Primary PE manifests itself in the initial period of sexual activity and is caused by changes in the central and peripheral nervous structures regulating copulatory function. Most often it is the result of psychological excitement and increased excitability.
Accelerated ejaculation and the associated attempts by men to control themselves often lead to the fact that the man begins to avoid sexual intercourse or consider himself sick, defective. And in the absence of any action to eliminate it, this type of PE always exists with a man.
Secondary PE is acquired as a result of the appearance of various inflammatory diseases of the prostate gland, urethra, etc. This PE is caused by pathological changes in other organs and body systems. Eliminating the presence of various diseases, the result of which could be premature ejaculation, you can restore normal ejaculation. The course of treatment of PE is assigned to each patient individually, based on the results of the survey. This treatment is aimed at eliminating the factors leading to premature ejaculation, and at achieving a man’s ability to control the duration of sexual intercourse.
Causes of Premature Ejaculation
The data of literary sources, research materials, authoritative opinions of scientists show that the physiological causes of PE and the concept of “ejaculatory control” are not clearly defined to this day. Nevertheless, it is believed that among the factors that cause premature ejaculation, a violation of the psychological control over the onset of ejaculation and the inadequacy of the tactile and deep sensitivity of the penis are in the lead.
This is a fairly broad look at the circumstances of PE. More specifically, various factors of physiological, organic, psychological, behavioral, sociocultural and other nature can be attributed to the causes of premature ejaculation:
1. The presence of the syndrome of paracentral lobules. This disease can be either congenital or acquired. According to Bancroft J., cortical disorders affect disorders of the genital organs and the bladder. In this syndrome, in addition to premature ejaculation, other disorders are also observed: nocturnal enuresis, pollakiuria, anisocoria, asymmetric elevation and inversion of the reflexogenic zones of the Achilles reflexes. The ejaculatory component disorders for this were established as the dominant lesion in 3.8% of those examined.
2. Inflammatory processes in the seminal tubercle. In the process of sexual intercourse in the seminal knoll, where the inflammatory process has arisen – colliculitis, blood circulation increases, ascending impulses increase, irritating the central nervous system zones responsible for orgasm. With a pathological increase (hypertrophy) and inflammation, such impulses intensify, orgasm occurs earlier, usually with a loss of quality of the orgasm itself.
3. Inflammatory processes of accessory gonads. Prostatitis and vesiculitis – inflammatory diseases of the accessory genital glands – are closely related to the seminal collic. Therefore, with their inflammation, the latter may also be involved in the pathological reaction. However, the treatment of these diseases without affecting the seminal collic does not bring a lasting effect.
4. Dysregulation of ejaculation in the sacro-lumbar spinal cord. Sometimes it is the result of a primary lesion of the spinal genital centers with increased excitability of the ejaculation center. With spinal lesions, with injuries of the lower thoracic and upper lumbar spinal cord (Goldmeier, Keane, Carter et al., 1997), with pelvic fractures, detachment of the posterior urethra and rupture of the bladder, strictures of the urethra.
However, with gross structural changes usually occurs anejaculation or tardyakulyatsiya, premature ejaculation occurs rarely.
5. Hypersensitivity of the glans penis. Nerve endings, located in the head of the penis, are the main receptors in the nerve arch, closing in the spinal cord. With an increased number of receptors and their greater than necessary susceptibility to the effects, premature ejaculation occurs.
6. Short frenulum of the penis.
7. The low threshold of the ejaculation reflex as a result of the characteristics of the sexual constitution. For this reason, ejaculation sometimes occurs with incomplete erection or unexpectedly, without prior sexual arousal.
8. Result of damage to the central vegetative structures concentrated in the hypothalamus. But according to Russian researchers, the specific weight of PE due to functional disorders of the activity of subcortical nerve centers is insignificant in the total mass of sexual disorders.
9. Injuries of the sympathetic nervous system during operations for abdominal aortic aneurysm, atherosclerosis and arterial hypertension.
10. Chronic intoxication with some poisons (alcohol, nicotine, narcotic and other substances), leading to a change in the excitability of all parts of the nervous system.
11. The negative effect of various types of drug therapy (chemotherapy, hormonal and antihypertensive therapy, antidepressants, etc.) on sexual function and, in particular, on ejaculation.
12. Excessive sexuality, high sexual activity of a man, which is manifested in the ability to frequent non-durable sexual acts at short intervals.
13. Lack of experience in controlling ejaculation when entering into sex life. Some sexologists believe that sexual intercourse in adolescence occurs in a rush, in a state of nervous tension, or because of the fear of being caught off guard.
14. Low frequency of sexual intercourse, which leads to increased sexual arousal (especially in young people).
15. Anxiety, anxiety, fear during sexual intercourse, associated with external factors or due to interpersonal relationships of partners.
16. Developed a habit of rapid onset of ejaculation during masturbation or prior sexual experience.
17. The result of the acquisition of experience in situations that promote short sexual intercourse.
18. Syndrome of obsessive expectation of failure (having happened for the first time, such failure forces to wait for its repetition next time).
19. Interpersonal problems of sexual partners. The most frequent and perceived interpersonal factors are: dissatisfaction with family life, failures in resolving interpersonal conflicts, lack of trust of a partner, fear of intimate and romantic relationships, sex-role conflicts.
20. Unconscious need of a man, as his only way of “escaping” from the overwhelming mother-like wife. In this case, at the stage of coitus, an insurmountable obstacle arises, from which one wants to get away more quickly due to accelerated ejaculation. And here, without the intervention of a doctor capable of resolving the conflict, one cannot succeed.
21. Negative knowledge about sex. For example, the installation on copulation as an extremely fast process of transferring sperm to the egg, from man to woman to conceive a child.
22. The general depletion of the nervous system as a result of an unhealthy lifestyle, fatigue, lack of sleep. For the category of nervous and restless men with increased excitability, heightened sensitivity of nerve endings to external influences is characteristic. They function, as it is sometimes said, at “elevated speeds”. And break in the most ordinary situations that do not cause any emotions in balanced people.
There may be more reasons, moreover, some researchers group them in different directions. For example, premature ejaculation may be due to psychological, somatic, neurological causes. But while candidate and doctoral dissertations are being written, I want to provide not theoretical, but practical assistance to those who need it.