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Premature
Ejaculation
Premature Ejaculation
is usually an unmistakable experience to a man or his partner, but
through the years it has been difficult for professionals to agree on a
precise definition of this common sexual concern. Simply defined,
premature is an ejaculation before the man wants it to occur. As Helen
Kaplan, M.D. and other professionals point out, this phenomenon may
occur because the man is unable to recognize that he is about to
ejaculate. And even when he does recognize he is approaching
ejaculation, he feels he is unable to control or delay the process.
Ejaculation is a reflex that, once a certain level of stimulation is
reached, is automatic. Controlling the ejaculatory reflex requires that
the man be able to recognize and regulate the amount of stimulation he
is experiencing so that he does not reach the level that will trigger
the ejaculatory reflex before he wants to. There is a point of no
return, called the point of inevitability, beyond which ejaculation will
automatically occur. So, to delay an ejaculation the man must learn to
control the amount of arousing stimulation he receives so that he does
not reach the point of inevitability before he is ready.
Men who experience
premature ejaculation frequently question their masculinity and lose
confidence in their sexual performance, which often leads to feelings of
lowered self-esteem. The term "premature ejaculator" itself
implies that the man is somehow "underdeveloped" or "not
fully mature". Therapists, when talking about this condition,
generally prefer the term "rapid ejaculator", but this too,
although less belittling, still has some implication that the man is
defective or to blame. In fact, the issue of interest is not at all
about the person but about the outcome, the earlier than desired
ejaculation.
Early ejaculation, and a
man's (or his partner's) associated negative feelings about the
experience, can often lead to increasing preexisting communication
issues in the relationship. In some cases, early ejaculation and the
emotional feelings surrounding the experience, if not discussed openly
and constructively, can lead to serious relational conflicts and more
sexual problems, like erectile difficulties and decreased sexual desire
by one or both partners.
Early ejaculation occurs
in men of all ages and of all socioeconomic backgrounds. It has been
reported in men who have no psychological problems as well as in those
who are suffering from extreme stress and anxiety. A medical condition
or physical reason is rarely found to be the cause of a man's problems
with ejaculation. However, if someone has had a good history of
ejaculatory control and then experiences early ejaculations, he should
be seen by a competent urologist to determine if there is a treatable
illness or neurological problem that has caused such a sudden change.
In most cases of early
ejaculation the man has a history of concern and worry about his ability
to control his ejaculation dating back many years, often to his first
sexual relationship or before. Some therapists think that young men
unknowingly are encouraged by events in their early sexual lives to
teach themselves to ejaculate rapidly. Early experiences of masturbating
quickly to get to the newfound good feeling of orgasm (or to avoid being
caught), or rushing through sexual experiences in the back seat of a
car, or on the family couch, may contribute to a young man unknowingly
learning to ejaculate quickly.
It is important to know
that it is neither uncommon nor abnormal for a man, on occasion, to
experience early ejaculation. For example, if he has not had intercourse
for some time, or is beginning to have sexual relations with a new
partner, an episode of loss of control is not unusual. These instances
of early ejaculation usually pass quickly and he returns, in a brief
time, to his former level of control.
Psychological factors,
such as fear of failure, or relationship issues, such as anger at one's
partner, may have some bearing on a man's lack of ejaculatory control.
There are several theories about the psychological causes for early
ejaculation and each theory has its own therapeutic approach to helping
the man improve his sense of control. Therapists treating a man, or a
man and his partner, often address these issues during the course of
treatment. However, the primary treatment of ejaculatory control is
helping a man, by various techniques, to repeatedly focus his attention
on the increasing erotic sensations in his body as he approaches orgasm.
By increasing his awareness of the buildup of these pleasurable
sensations he is better able to judge where he is along the path of
reaching an orgasm and ejaculating. (Note: orgasm and ejaculation are
separate events, caused by separate systems in the male's body, though
they usually occur at the same time. The term orgasm is commonly used
when speaking of a male's ejaculation. Technically, however, orgasm is
just the peak of the intense pleasurable feeling that usually follows a
man being highly sexually excited. Ejaculation is the term used for the
expulsion of the fluids, the ejaculant, or cum, from the end of the
penis.) He learns to make what has felt beyond his control more
understandable and controllable. Focusing on the increasing erotic
sensations of an impending orgasm, rather than trying to avoid feeling
these sensations (by focusing on baseball scores, wearing two condoms,
or applying desensitizing cream to the penis) has been proven the most
successful method for assisting men and their partners in overcoming
rapid ejaculation.
This approach was first
developed in 1956 by Dr. J. Semens and has been modified by others
including William Masters and Virginia Johnson in the late 1960's and
early 1970's. Treatments for rapid ejaculation or any other sexual
concern are highly individualized. Individuals or couples who desire
help with sexual concerns may want to read more on the subject and, if
the difficulties continue, seek the help of a trained sex therapist.
Certified sex therapists are available to help men and/or couples work
on this problem.
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