Premature ejaculation during sex

Many men occasionally ejaculate sooner during sexual intercourse than they or their partner would like. As long as it happens infrequently, it's not cause for concern. However, if you regularly ejaculate sooner than you and your partner wish — such as before intercourse begins or shortly afterward — you may have a condition known as premature ejaculation.

Premature ejaculation is a common sexual complaint. Estimates vary, but as many as one out of three men may be affected by this problem at some time.

Premature ejaculation may be primary or secondary.

Symptoms:

Ejaculation that always or nearly always occurs within one minute or less of vaginal penetration

The inability to delay ejaculation on all or nearly all vaginal penetrations

Negative personal consequences, such as distress, frustration or the avoidance of sexual intimacy.

Symptoms of secondary premature ejaculation.

Causes:

• Psychological causes like performance anxiety, stress, depression.
• Erectile dysfunctions.
• Anxiety.
• Relationship problems.
• Certain medications like antidepressants and psychotropics.
• Biological causes like
  

1. Abnormal hormone levels
2. Abnormal levels of brain chemicals called neurotransmitters
3. Abnormal reflex activity of the ejaculatory system

• Certain thyroid problems
• Inflammation and infection of the prostate or urethra
• Inherited traits.

Complications of premature ejaculation:

• Relationship strains or relationship stress: This is the common complication.
• Fertility issues.

Treatment:

Sex therapy:

Squeeze technique

During which the patient and/or his partner squeeze the erect penile shaft before the ejaculatory reflex is stimulated.With this technique the patient will learn to voluntarily delay ejaculation while maintaining sexual excitation, thereby "cancelling" the orgasm .Significant improvements are seen; but therapy is time consuming and requires a partner willing to participate.

Start-stop method

Technique involves masturbatory stimulation of the penis till the sensation of heightened arousal is met but prior to the onset of the ejaculatory reflex.

The stimulation is then withheld until the sensation resolves. This is repeated until the man reaches a point that extravaginal stimulation occurs without ever reaching the sensation of inevitability.

In this method, the man learns to recognize the stage after which he cannot control

ejaculation. The treatment method trains the person to remove the stimulus just before

that stage is reached so that the urge to ejaculate is controlled. For example, when during masturbation, the man reaches a point just before ejaculating, he stops the stimulus until he starts losing the erection. Once the stage is past, he can resume the activity. This process is repeated again and again until the individual is able to delay ejaculation till the time he wishes. This method called the 'Masters and Johnson method', is most effective when the help of the partner is sought during actual intercourse.

Psychotherapy.

Medications like certain antidepressants and topical anesthetic cream.