Premature Ejaculation

Premature Ejaculation (PE) consists in a difficulty to acquire a complete control of the ejaculatory reflex.

People that have this difficulty pass from excitement to orgasm very quickly, being the plateau stage (a high arousal stage, usually prior to the orgasm stage) is almost non-existent. This aspect usually causes to the individual discomfort and anxiety, affecting the quality of their sexual intercourses. Thus, it is not infrequent that with the passage of time sexual intercourses end up being avoided.

Fortunately, this has a solution, having a very favourable prognosis, with up to 90% of therapeutic success if treated correctly. 

From  Andrologia Mallorca we help to know your case, advice you, while looking for the best professional attention and treatment, adapting the same to your case. We have a large team of professionals ready to help you. Don’t be afraid to ask for help if you need it! 

Let’s see more details about this erotic difficulty.

IS PE VERY COMMON?

Premature ejaculation (PE) can affect between 20-25% of the adult population, being one of the most common causes of consultation. In adition, this aspect does not only affect young people, but it can be also presented at any age.

WHAT ASPECTS DO WE EVALUATE?

When we see a case of PE the first thing we need to determine is assessing since when it occurs and under what circumstances it happens. In this sense, we can talk about:

  • Primary PE: That is, it has always been given, from the first shared erotic relationships. These are the most common cases of PE, accounting for 70-80% of the total.  
  • Secondary PE: These would be those cases that appear after a certain period of normalcy. Some cases of anxiety, conflict with the couple or high levels of stress can cause it. However, this is less common.
  • Situational: It is given only in some situations and in certain contexts. For example: at the beginning of a relationship, or only in penetration, but with other practices, no.
  • Subjective: Or false self-diagnosis, for a merely question of expectations. It would not be, therefore, a PE as such.

Let’ now know its causes.

CAUSES

Organic causes:

Their account for approximately 15-20% of the cases.

  • Neurological disorders, associated with a difficulty in distinguishing the signals of high arousal and premonitory sensations that accompany ejaculation. In addition to a hyperexcitability of the sympathetic system which results in lower ejaculatory latency, as well as, serotorinergic disorders and an increase in oxytocin.
  • Prostatitis 
  • Epilepsy
  • Brain tumours

Psychological causes

It is the most common etiology, bieng found in approximately 80% of the cases Anxiety is the most frequent cause

It is important to distinguish between precipitant factors (those that cause the problem), predisposing factors (when they appear) and maintenance factors (perpetuating them).

Precipitant factors:

  • Learning from the first masturbatory experiences.
  • Traumatic experiences of abuse.
  • Biased sex education.

Predisposing factors:

  • Conditioning from first unsatisfactory experiences.
  • High expectations.
  • Anxiogenic personality.

Maintaining factors:

  • Anticipatory anxiety with hipervigilance.
  • Excess of self-observation and a high perception of failure.
  • Couple crisis.
  • Little time for games and other practices.

Other factors: age, new partner, sexual intercourse frequency. 

CONSEQUENCES

This condition maintained in time and without any treatment can imply more difficulties such as lower sexual desire and arousal. It is frequent that erectile dysfunction can also appear secondary to the same fear and tension that the individual experiences, which can lead to avoiding sexual intercourses or even developing an aversion to these.

In the couple, the appearance of scenarios such as: anorgasmia, lack of desire or, attitudes of demand for execution are frequent, which translates into an unempathetic and collaborative attitude.

HOW DO WE WORK?

Pharmacological therapy

Some drugs that are usually given are tricyclic antidepressants, selective serotonin reuptake inhibitors, such as fluoxetine, sildenafil better known as Viagra and, Dapoxetine, better known in Spain as Priligy, a specific drug for PE that is taken on demand. Everything needs medical supervision and prescription.

Cognitive behavioural therapy

  • Psychological education
  • Sexual history
  • Cognitive restructure

Sexual therapy

  • Pelvic floor strengthening (Kegel exercices)
  • Self-stimulation training program.
  • Breathing exercises
  • Couple therapy

At first it is common to “forbid intercourse” with exercises such as:

  • Non-genital sensory focus.
  • Communication of fantasies with the partner.
  • Penetration without movement 
  • Stop and start technique
  • Use of erotic articles in individual or shared relationshi

Remind that in Andrologia Mallorca have a large team ready to help you.

Don’t be afraid to ask for help if you need it!