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stephany By On 27/04/2020 at 16:30

In Male Infertility

What is premature ejaculation?

Although premature ejaculation is the most common sexual dysfunction in men at 50%, there is still no clear definition. Various definitions have been made about this concept, which has been included in the medical literature since the end of the 1800s. In the 1970s, when the subject started to attract attention in the modern ages, Masters and Johnson defined premature ejaculation as “the man's failure to delay his orgasm until his partner has an orgasm and to monitor this in 50% of sexual relations ”. In the following years, many definitions were brought about the subject. Today, we can summarize the definitions for premature ejaculation as follows:

“ Ejaculation that occurs approximately 1 minute after vaginal penetration at all times or in most relationships. "

“The ejaculation, that is, ejaculation, cannot be delayed after the vaginal peteration or until the vaginal penetration .”

The failure of both partners to control ejaculation enough to enjoy sexual intercourse ."

Are women experiencing premature ejaculation problems?

Premature ejaculation is also a condition observed in women. However, premature ejaculation does not cause as much a problem for women as it is for men, as women can reach repeated orgasms in terms of physiology. In men, ejaculation is a more troublesome situation, since a certain time is required for erection and ejaculation after ejaculation.   

How common is the problem of premature ejaculation in men?

The problem of premature ejaculation in men is the most common among sexual problems. Approximately 20% of Turkish men experience premature ejaculation.

What are the types of premature ejaculation?

  • Lifelong premature ejaculation: The problem of premature ejaculation that begins with the first sexual activity and lasts a lifetime. It is also called primary premature ejaculation. The incidence is regarded as the 2,3-3,2'dir.türki% to 2.5%.
  • Acquired premature ejaculation: A normal ejaculation, or ejaculation, occurs when sexual intercourse first begins. It is the problem of premature ejaculation experienced as a result of any problems experienced later. It is typically considered the average rate of 4% in 3,9-4,8türkiye%.
  • Variable premature ejaculation: While the person experiences premature ejaculation from time to time, they also experience normal ejaculation from time to time. It is the most common form of premature ejaculation and is seen in 8.5-11.4%. The average rate is monitored by 8% -8.5 in Turkey.
  • Sensory variable premature ejaculation: There are cultural or abnormal psychological conditions. While the person does not actually experience premature ejaculation, they do not have to worry about premature ejaculation. In general, 5.1%, -6.4, is seen by 5% in Turkey.

What are the causes of premature ejaculation?

It is not known exactly what caused the problem of premature ejaculation continuing throughout life. Speculative psychological theories are often proposed. Theories have been suggested that hypersensitivity of stimulants controlling brain emptying or hypersensitivity of penis skin plays a role in premature ejaculation.

Variable and sensory variable premature ejaculation problem is completely based on psychological causes. Daily living conditions and stress are effective.

The acquired premature ejaculation problem can occur for various reasons.

  • Psychological causes: Stress, environmental factors, relationship with the partner, lifestyle issues, etc., can prepare the ground for the problem of premature ejaculation.
  • Endocrine factors: Thyroid problems known as goiter among the people can lead to high thyroid, hyperthyroidism premature ejaculation problem.
  • Urological problems: Prostate diseases, prostate infections, urinary tract infections or sexually transmitted diseases can cause premature ejaculation.
  • Sexual health problems: Functional disorders that we encounter in sexual health or sexual adjustment problems of women can cause premature ejaculation.

Does circumcision cause premature ejaculation?

There is a false belief in the society that circumcision causes premature ejaculation. However, studies reveal that circumcision does not cause premature ejaculation, but has the opposite effect. There are also studies that removing or cutting the foreskin can be used as a treatment method in premature ejaculation. On the other hand, there are publications regarding the decreased sensitivity of circumcised men in studies conducted with circumcised and uncircumcised men.

In short, the relationship between circumcision and premature ejaculation is still a more controversial issue; however, it is generally accepted that circumcision does not cause premature ejaculation.

Can impotence cause premature ejaculation?

Problems of premature ejaculation and impotence can often confuse each other. It is understood that many patients who applied with impotent complaints actually experienced premature ejaculation after detailed examination. Depending on male physiology, it is necessary to have a certain time for erection and ejaculation / orgasm after orgasm. Repeated orgasms are observed in young men around 30%, while only 30% over 30 years. As a result, due to the difficulty in re-erection due to premature ejaculation and male physiology, a person can define himself as impotent. In order to reveal the difference, the doctor must make a good inquiry. Sometimes impotence and premature ejaculation can occur at the same time. In such cases, the problem of impotence must be treated first.

What are the diseases that cause premature ejaculation?

Sexual problem, thyroid hormone disorder, prostate disorders, stress and besides;

Diabetes: In patients with diabetes, especially the erection problem carrying blood to the penis is affected. However, the effect of diabetes on penile nerves suggests that it will play a role in premature ejaculation.

Testosterone hormone disorders: Testosterone hormone deficiency causes premature ejaculation. On the other hand, in some studies, there are also opinions that low testosterone causes mainly late ejaculation or absence of orgasm.

Pituitary gland diseases: There are several studies with problems in the pituitary gland that can cause premature ejaculation; however, the results are not clear. However, it is clearly known that people with hypertroidism have premature ejaculation.

Varicocele: There are various opinions that varicocele can lead to premature ejaculation.

Is frequent masturbation the reason for premature ejaculation?

This issue is highly controversial and based on misjudgment. Especially in young men or men who have just started sexual intercourse, pre-intercourse masturbation can be recommended to eliminate the excitement in the first relationship. In this case, contrary to popular belief, masturbation is one of the factors preventing premature ejaculation. However, frequent masturbation may cause ejaculation, in other words, ejaculation problem, especially if there is a psychological and genetic predisposition. The situation referred to here as the genetic predisposition is the changes in receptor and penile skin sensitivity, which plays the basis of the primary premature ejaculation.

Is alcohol use a reason for premature ejaculation?

Due to its stimulating effect, low dose of alcohol may be recommended to prevent premature ejaculation. However, when high doses of alcohol consumption are reached, problems preventing erection can be seen in this case.

Do erection drugs prevent premature ejaculation?

Erection, erection problem drugs do not prevent premature ejaculation. However, since the drugs taken will continue the erection, even if there is premature ejaculation, partner satisfaction is provided since the erection continues. Erection drugs have no effect on ejaculation time

How is premature ejaculation diagnosed?

The gold standard in the diagnosis of premature ejaculation is doctor-patient interview. If there are different diseases such as underlying hormonal problems and urinary tract infections causing premature ejaculation, the tests for these are completed. The diagnosis of premature ejaculation can be established by taking the patient's story in detail. In appropriate patients, ejaculation time can be learned from the patient. The patient's complaint can be evaluated with the Turkish validated inquiry forms. The difference between impotence and premature ejaculation, the most common problem, can be demonstrated by taking the detailed history of the patient.

How is the treatment of premature ejaculation?

Various methods are used in the treatment of premature ejaculation. Depending on the patient's condition, one or more of these treatments can be used in combination at the same time.

1-Drug treatment: Drugs intended for premature ejaculation have also been developed, similar to those that provide erection, that is, those that resolve the erectile problem, used in sexual dysfunction. Dapoxetine should be taken 1-3 hours before sexual intercourse.

2-Exercise and sports: In the treatment of premature ejaculation, exercises that run the pelvic muscles are used. Kegel exercise is the most common exercise method. It can be defined as a urine retention exercise with breech muscles. Kegel exercises, which are urinary incontinent and also used in children, women and men, can be performed around the clock. The muscles that provide urine retention are the muscles that work with the muscles that prevent ejaculation. It is aimed to strengthen these muscle structures with exercises. During the sexual intercourse, when the person feels that he will empty, he will contract his muscles in this area to ensure the contraction of the muscle structure in the bladder neck and control the emptying. Kegel exercise is one of the effective treatment methods against premature ejaculation.

Apart from Kegel exercises, fitness and similar sports that operate the pelvic floor muscles are also useful in preventing premature ejaculation.

3-Creams and gels: Local anesthetic creams and gels, defined as topical agents, can be prevented from premature ejaculation. The most important advantage of gels and creams applied to the penis head and foreskin is that they are local applications and have no systemic side effects. However, creams and gels can prevent the feeling of orgasms in women and men according to the amount of use. Especially the bad smell of the gels used can create an unpleasant environment during intercourse.

4-Condom: Condoms are one of the treatment methods used to prevent premature ejaculation as they reduce the sense of sensation during intercourse. More than one condom can be used for this, as well as local anesthetic condoms.

5-Sex therapies: One of the effective methods in the treatment of premature ejaculation is sex therapies. Collaborating with psychiatrists is among the treatment methods that can yield useful results. Keeping the foreplay period as long as possible; As soon as the feeling of ejaculation is felt, methods such as changing the position of the partners can be applied.

Is there a herbal treatment for premature ejaculation?

The nutrients consumed can be used to provide erections, increase sperm count or improve sperm quality. However, in early ejaculation, there is no benefit from herbal remedies or nutrients consumed.

What problems does it cause if premature ejaculation is not resolved?

In the vast majority of the problem of premature ejaculation, psychological causes lie at its origin. Stress in the person and his partner can cause problems in the relationship. For this reason, it is important to evaluate cases with premature ejaculation in common with a urology / andrology specialist-psychiatrist. Failure in sexual life can lead to serious problems by creating imbalance and maladjustment in couples' mental state.

Can the treated premature ejaculation recur?

When the underlying condition is treated, the problem of premature ejaculation usually improves. Treatment of premature ejaculation is usually situational, as the patient group based on the organic problem is very few. As soon as the drug is used, premature ejaculation disappears. When the drug is stopped, premature ejaculation may come back.

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