THINK ON THESE – Understanding premature ejaculation

Among men – and their respective partners – the most common sexual problem is erectile dysfunction, or more popularly known as impotence. More often than not, impotence mostly affects older men.
But there is another sexual dysfunction among males that strikes not only older men but younger people as well: premature ejaculation (PE). “Premature ejaculation occurs when a man ejaculates sooner during sexual intercourse than he or his partner would like,” explains the Minnesota-based Mayo Clinic.
PE has also been called early ejaculation, rapid ejaculation, rapid climax, premature climax, and (historically) ejaculation praecox. Actually, there is no uniform cut-off defining “premature,” but a consensus of experts at the International Society for Sexual Medicine endorsed a definition including “ejaculation which always or nearly always occurs prior to or within about one minute.”
The International Classification of Diseases applies a cut-off of 15 seconds from the beginning of sexual intercourse. Although men with PE describe feeling that they have less control over ejaculating, it is not clear if that is true, and many or most average men also report that they wish they could last longer. Studies have shown that men’s typical ejaculatory latency is approximately 4–8 minutes.
The Mayo Clinic informs that a person may meet the diagnostic criteria for PE if he experiences the following: always or nearly always ejaculate within one minute of penetration; is unable to delay ejaculation during intercourse all or nearly all of the time; and feels distressed and frustrated, and tends to avoid sexual intimacy as a result.
One out of three men may be afflicted with PE but this condition remains underdiagnosed and undertreated. “Men with PE are often reluctant to discuss their condition or are in denial,” Dr. George Lee Eng Geap, consultant urological surgeon at Gleneagles Hospital in Kuala Lumpur, Malaysia, was quoted as saying in article which appeared in Philippine Daily Inquirer. “Their partners, on the other hand, avoid raising the topic for fear of hurting their man’s feelings. This communication gap hinders diagnosis and treatment.”
“Because of the social stigma attached to PE, very few couples and even fewer men dare speak about it,” added Dr. Ulysses Quanico, president of the Philippine Urological Association (PUA).
But how widespread is the problem of PE among Filipinos? According to the 2013 Asia-Pacific Sexual Behaviors and Satisfaction Survey, 91 percent of men in the country find it highly important to sexually satisfy their partners; men want their partners to feel happy, loved and satisfied.
Unfortunately, seven out of 10 Filipinos (72 percent) were concerned that they weren’t able to sexually satisfy their sexual partners. And almost half (46 percent) were worried about ejaculating too early or not being able to control when to ejaculate.
In an article published in Health and Lifestyle, Dr. Jaime Songco, president of the Philippine Society of Urological Oncology and PUA vice president, identifies two types of PE: lifelong (primary) or acquired (secondary).
According to the International Society for Sexual Medicine, lifelong PE is characterized by the following: ejaculation that always or nearly always occurs within one minute of vaginal penetration; the inability to delay ejaculation on all or nearly all vaginal penetrations; and negative personal consequences, such as stress, frustration or the avoidance of sexual intimacy.
Secondary PE shares the same symptoms as lifelong PE, except for one key difference: that is, secondary PE develops after one had previous, satisfying sexual relationships without ejaculatory problems. This type of PE may be brought about by several problems or clinical conditions. “The most common of course is infection like prostatitis. Prostatitis or the inflammation of the prostate can make one ejaculate faster,” Dr. Songco was quoted as saying.
The exact cause of PE isn’t known, Dr. Songco claimed, but contributory factors have been identified. It was believed previously to be solely a psychological problem, but doctors now acknowledge it is more complicated and is actually caused by a complex combination of both psychological and biological factors.
Some doctors believe that early sexual experiences may establish a pattern that can be difficult to change later in life, such as: situations in which you may have hurried to reach climax in order to avoid being discovered and guilty feelings that increase your tendency to rush through sexual encounters.
Other factors that can play a role in causing PE include erectile dysfunction (“men who are anxious about obtaining or maintaining an erection during sexual intercourse may form a pattern of rushing to ejaculate, which can be difficult to change”) and anxiety “many men with premature ejaculation also have problems with anxiety — either specifically about sexual performance or related to other issues”).
Relationship problems may also play a significant part. “If you have had satisfying sexual relationships with other partners in which premature ejaculation happened infrequently or not at all, it’s possible that interpersonal issues between you and your current partner are contributing to the problem,” the Mayo Clinic explains.
The Mayo Clinic lists these biological factors that may contribute to PE: abnormal hormone levels, abnormal levels of brain chemicals called neurotransmitters, abnormal reflex activity of the ejaculatory system, certain thyroid problems, inflammation and infection of the prostate or urethra, inherited traits, and nerve damage from surgery or trauma (rare).
Various factors can increase your risk of PE, include erectile dysfunction (“fear of losing your erection may cause you to consciously or unconsciously hurry through sexual encounters) and stress (“emotional or mental strain in any area of your life can play a role in premature ejaculation, often limiting your ability to relax and focus during sexual encounters”). 
Health problems can also be contributing factor. “If you have a serious or chronic medical condition, such as heart disease,” the Mayo Clinic points out, “you may feel anxious during sex and may unknowingly rush to ejaculate.”
While PE alone doesn’t increase your risk of health problems, it can cause significant problems in your personal life. A common complication of PE is relationship stress. In addition, PE can occasionally make fertilization difficult or impossible for couples who are trying to have a baby.
“Behavior modification therapy can help most men overcome premature ejaculation,” The Merck Manual of Medical Information claims. “A therapist provides reassurance, explains why premature ejaculation occurs, and teaches the man strategies for delaying ejaculation.”
Other methods that can help a man delay ejaculation include drug treatment, application of an anesthetic to the penis, and use of condoms, which tend to decrease sensation. Sometimes a combination of drug treatment and behavioral therapy enables a man to delay ejaculation even longer than he might be able to with only one of these treatments.
“When premature ejaculation is caused by more serious psychologic problems, psychologic therapy may help,” the Merck manual said.
Meanwhile, a relatively simple method called the squeeze technique may also be effective for some. This consists of the following steps, according to the Mayo Clinic:
Step 1. Begin sexual activity as usual, including stimulation of the penis, until you feel almost ready to ejaculate.
Step 2. Have your partner squeeze the end of your penis, at the point where the head (glans) joins the shaft, and maintain the squeeze for several seconds, until the urge to ejaculate passes.
Step 3. After the squeeze is released, wait for about 30 seconds, then go back to foreplay. You may notice that squeezing the penis causes it to become less erect, but when sexual stimulation is resumed, it soon regains full erection.
Step 4. If you again feel you’re about to ejaculate, have your partner repeat the squeeze process.
“These steps are to be repeated as many times as necessary, and eventually, one can do actual intercourse without prematurely ejaculating,” the Mayo Clinic says. “After several sessions, one develops the confidence and know-how to delay ejaculation even without doing the squeeze technique.”