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Conditions: Premature Ejaculation

Overview - Premature Ejaculation

How does ejaculation occur?

Sexual stimulation (physical and/or mental) causes nerves in the penis to send chemical messages to the spinal cord and the brain. Brain chemicals help relay messages of stimulation throughout the brain, while nerve signals from the brain carry these messages to the rest of the body through the spinal cord to the male reproductive organs. When a man reaches a certain level of excitement during this process, chemical and nerve messages sent to the pelvis cause ejaculation. While not completely understood, it is believed that the chemical serotonin plays a major role in this process.

Ejaculation is the release of semen from the penis. Ejaculation involves mainly two phases. The first process through which the components of semen are released from the male reproductive organs (prostate, seminal vesicle, vas deferens) is called emission. During this process semen is deposited into the urethra (urine channel). The second phase (ejaculation proper, evacuation) is a reflex that causes rhythmic contractions of the muscles around the urethra, which propels the semen through the urethra and from the penis.

What are the components of semen?

Semen is the fluid releases from the penis upon ejaculation. Semen is made up of two parts: 1) sperm from the vas deferens and 2) seminal fluid which contains fluid from mainly the prostate gland and seminal vesicles.

Each time a male ejaculates, normally between 50- to 500-million sperm are released. However, they make up only about 2-5% of the volume of semen. The bulk of the semen is composed of the ejaculate fluid portion of semen. Men produce between 1 ml and 5 mls of semen during each ejaculation.



What is premature ejaculation (PE)?

Premature ejaculation is repeated ejaculation in response to minimal stimulation before, at the time of, or shortly after penetration, but before the man wishes it, and over which the man feels he has little or no control. It is important to recognize that premature ejaculation is a subjective diagnosis and totally depends on the satisfaction of the partners.

How common is PE?

PE is the most common sexual dysfunction reported by men but is still under-diagnosed and under-treated. Estimating the prevalence of PE is difficult since many men do not want to talk about it, while others may not even perceive that they have PE.

However, recent research indicates that 25-30% of men struggle with PE.

PE can happen at any age and its prevalence is consistent across all ages.

Is there variation in incidence between countries?

Global studies consistently report that 20-30% of men experience PE worldwide. This means that PE is experienced at similar rates across the globe.

What is the difference between life-long and acquired PE?

Primary PE refers to men who have experienced this sexual problem since first having sex.

Secondary PE refers to men who had ejaculatory control at some point but began experiencing PE later in life, sometimes even after years of satisfying sex, without explanation.



How does PE affect a man's psychology?

PE can have a broad impact on many aspects of a man's life. Men experiencing PE can suffer anxiety, embarrassment, inadequacy, depression, anger and guilt.

PE can cause both personal stress, and stress to a relationship. In one study, men with PE were less satisfied with sexual intercourse and their sexual relationship, and suffered more problems with sexual anxiety and arousal compared to non-sufferers.

Some men with PE have trouble staying in relationships or may be scared to begin new ones.

Does PE affect the partner of the man with PE?

PE is a problem for the couple as a whole. Partners sometimes experience frustration and anger. Also, many couples do not discuss the problem with each other or with friends and family and there can be a breakdown of intimacy between them.

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