The release of the seminal fluid from the cavity of the penis out of the body is known as an ejaculation. And premature ejaculation is an untimely incidence, which happens rapidly when a man or his partner do not want it to happen so lest it destroys their satisfaction during sex.
Premature ejaculation is also known as rapid ejaculation, or early ejaculation.
It is not something that is stressful, but it causes you dissatisfaction as you cannot have pleasure due to this physical and sexual difficulties. Since it is frustrating, it makes sex less satisfying and may wreck havoc on your sexual relationship.
Every 1 out 3 men aged between 18 and 59 years old suffer from this sexual dysfunction. This is being one of the most common sexual dysfunction in men; premature ejaculation is likely to be prevalent in 20-30% in adults all across the global population.
The Process Of Ejaculation
Every sexual behavior is controlled by the central nervous system and the spinal cord. It is similar for ejaculation as well. When you are sexually stimulated, the chemical neurons send a signal to the central nervous system, and then the brain. Your reproductive organs receive the signals from the brain due to sexual excitement, and it stimulates you to ejaculate, and as a result, seminal fluid releases from the penis tract. The whole process of ejaculation comprises two types of phases: emission and expulsion.
Key Phases Of Premature Ejaculation
The process of emission develops when the sperms interact with the seminal fluid to form semen by traveling from the testicles to prostate. In the transit of the sperm laden semen, the vasa deferentia tubes help the process, which first induces the transit from the testicles to the prostate and then from the base of the penis.
The expulsion, the process of this mechanism seems quite familiar. Expulsion occurs when the muscles in the penis contract and help facilitate the expulsion of seminal fluid from the penis. It is quite normal to have the climax and ejaculation at the same time. For many men, the climax happens without the ejaculation. Your penis gets back to its normal position once it releases the semen through the ejaculation.
So, this is how ejaculation happens. Many a times, premature ejaculation seems to be intertwined with erectile dysfunction. When the lack of flexibility hinders your capability to flex penis muscles and get an erection and maintain it after a sexual stimulation, it is known as an erectile dysfunction. It is normal to experience insensitivity once the ejaculation period is over, and hence it is tough to gauge the real cause of premature ejaculation. However, in many cases, erectile dysfunction is linked to causing premature ejaculation, and hence the primary focus is to treat ED, which can solve the premature ejaculation problems.
When it comes to premature ejaculation, there are three types of ejaculation issues.
They are as follows as below:
i. Premature ejaculation
ii. inhibited and
Premature ejaculation is one of the most common types of sexual dysfunction, which affects almost every man in their life. It occurs when there is an instant urge of expulsion of seminal fluid immediately after the penetration.
Inhibited ejaculation is what that takes time to get started. And the retrograde ejaculation is what that is supposed to occur impacted by orgasms but retracted back inside the urethra instead of getting out the penis.
There are many causes that trigger the onset of the premature ejaculation and inhibited ejaculation in men.
Causes Of Premature Ejaculation
It is widely due to performance anxiety that results in premature ejaculation in most of the men who suffer from premature ejaculation. Performance anxiety instill the feeling of how would they perform when it comes to performing during sex, and an excessive nervousness triggers the onset of premature ejaculation in men, which is more often preceded by the inhibited ejaculation as well. It happens due to lack of desires and attraction towards the female partner followed by a series of physical and traumatic conditions including strict religious belief that forces one to take sex as a sinful act. In addition, there are certain types of drugs that contribute to the development of premature ejaculation like the use anti-depressant medicines.
The nerve damage due to diabetic neuropathy in diabetic men can also contribute to the retrograde type of premature ejaculation in men as well. Certain medications that are applied to use correct mood disorder can give rise to retrograde PE. In addition to this, various surgery processes like prostate operation or bladder neck operation cause PE in men. This type of PE does not need any medical attention, unless they cause any issues with fertility.
The fertility apart, there is more to premature ejaculation, which can be a reason of dissatisfaction and unhappiness for men. However, there are different types of treatment options available to treat this sexual dysfunction.
Many believe that while undergoing the premature ejaculation treatment, there may be some underlying health risks for the patients. We will discover if this assumption is true or just a misconception.
Treatments Of Premature Ejaculation And Their Problems
There are many options to treat your sexual dysfunction like premature or involuntary ejaculation with medications.
The prescription drug like Viagra, Cialis, and Levitra are mainly designed to treat erectile dysfunction in men as they are PDE5 type inhibitors. Human testing has shown a varied level of efficacy of these drugs to treat this sexual disorder in men, and help boost sexual stamina while improving endurance and performance in the bedroom.
However, while you are on the medication of any of these drugs to keep your premature ejaculation in checks, they are likely to cause a series of health complications to you.
The first and most common type of side-effects of the prescription male enhancement drugs like Viagra, Levitra, Cialis is common cough and cold. The effects of the pills start showing its reaction as soon as it gets concentrated in your system, and hence you face from mild to severe types of headaches and dizziness. More often, the drugs bring with them the conditions of acid reflux and stomach ache that are very frustrating and disturbing, hindering you from taking part in the peaceful and enjoyable sexual activity.
These drugs can cause drug interactions with certain types of medicines, which is more common in case of diabetic and cardiovascular drugs. Since the prescription ED drugs contain nitrates, they can easily interact with the nitric oxide present in the heart and diabetes drugs. ED drugs are susceptible to increasing the level of nitric oxide in the blood, which is a key to dilating the blood vessels in the penis, including the other vessels and arteries in the blood system, and thus they bring the blood pressure down to an extreme point and cause low blood pressure.
People with heart disease and diabetes who take these ED drugs without any consultation with their doctors, may risks their life and face even death.
According to the International Society for Sexual Medicine (ISSM) guidelines 2010 which has been updated in 2014, the most effective and successful treatment option include pharmacotherapy, that comprise various types of medical therapy such as selective-serotonin uptake inhibitors (SSIR), PDE5 type 5 inhibitors, topical anesthetics, glans penis augmentation using hyaluronic acid or HA gel and selective dorsal neurectomy (SDN).
Selective-Serotonin Reuptake Inhibitors Or SSRI
As per the guidelines set by the American Urological Association in the year 2004, a set of treatment procedure was followed for SSRI to treat premature ejaculation with the help of urologists’ enhanced practice management. It was observed in the survey, that as many as 71% of US urologists preferred the treatment for PE with SSRI to any other pharmacotherapy as an initial PE management.
According to the study carried out between 1943 and 2003 on the effectiveness of the SSRIs, various types of selective-serotonin reuptake inhibitors like paroxetine and on demand dapoxetine exert effective treatment possibilities for PE. However, there is little difference between these two SSRIs in terms of their efficacy levels on the premature ejaculation.
With the daily administration of 20 mg of paroxetine, it exerts good effectiveness and easily delays the ejaculation for the maximum length of time, while the on-demand dapoxetine does not offer longer effectiveness and the delay in ejaculation only lasts for a minimal period.
Nonetheless, all types of serotogenic drugs does not offer equal efficacy for the patients with PE. Its efficacy differs from persons to persons. Although it is a better oral medication to treat PE, it does not treat the sexual disorder permanently. At the same time, it does not stop the recurrence of the disease once the medication is stopped and its efficacy is affected as well.
That apart, while you are on the medication of SSRIs to treat your PE, a series of health complication is likely to affect you. The drug induced side-effects like fatigue, nausea, and dizziness with yawning hover over you, and interferes with your daily activities.
As with daily SSRIs treatments for PE, the side-effects are likely to go away within 3-4 weeks. Simultaneously, it does not interfere with the indulgence of the sexual intimacy with your partner due to the delayed ejaculation.
On the other hand, on demand SSRIs drugs interfere with the spontaneity of the sex, and it does not let you have a satisfied sex with your partner during sex.
Still, the sexual enhancement market is highly dominated with the SSRIs to treat PE.
Topical Local Desensitizing Agent
When you are eager to delay your ejaculation, and want to have the longest run of sexual pleasure with your partner, you can use local topical desensitizing agent on the penis glans. While using this agent on the penis glans, it can restrict the sensitivity of the penis during sex and help in delaying the ejaculation.
The topic desensitizing agents like lidocaine or prilocaine cream or spray can delay sensation on the glans of the penis by numbing its sensitivity to sexual stimulation and facilitates the premature ejaculation delay. Other than spray and cream, you can find topical gels as well to delay your ejaculation. The best part of this pharmacology therapy is that it does not hinder the effects of the sensation on the penis, thus helping you indulge in sexual tryst without any external influences.
However, using this type of pharmacology therapy causes you several side-effects like local irritation on the penis member. Sometimes more severe side-effects in the forms of transvaginal contamination, penile hypothesia and female genital hypothesia are likely to happen. However, the likelihood of erectile dysfunction is at a higher risk with the use of this numbing agent.
Furthermore, the use of these topical desensitizing agents can cause you irritation due to its inconvenience and messy textures. The daily and frequent application of these agents can result in lack of desires for sexual activity, and rip off spontaneity and arousal for sex.
SDN Or Selective Dorsal Neurectomy
The penile dorsal nerve is responsible to cause sensitivity to the penis glans since it is a sensory nerve. Patients with hypersensitivity in the penis are susceptible to develop primary forms of premature ejaculation.
The reduction of the sensitivity in the penile member can reduce the sensation resulting in premature ejaculation using the surgical treatment procedure. With regard to this, the most effective surgical treatment is selective dorsal neurectomy, which is recommended for the urologists worldwide to treat conventional form of premature ejaculation.
At the same time, less invasive surgical process such as Glans penis augmentation PA using Hyaluronic acid is highly preferred to decrease the sensitivity in the penis area, and treat premature ejaculation.
However, according to the 2010 ISSM guidelines, these treatment procedures are not sufficient to treat conventional premature ejaculation as they can cause permanent loss of sensitivity in the penis member and also sexual interest.
So far, it shows that any type of treatment for PE can cause you mild to severe complications and problems.
Therefore, you take up behavioral therapy and other methods that do not cause any problems to you.