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Premature Ejaculation

Premature ejaculation is regarded as one of the most common sexual dysfunctions among males. Premature ejaculation is estimated to occur in 24% of men (Porst, et al., 2007). Premature ejaculation is defined as ejaculation with minimal sexual stimulation before or shortly after penetration and before the person wishes it (4th ed., text rev.; DSM–IV–TR; American Psychiatric Association, 2000). This sexual dysfunction occurs in the third stage of the sexual response cycle, the orgasmic phase. Ejaculation of semen occurs quicker than expected usually due to anxiety. A diagnosing clinician should assess for factors affecting duration of excitement phase in the sexual response cycle such as age, novelty of sexual partner or situation and frequency of sexual activity. In order to be diagnosable, premature ejaculation must cause interpersonal difficulty or distress for the individual. In addition, premature ejaculation must not be due to the direct effect of a substance.

Two types of classifications for premature ejaculation include primary (occurring since the start of sexual activity) and secondary (beginning later in life following a period of normalcy).
There are many theories for the cause of premature ejaculation including:

  • Evolutionary advantages
  • Inability to perceive one’s level of sexual arousal
  • Low frequency of sexual activity
  • Psychological causes
  • Physical causes (LoPiccolo & Stock, 1986).

Relationship problems are also contributing factors to premature ejaculation (Hunter, Goodie, Oordt, & Dobmeyer, 2009). Examples include:

  • Dissatisfaction
  • Power struggles
  • Poor communication
  • Differing value systems
  • Lack of intimacy
  • Personal expression
  • Physical affection
  • Differing sexual preferences

Psychological factors which may lead to premature ejaculation include:

  • Depression
  • Anxiety
  • Stress
  • Performance anxiety
  • Low self-esteem
  • Unrealistic standards in oneself or ones partner
  • Negative beliefs about sexual interactions (Hunter, Goodie, Oordt, & Dobmeyer, 2009)

Other factors include:

  • Age
  • Fatigue

Working with a qualified sex therapist can assist in resolving interpersonal and emotional intimacy issues such as premature ejaculation.

Pharmaceutical agents designed to reduce premature ejaculation include topical creams, and selective serotonin reuptake inhibitors. Practicing relaxation techniques or distraction methods may be beneficial to assist in delaying ejaculation.

References:

American Psychiatric Association. (2000). Diagnostic and statistical
manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

Hunter, C. L., Goodie, J. L., Oordt, M. S., & Dobmeyer, A. C. (2009). Sexual dysfunctions. In , Integrated behavioral health in primary care: Step-by-step guidance for assessment and intervention (pp. 195-211). Washington, DC US: American Psychological Association. doi:10.1037/11871-013

LoPiccolo, J., & Stock, W. E. (1986). Treatment of sexual dysfunction. Journal Of Consulting And Clinical Psychology, 54(2), 158-167. doi:10.1037/0022-006X.54.2.158

Porst, H., Montorsi, F., Rosen, R. C., Gaynor, L., Grupe, S., & Alexander, J. (2007). The Premature Ejaculation Prevalence and Attitudes (PEPA) Survey: Prevalence, Comorbidities, and Professional Help-Seeking. European Urology, 51, 3, 816-824.



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