Sexuality: where does premature ejaculation come from and how to treat it?

As its name implies, premature ejaculation means the premature emission of semen during a sexual act.

This notion of prematurity is medically difficult to define, because it can be very subjective. As well as its origin, which can be psychological or physiological.

Some men think they ejaculate too quickly. They cannot maintain an erection as long as they or their partners would like. However, this “too soon” is very subjective, because there is really no standard on the duration of the sexual act. From a purely medical point of view, the International Society for Sexual Medicine defines that ejaculation can be considered premature when it occurs before or within a minute of penetration.

Several possible causes

Various psychological factors may be involved, including depression, low self-esteem, poor body image, performance anxiety, stress, relationship problems, or even sexual abuse or past sexual experiences.

But there may also be biological factors, such as erectile dysfunction, hypersensitivity of the glans, weakening of the pelvic floor muscles, hormonal imbalance (thyroid disorders), imbalance of neurotransmitters in the brain (especially at the level of serotonin receptors), inflammation of the prostate or urethra, neurological disease (multiple sclerosis), or even heredity.

… and therefore various treatments

If a biological cause is identified, a specific treatment can be proposed: drugs based on serotonin reuptake inhibitors (from the same family as Prozac) in case of neurotransmitter imbalance, local anesthetics in case of glans hypersensitivity… But if this is not the case, it is better to refrain from taking these drugs, given the side effects they expose.

When the cause is more psychological, a consultation with a sexologist can be beneficial. This professional will be able to recommend learning techniques, such as the work of the pubococcygeus (PC) muscle, the “start and stop method” or the “squeeze method” that, by allowing the man to better tame his sensations, also allows him to find control.

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