Premature Ejaculation

Ejaculation refers to the discharge of semen in males. This may occur prior to when one or both partners desire it (prematurely). Normally, mental and physical sensual stimuli induce neural signals that result in rapid contraction of male reproductive ducts and accessory glands. This conveys sperm and fluid (collectively called semen) into the urethra, which is also the tube that passes urine from the bladder to outside the body. The subsequent contraction reflex expelling this semen from the penis is known as ‘orgasm’.

Those affected would be relieved to know that premature ejaculation is a very common and treatable complaint. If it happens randomly and not too often, there is usually no need for concern. Certain criteria have been outlined for premature ejaculation to be significant:

• Ejaculation always or nearly always takes place either before or within one minute of penetration

• You are not able to delay ejaculation at all or nearly all of the time during intercourse

• There are negative personal consequences such that you feel distressed and frustrated due to which you may avoid intimacy

The disorder can be divided into two types. It is primary (lifelong) if all previous sexual experiences have had premature ejaculation and secondary (acquired) if you once had acceptable ejaculatory control, but now it occurs too soon.

A specific cause for the disorder has not been identified, although various psychological factors play a central role. If initial sexual encounters were performed in a hurried manner, it is possible that this establishes a habit in later life. As we all know, habits are generally not easy to change. Another closely related disorder, erectile dysfunction can encourage your tendency to consciously or unconsciously, rush through intercourse. It thus follows that any sort of anxiety or stress can contribute towards premature ejaculation. Relationship problems would put a strain on intimacy too.

Additionally, certain biological factors are thought to be involved in this complex diseases process. To name a few – abnormal levels of hormones, or chemicals in brain; thyroid disease; abnormality of the ‘orgasm’ reflex; infection or inflammation of the prostate (gland that secretes fluid component of semen) or urethra (tube through which urine and semen pass out); damage to nerves from surgery or injury; inherited traits – could be considered. Cigarette smoking, diabetes, heart diseases and drug abuse are associated risk factors.

When to seek expert advise

You may feel embarrassed to talk to anyone about this but do not let that stop you from seeking medical advice. Remember, premature ejaculation is a treatable disorder and you can always get an appointment at the Kidney and Bladder Service Line at the Aga Khan University Hospital.

Feel free to discuss any query or doubt with them; sometimes a simple discussion can lead to personal satisfaction and a healthy mental state. 

Also, try not to postpone going to a doctor as sometimes, a serious underlying medical illness may be present which could be influencing ejaculation.