Introduction
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In Nigeria, and Africa generally, the definition of a "MAN" usually includes how well he can satisfy a woman or women in bed. For this reason, problems like
erectile dysfunction (ED),
premature ejaculation(PE) and
impotence cause a lot of distress to African men. The sad problem is that many of them do not feel confident enough to seek help for them until their partners begin to complain. The good news, however, is that premature ejaculation, which we will be focusing on today, is totally curable or manageable depending on the underlying cause.
You can also watch out for my posts on erectile dysfunction and impotence.
By way of definition, a lot of medical experts prefer not to put a time frame on the duration of normal sex, and only define PE as ejaculation or "
cumming"earlier than both parties wish for. Some, however, decided to give it a duration ranging from 1 to 2 minutes after
introitus ("penetration"). This definition is more lenient, because if you use the first definition, then, as far as a lot of women are concerned every man will be defined as having PE. A woman who has delayed orgasm for instance, may not be satisfied with sex even after an hour of penetrative sex. So the problem here will be the delayed orgasm, not PE.
If you are one of those that like proper definitions, however, the American Psychiatric Association defines premature ejaculation as persistent or recurrent
ejaculation with minimal sexual stimulation
that occurs before the participant wishes to ejaculate
and is associated with marked distress or interpersonal
difficulty.
Permit a little digression here. A higher percentage of women need between 20-30 minutes including foreplay to be satisfied. Some will never reach an orgasm unless you stimulate the clitoris manually or orally (your choice). You would want to ask how safe, oral sex is. The answer will be available in subsequent posts.
Types
PE can can be acquired, where the man has had previous
successful gratifying intercourse; or lifelong, where the man has never been able to delay his ejaculation right from the moment he became exposed to coital sex.
It could also be generalized, where the man always has PE, or situational, where the PE is only linked to a particular environment or partner.
Classification
Mild: ejaculation occurs between 30 seconds to 1 minute
Moderate: ejaculation occurs between 15- 30 seconds
Severe:
ejaculation occurs under 15 seconds or even before
intromission.
Causes
The most popular view is that premature ejaculation is psychological, but some experts have postulated the following:
1.
Hyperexcitability of the penile skin
Some individuals are just more excitable than
norma,l and find it difficult to control the intensity of the excitation.
2.
Higher testosterone
levels
Testosterone is the male sexual hormone that is responsible for male sexual characteristics, libido, sexual drive etc. So if you have this in bucket loads, it may explain why you will just fire before you even get set.
3.
Lower serotonin levels
Serotonin is a neurotransmitter
involved in the regulation of mood, sleep, general feeling of well- being and many other functions. It has also been shown to play a role in delaying ejaculation time.
The following
factors however play a significant role in contributing to, or even primarily causing
PE:
1. Pressure from the sexual partner: A sexually demanding partner can reduce the
confidence of a man and even affect how well he can perform with other women. This explains why sex therapy always
involves the participation of both partners.
2. Relationships: A man in a forced relationship for instance, may find it difficult to maintain an erection.
3. Peer effects: Friends usually tend to exaggerate their sexual prowess; bragging about how long they can go and for how many rounds. This may stir a feeling of being inadequate and psychologically defeat the individual.
4. Socio-cultural or religious influences: The restrictions of religion or culture may also affect a man's ability to perform o
ptimally.
5. Medical: Conditions like diabetes melitus, hypertension, chronic prostatitis, depression and lots more can cause secondary PE.
6. Individual vulnerability: Individuals that have had previous bad sexual experiences may eventually come down with
PE.
7. Marital status: The feeling of guilt may affect a man's performance if he is seeing someone else.
8. Attitudes towards sex: Some people are just not that keen about sex, or may see it as being diabolical, a waste of energy, or as succumbing to the basal animal in them.
Treatment
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Premature ejaculation is a very treatable condition, but it is important to bear in mind that the treatment may not be
rapid. It is also important to get the sexual partner involved in the treatment and with sessions with the therapist. First of all, let a doctor know about your condition, preferably see a psychiatrist, psychologist, sex therapists or a urologist. If you are fortunate enough to get a general practitioner like me, who is interested in managing sexual disorders, that will be okay too. You should be assessed initially to make sure there is no medical condition causing your problem. If none is found, treatment usually involves, but is not limited to one or a combination of the following modalities.
1. Sex therapy techniques
These include the pause-squeeze or stop-start technique. Here, the sexual partner trains herself in
recognizing when the man is about to ejaculate and stops whatever she is doing.
She then applies a firm but gentle
pressure on the penis where the glans joins the shaft for about 10 seconds and then continues with her act. T
he guy can also control the stopping and apply the pressure himself with the
cooperation of his partner. She then rubs the penis on her labia or
mons, and when he is about to release, she stops again and applies pressure. Even after
intromission, she continues with the technique until she is ready to end the encounter. A
fter doing this for some time, the guy will be able to get a longer interval and subsequently may not even require the
technique again.
2 Relief of pressure
It has been found useful for the guy to have a quick masturbation before
a sexual encounter. This should be done about 30 minutes to one hour before sex. Caution should however be taken in older people who may not be able to get an erection again after masturbating.
3 Sex therapy
If you are really serious about solving your PE problem, you will have to see a sex therapist or psychologist. Sex therapists may not be readily available in your area because of their number and the awareness of people about their practices, but you can always book an appointment with one. I will get you the contacts of some before the next update of this post. The Therapist
will look for a psychological cause of your problem, teach you how to pleasure your partner to orgasm even without
intromission while you work on delaying your ejaculation, teach you how to channel your thoughts on other things to reduce your focus on sex, teach you breathing techniques while in the act, in fact, many of us need a sex therapist without knowing we do.
4 Second attempt at coitus
Instead of masturbating, you can surrender yourself to the first failed attempt at sex, then gently work yourself up towards getting another erection. Let your partner know what you are doing, and fill in the gap with foreplay and pleasuring her while she
coarses your penis back to action. Do not rush yourself, and do not focus on getting the erection, just focus on pleasuring one another and you are bound to get a more satisfying second attempt at sex.
5 Drugs
Drugs like SSRIs have been proven to delay ejaculation. From experience, however, I always
advice on trying other modalities first. Therapy through drugs may bring about a feeling of
defficiency, or being "incomplete," unlike when you achieve success through other means.
If however, you prefer to go straight
for drugs, meet your doctor for a prescription. Remember the categories of doctors I mentioned above, as not all general practitioners may take you seriously. You can also inbox my mail for advice.
Natural supplements (more here) have also been advocated, but because of limited proof to back the claims, I will not make any comments here.
6 Desensitizing creams
Some
creams like EMLA cream have been used to decrease the sensitivity of the penis thereby prolonging intercourse. These creams are originally topical local pain relievers that work by reducing nerve conduction. Always remember not to rub them into the penis, just apply it for about 30 minutes to one hour, wash it off so as not to desensitize your partner too, and you are good to go. Remember though, to see your doctor first.
7 Condoms with lesser sensitivity
You can use
thicker condoms, especially when you are sure the problem is only a transient one or when you are just meeting the woman of your fantasies for the first time. After you have played out your fantasies and the initial fever has died down, you may be able to perform satisfactorily even without the condom. Just remember that AIDS is real if you are not with your wife or life partner.
8 Lifestyle modification
Like many other health conditions, all you need may just be an improvement in your general state of health. Exercise regularly, take lots of water and cut down on carbonated drinks, eat healthy food, and keep a happy state of mind.
Conclusion
Remember that PE has a cure, and the duration of therapy depends on the type that you have. Preferably, see a therapist, and do that in the company of your partner. If you do not have an access to one, talk to your doctors until you find one that is really willing to help you.
Kindly leave a comment on what you think
