Premature ejaculatIon (PE).

Is PE solely the problem of an individual or a couple?
How does it affect relationships?
When does PE begin to be a problem?

Based on a study conducted between 2009 and 2013 by ISSM (International Society for Sexual Medicine) covering many countries, the highest rate (25.8%) of PE is observed in China.

There is no serious statistics on Azerbaijan. However, based on my experience and researches in sexual therapy field and views of my colleagues, the results are not so different. 1 in 4 men has this problem.

I think it would be more useful if we didn’t focus on statistics, instead of causes and other valuable information. If you have questions, you know I’ll be glad to answer.

Causes: 

► Starting regular sexual life at a later age
► Sexual inexperience
►Having the first sexual experiences with fear of getting caught or in inappropriate conditions

There is a need for some sexual experience to diagnose premature ejaculation. Every young man ejaculates prematurely in their first sexual experience due to lack of control over ejaculating. Control over ejaculation comes with time and sexual experience. This is a kind of learning period. However, some factors may also lead to ejaculating prematurely. For example late engage in sexual activities, insufficient sexual experience, sexuality in stressful conditions, sexuality aiming ejaculation and so on. These factors make it difficult to learn to control the ejaculation and the most important factor among them is Anxiety.

Higher levels of anxiety lead to the hindered process of learning to control ejaculation. First sexual acts being paid or in a risky environment, in fear of getting caught causes sexually anxiety which in turn makes it very hard to gain and learn controlling ejaculation. Having first intercourse in late ages also a big factor. Even if an individual is comfortable with their partner, not being comfortable inside will still cause loss of control. Anxiety won’t only prevent learning and enjoying what the body wants, it will also start ejaculatory reflex.

A man who suffers from PE will be too focused on controlling his ejaculation reflex at the same time with gaining and maintaining the erection and will ignore the partner’s satisfaction. In Rowland’s 2003 study, men have been found to have negative emotions such as shame, guilt, and tension in these situations.

When evaluating PE, these are considered matters:

♀ Partner’s approach to this problem

♀ Partner’s satisfaction and whether they had an orgasm

♀♂The closeness of the couple and the quality of the relationship in general

♀♂ Whether they can communicate about the problem

♀♂ Is pregnancy desirable? Do they about this subject?

♀♂ Is the man or the partner anxious about this problem?

Concerns that arise in a relationship due to PE:

• Closeness decreases
• Disappointment and confusion arise in both of them
• Men who suffer from PE begin to rely less on their sexual skills
• Difficulties with fulfilling their partners’ expectations
• In order to keep foreplay short, they avoid oral and hand stimulation that is important for clitoral arousal

Treatment

Medical therapies are complete therapy for sexual therapies. The point of sexual therapies with the presence of both sides is to gain man control over ejaculation. Also, correcting wrong sexual beliefs, ensuring the quality of foreplay, learning of sexual communication and enjoying sexuality as a whole not only as intercourse is the perception sexual therapy tries to create. This treatment is performed by mental health professionals who have been trained in sexual therapy.

When patients attend sexual therapy as a couple, the effect of the treatment of PE rises. It also improves the couple’s relationship and the quality of their communication as a family.

1. Revicki, D. 2008
2. Rowland, D. 2003.
3. Hartmann, U. 2005
4. Rawinska 2014
5. Stanley 2014
6. Serefoglu 2011

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