Premature ejaculation: Causes, treatment, tips to get it under control

Premature ejaculation is a disorder that affects young males in particular, especially those who have just become sexually active. They do not yet have enough experience and do not know how to control their sexual desire.

However, rapid climax and premature expulsion of seminal fluid are also found in older, experienced men.

In the International Classification of Diseases, ICD-10, Premature ejaculation is classified as a sexual dysfunction, not caused by organic disorder or disease (i.e. dysfunctio sexualis non organica). The ICD-10 code is F52.4 and is found under Premature ejaculation, also known by its Latin name, ejaculatio praecox.

Premature ejaculation is a sexual dysfunction

People's sexuality, and therefore their sexual behaviour, has undergone a long-term evolutionary process. Of course, people still have an instinct that forces an them to look for a sexual partner. The result is reproduction and the continuation of the existence of the species, tribe, family and humanity.

However, sex life is an important component of interpersonal relationships.

In other words, it is not simply a tool for the continuation of the human species.

Sexual dysfunction is a quantitative disorder of sexual performance.

The disorder can affect the following:

1. sexual desire
2. sexual arousal
3. orgasm
4. sexual satisfaction

Important information is also obtained from the evaluation of issues such as:

• sexual attraction
• sexual activity
• frequency of sexual intercourse
• required time to ejaculate
• partner search
• cooperation and willingness of the partner to participate in sexual intercourse

One of the most common sexual dysfunctions is insufficient rigidity of the penis as a form of erectile dysfunction. As a result, premature ejaculation and libido disorders occur. The latter occurs mostly in women. Similarly, another common sexual issue is sexual desire disorder, like frigidity or vaginismus.

Ejaculation is...

Ejaculation is the expulsion, or discharge, of semen from the penis. It occurs during sexual intercourse, during masturbation, or spontaneously. The spontaneous discharge of semen in men is referred to as spontaneous ejaculation. Ejaculation takes place together with the sensations of climax, i.e. orgasm.

Some statistics on ejaculation:
The average male will ejaculate 7500 times in his lifetime
The volume of ejaculate is from 0.1 - 10 milliliters
A man will ejaculate approximately 17 liters of semen throughout his lifetime

Sperm cells travel about 10 cm to reach the egg
Sperm can live up to 6 days
The mean of total sperm count is about 120 million per 1 ml of fluid
However, nowadays that number is getting closer to 25 million due to the various negative effects

In order for sexual intercourse to be successful, the penis needs to become erect.

That happens due to nerve stimuli, which results in the dilation of blood vessels in the penis. Nerves, muscle vascular and hormonal factors are involved in erection and ejaculation. The penis fills with blood. After a certain period of stimulation, the emission phase begins, i.e. the transport of ejaculate (seminal fluid, seed) through the urethra.

During ejaculation, muscle contractions occur, which causes the ejaculate to be ejected. During this phase, the man has an orgasm, accumulated sexual excitement called sexual climax. Another definition says that orgasm is the result of the relaxation of the muscles that are involved in ejaculation.

So, what is premature ejaculation?

Premature ejaculation, a.k.a. rapid ejaculation, rapid climax, premature climax, and ejaculatio praecox, has many definitions.

It has been described as a condition where intercourse lasts less than one minute. Another definition says it is the inability to delay ejaculation long enough in order to be sexually satisfied.

Or, if a man reaches a climax with ejaculation very quickly after the start of the intercourse without his partner having reached the climax herself.

According to sexologists, the time limit neded to assume premature ejaculation is 30-60 seconds after vaginal penetration.

Of course, how long intercourse should last is relative to the individual. Some take 2 minutes, others 10 minutes to reach orgasm. It is reported that the average length of sexual intercourse needed to ejaculate is 3-7 minutes. However, for some women, it may take up to 10 minutes.

3 - 7 minutes is the average time to reach orgasm.
10.2% of women will never have an orgasm.
27.5 women will have an orgasm within 1 minute.

Premature ejaculation is divided into several types:

1. ejaculation before insertion of the penis into the vagina - ante portas, meaning "before the gate"
2. when the penis penetrates the vagina - intra portas, i.e. inside the gate
3. very soon after the movements begin

Another classification speaks of a primary and secondary type of prematureejaculation.

Primary ejaculation is defined as that which has persisted since the very first sexual intercourse. Secondary, or acquired, premature ejaculation may be caused, for example, by penis length or inflammation of the glans, of the head of the penis. Most of these factors are psychological in nature.

What other causes of premature ejaculation in men are there?

The are several causes of premature ejaculation. Primary premature ejaculation has persisted since the first sexual intercourse, whereas the secondary form stems from a physical or mental issue.

Premature ejaculation occurs at any age.

The causative agent of rapid ejaculation can be biological, psychological, social or a combination. Therefore, in some cases, no clear cause can be determined, so it needs to be examined mor ethoroughly. The problem can be short-lived or permanent.

A professional examination by a urologist or sexologist is important, especially if these difficulties persist for a long time.

Table: possible causes of premature ejaculation

Premature ejaculation occurs mainly in adolescence in men who do not yet have enough experience and are too aroused. Penile penetration, thrusting movements inside the vagina, and the inability to control arousal cause the sufferer to ejaculate.

A rapid climax may cause a misunderstanding on the part of the partner.

A negative experience can lead to fears of further sexual intercourse and failure. Thus, a vicious circle is formed, which may ultimately be the result of an erectile dysfunction. Repeated failures often lead to the breakdown of the relationship and the deterioration of the young man's psyche.

Table: Causes of premature ejaculation (brief overview)

In many areas of health and the human body, people speak about a healthy lifestyle, a healthy diet, overweight, obesity and, of course, smoking and alcohol. One could theorise about how they relate to men's premature ejaculation. However, ther emigh be a certain relationship or causation.

Learn more about: 

Bad lifestyle choices and the quality of erection

The sudden appearance of the issue in men who have not had any problems with the duration of sexual intercourse deserves some attention, too.

Premature ejaculation due to a urological problem is assumed. This acquired form may be the result of a prostate problem. In case of inflammation of the prostate and urinary tract, a professional examination is required.

A symptom of premature ejaculation is when the ejaculation occurs too early, i.e. before reaching a climax. However, this description is subjective and does not define the problem as such. The World Health Organization defines it in terms of time. It states that premature ejaculation occurs within 30-60 seconds after intromission, i.e. the penile penetration.

It also says that it is ejaculation with minimal stimulation before, on or shortly after penetration and before the person wishes it.

The sufferer is not able to delay the time of ejaculation after penetration.

In rare cases, ejaculation can occur without an erection. However, recurrent ejaculation is often the cause of erectile dysfunction.

Even though there is enough time to ejaculate, the sufferer may think that it is not. This is called subjective premature ejaculation.

The problem needs to be addressed and resolved as early in life as possible, as it can be the result of erectile dysfunction and other psychological issues, or a cause for reduced sexual desire. Therefore, an early professional examination by a sexologist or urologist is very important.

More serious mental health issues should be consulted with a psychologist or psychiatrist.

Expert consultation includes an examination by a urologist or sexologist. Medical history is important. The sufferer describes his problem concerning rapid ejaculation. The doctor might recommend a physiological examination of the genitals, foreskin, and glans.

This is recommended in cases of a short frenulum or other changes in the genitals.

A blood test may be performed to for a differential diagnosis. The examination may reveal hormonal problems or inflammation.

Important questions regarding rapid climax:

• Has the problem persisted since the beginning of sexual activity or only for a short time?
• How long does it take to ejaculate?
• Does the man have a permanent or random sexual partners?
• Is the intercourse regular?
• Or: Why aren't they regular?
• How often does the man's partner reach the climax?
• How often does the man climax sooner than his partner?
• Frequency of sexual intercourse
  • time of day
  • ambience
  • intercourse technique
  • frequency of intercourse
  • what influences this frequency
• Has there been a change in frequency of sexual intercourse due to the disorder?
• What is the partner's attitude about the issue?
• Type of contraception
• Associated diseases
• Medications taken

The course of premature ejaculation depends on the individual sufferer. Subjective perceptions can be different. It depends on the evaluation of the partners. Of course, it is also up to both partners to evaluate the whole issue and the subsequent willingness to a solution on the part of the partner.

The understanding, or negative attitude, of the female partner has a fundamental influence on how the course will progress. It is young and inexperienced men that are usually faced with the issue: concerns about future failure and being misunderstandood by the woman can have a negative impact on other sexual activities.

Ejaculation of seminal fluid without erection is a serious, but rare condition. Ejaculation can also occur before or just after the penis penetrates the vagina. The problem may be increased sexual arousal or low ejaculatory threshold.

Insufficient experience can be helped by education and counselling. The risk, however, is a worsening of the mental state, an emergence of erectile dysfunction, or a reduction in sexual desire.

On the bright side, treatment is simple. The specific form depends on the causative factor.