Premature ejaculation can be listed among the most common sexual problems experienced by men. When it comes to the key definition of the disorder, it needs to be noted that having a “premature” ejaculation involves the release of semen a few minutes after the start of sexual activity, which often indicates the hypersensitivity of male genitalia. In reference to the disorder under analysis, the amount of time needed to have an orgasm may vary depending on many factors that will be discussed in the paper.
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DSM-5 Criteria and Types
Nowadays, premature ejaculation disorder can be listed among the most common sexual disorders in adult men from across the world. The diagnosis of the condition involves the use of the DSM-5 criteria that help to differentiate between this disorder and other types of ejaculation problems. To be diagnosed with the disorder, a male patient needs to report the following:
- The patient ejaculates one minute or less after the start of the sexual contact (vaginal penetration, other types of sexual contacts are not included in the criteria);
- The problem exists for at least 6 months and is manifested in the majority of sexual acts;
- The issue has significant psychological consequences such as stress, conflicts between intimate partners, or sexual dissatisfaction;
- The condition is not related to external factors such as the use of substances or medications and the presence of other disorders (Sungur & Gündüz, 2014).
When using the above-mentioned criteria to diagnose the condition, healthcare specialists should differentiate between the types of early ejaculation disorder. First, there are three degrees of severity of premature ejaculation, and these degrees indicate the time between the start of the act and ejaculation. Also, there are types of early ejaculation disorder that classify cases based on the situations in which premature ejaculation occurs. Thus, the disorder can be acquired (starts unexpectedly after a series of successful sexual acts) or life-long (fast ejaculation since the first sexual experience) (Sungur & Gündüz, 2014). Additionally, it is important for healthcare specialists to differentiate between situational and general types of early ejaculation to make conclusions concerning the role of psychological factors.
History and Symptoms
Speaking about the disease in the context of history, the discussion of the inability to control ejaculation started many centuries ago and is still considered a significant problem affecting the psychological well-being of both men and their partners. Thus, the problem of early ejaculation is mentioned in ancient works devoted to sexual relationships such as Kamasutra (Rao, Darshan, & Tandon, 2015). In reference to the key symptoms of the disorder, they are closely interconnected with the diagnostic criteria discussed in the previous paragraph. The key symptom indicating its presence is the inability to control and delay the release of semen. As a result, it causes other psychological problems such as the feeling of guilt or dissatisfaction.
The causes of the disorder present a significant question to be discussed since there are many popular theories that still have supporters even though there is no solid evidence. Among the brightest examples of such controversial theories is an attempt to find the links between early ejaculation and frequent masturbation in adolescents (Brewer & Tidy, 2017). Speaking about early ejaculation and other sexual disorders, modern researchers often relate it to such factors as prostate issues, hypersensitivity of the penis, or hormonal imbalance (Rao et al., 2015). It is also believed that early ejaculation can be interconnected with various physical health problems such as diabetes or blood tension abnormalities.
The degree to which the presence of premature ejaculation is predicted by psychological issues is another question attracting the attention of many researchers in the field. Even though there are suggestions that early ejaculation can develop as a result of sexual abuse or anxiety, many scholars focus on describing psychological difficulties as the consequences of the disorder (Brewer & Tidy, 2017). Continuing on the topic of causes, there is solid evidence proving that sexual problems such as early ejaculation or the inability to release semen can be related to substance abuse or medication mistakes (Rao et al., 2015). Thus, there are many factors that are directly and indirectly related to the development of early ejaculation disorder.
Considering that there are different types of premature ejaculation disorder, the consequences of the condition can be various. In terms of the prognosis, it strictly depends on the frequency of such episodes and related circumstances. Nowadays, there is no clear statistical information concerning recovery rates since male patients tend to have individual preferences and expectations when it comes to sexual activity. The success of psychotherapeutic, pharmacological, and surgical interventions may depend on the subtype of the disorder. Thus, in patients who report situational problems (for instance, issues that occur with the beginning of new romantic relationships), the causes often relate to poor interpersonal compatibility or the lack of trust. Sometimes, the decision to end relationships can be helpful in managing the disorder.
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Continuing on the topic of prognosis, it is important to focus on possible complications and consequences of the condition. First, in some cases, the failure to manage the problem under analysis poses a threat to patients’ reproductive ability (Rao et al., 2017). Apart from that, the complications of the disorder include severe psychological stress or depression. Importantly, the severity of consequences often depends on women’s reaction to the problem and their readiness to support their male partners emotionally.
Treatment and Prevention
Treatment plans for individuals with early ejaculation disorder are aimed at achieving specific short and long-term goals. The plans can include pharmaceutical interventions (SSRIs, anesthetics, anti-depressants), surgical operations, and psychotherapy sessions helping to reduce specific psychological problems that contribute to the development of the disorder (Waldinger, 2014; Baldwin, Manson, & Nowak, 2015). The choice of treatment options is inextricably connected with the supposed causes of the disorder, the presence of other problems with physical or mental health, and the severity of the condition. As for the psychological aspect of the disorder, evidence-based therapies that are successfully used to treat situational premature ejaculation include couple-therapy, psycho-education, and CBT (Waldinger, 2014).
The approaches to the prevention of this condition and tips for overcoming it are closely related to all aspects of a healthy life. For instance, knowing that this problem can develop due to medication mistakes, it is pivotal to strictly follow medication recommendations. Also, one has to pay attention to any issues with reproductive and psychological health to prevent the development of premature ejaculation. Importantly, tips for overcoming the disorder include the use of anesthetic sprays, techniques for delaying the release of semen, and thicker condoms that make friction less intense (Waldinger, 2014). Despite their effectiveness, all measures should be discussed with healthcare specialists to exclude unwanted outcomes.
In the end, the ability of adult men to engage in healthy sexual relationships with women is strongly associated with living a full-fledged life in many countries. Taking that into consideration, it becomes clear why such problem as premature ejaculation is widely discussed and attracts the attention of both mental health specialists and professional urologists. Being associated with a range of negative consequences, the disorder is treated with the help of medicaments, surgery (in severe cases), and psychotherapeutic techniques.
Baldwin, D. S., Manson, C., & Nowak, M. (2015). Impact of antidepressant drugs on sexual function and satisfaction. CNS Drugs, 29(11), 905-913.
Brewer, G., & Tidy, P. (2017). Premature ejaculation: Therapist perspectives. Sexual and Relationship Therapy, 32(1), 22-35.
Rao, T. S., Darshan, M. S., & Tandon, A. (2015). An epidemiological study of sexual disorders in south Indian rural population. Indian Journal of Psychiatry, 57(2), 150-157.
Sungur, M. Z., & Gündüz, A. (2014). A comparison of DSM-IV-TR and DSM-5 definitions for sexual dysfunctions: Critiques and challenges. The Journal of Sexual Medicine, 11(2), 364-373.
Waldinger, M. D. (2014). Pharmacotherapy for premature ejaculation. Current Opinion in Psychiatry, 27(6), 400-405.