Premature ejaculation – the most common sexual problem in men?

E-prescription Family doctor Specialist

Erection is an essential element of successful sexual relations, at least from the technical perspective. Potency pills considerably improve the comfort and sensations in the bedroom. But impotence, that is erection problems, is not the only sexual dysfunction that men struggle with. Even more common is premature ejaculation. Also, men sometimes complain about the lack of orgasm. How to deal with such situations?

Premature ejaculation

Premature ejaculation is a sexual dysfunction affecting even up to 30% of men, depending on how we define this term. Premature ejaculation is a situation when an ejaculation occurs before the penis is put in the vagina – such cases, however, constitute a minority (around 2%). A bigger proportion of men meet the definition of premature ejaculation in which ejaculation occurs within the first 2 minutes of sexual intercourse or the man ejaculates uncontrollably earlier than he and his partner would want to.

See: Premature ejaculation – drugs. When to start taking them?

Premature ejaculation causes

Premature ejaculation is a dysfunction that may be caused by numerous factors and, contrary to common beliefs, it is not only about excessive potency in young, inexperienced males who have few occasions to reduce their sexual tension. Premature ejaculation may be a consequence of a low serotonin level, weak Kegel muscles, hypersensitivity of the penile receptors, hyperactivity of the pudendal nerve, and a reduced sensory threshold for tactile stimuli. An important and extremely broad group of potential causes of premature ejaculation are emotional and mental factors – the fear of failure, traumatic memories, etc.

See: Premature ejaculation – treatment and advice at the sexologist’s

Tablets to delay ejaculation

Although premature ejaculation is the most common sexual disorder in men below the age of 60, it is the least common dysfunction to be treated. It is a shame because there are methods to improve the comfort of a man and his partner to a large extent. Pharmacological methods are increasingly more popular when it comes to treating premature ejaculation. Tablets to delay ejaculation usually are serotonin reuptake inhibitors, that is drugs primarily used for depression. By affecting the level of serotonin, they allow solving the problem of premature ejaculation. Additionally, you can also use various lotions, gels, and creams for premature ejaculation – they contain numbing substances, such as lidocaine. Their disadvantage is that they also numb the partner and may lead to a weaker erection.

Apart from pharmacological treatment of premature ejaculation, there is also a wide range of behavioural as well as cognitive and behavioural therapies. Patients also do exercises (e.g. using the start-stop method, pressure method, or the Kegel exercises). Masturbation and relaxation techniques are frequently used for this purpose.

See: Methods to treat premature ejaculation

Impotence – problems with erection

Another frequent sexual dysfunction is impotence, that is erection problems. Erectile dysfunction is defined by the World Health Organization as a permanent or recurring inability to achieve or maintain an erection during a sexual intercourse. Erectile dysfunction may have somatic, hormonal, and emotional backgrounds. In contrast to premature ejaculation, which is statistically more common among young men, impotence is a phenomenon that more often affects older men. It is estimated that, in Poland, even 3.5 million of adult men are suffering from erectile dysfunction, but, just as is the case with premature ejaculation, only a small proportion of them seeks specialist medical help.

Erection problems – causes

The most common causes of erection problems include hormonal disorders, especially a low testosterone level. Another source of impotence are vascular lesions, including the occlusion of the blood vessels supplying blood to the penis. Impotence may be caused by a range of chronic diseases, including diabetes, atherosclerosis, kidney or liver insufficiency, and multiple sclerosis. We cannot forget about intimate diseases – from ordinary inflammations, through prostate enlargement, to prostate cancer.

Obviously, erectile dysfunction may also stem from neurological problems, especially within the area of the spine and the spinal cord. There are also many drugs that may induce impotence – erectile dysfunction is observed in men who are starting the treatment of hypertension or depression.  Of course, impotence may also lie in emotional factors: the fear of failure, traumatic experiences, the sense of guilt and sin, cultural pressure, partner pressure, insecurity, low self-esteem – the range of psychological causes of impotence is unlimited.

Check: What can be recommended for premature ejaculation?

Potency pills, erection drugs

Erection dysfunction is a disorder that, today, is treated – temporarily or permanently. Pharmacological methods come to the rescue – potency pills allow you to get an erection and maintain it for the time of sexual intercourse. Erectile dysfunction is mainly treated with phosphodiesterase inhibitors. These are erection drugs that inhibit the activity of the PDE5 enzyme responsible for the decomposition of a substance called cGMP, which participates in the erection mechanism. Erection drugs increase the cGMP level in the cavernous bodies of the penis, which allows you to achieve and maintain an erection. Such erection drugs contain one of the three active substances: sildenafil, wardenafil, and tadalafil.

Besides, erectile dysfunction may also be dealt with using alprostadil injections, a substance that improves the blood supply to the penis and improves an erection. Alprostadil may also be administered via a special tube inserted in the urethra.

However, if erectile dysfunction has a mental background, impotence treatment is based on a psychotherapy aimed at finding the fears, traumas, and blocks, and – subsequently – eliminating them and learning new patterns of behaviour.

Premature ejaculation and lack of erection

It might seem that premature ejaculation is a completely opposite problem to erectile dysfunction. Yes and no. Both premature ejaculation and lack of erection may stem from fears and blocks of a similar emotional background. What is more, a traumatizing experience of premature ejaculation may make a man afraid of intimate relations, which would result in the lack of erection or erection fading during sexual intercourse. Not to mention the most obvious comparison – both premature ejaculation and impotence make sexual intercourse impossible or much shorter, leaving you with a sense of dissatisfaction and embarrassment, and destroying the relationship with your partner.

Lack of orgasm – how to achieve an orgasm?

An orgasm is a state of the highest sexual arousal and pleasure. It usually accompanies an ejaculation. The lack of orgasm is a problem mostly affecting women, but there is also a certain proportion of men struggling with the inability to reach the peak. Men find it even more frustrating, as erection, potency and orgasm constitute the hard and fast components of masculinity endorsed by the modern culture.

Check: How to prevent premature ejaculation?

Lack of orgasm – causes

The lack of orgasm may be caused by various factors, such as:

• Low testosterone,

• Depression and other mental disorders,

• Low self-esteem,

• Chronic stress,

• Fear, guilt, anxiety,

• Growing up with cultural and religious prohibitions,

•  The fear of an unwanted pregnancy, HIV, etc.,

• Traumatic sexual experiences,

• Nervous system diseases,

• Drugs (e.g. antidepressants, hypertension medications),

• Bad habits: alcohol, cigarettes, narcotics,

• Spinal defects, diseases, and injuries,

• Reproductive organ disorders,

• Lack of experience, bad choice of sex techniques and positions,

• Anatomical incompatibility with the partner.

How to reach an orgasm – treatment

As you see, there are numerous causes of the lack of orgasm in men and they are not limited to a single scientific field or a sphere of life. In the simplest cases, it may be enough to change or go off medications or drugs. Changing sexual practices (sex positions, methods of stimulation, etc.) may also prove helpful. In other cases, the lack of orgasm may constitute a disorder requiring an advanced psychotherapy or serious lifestyle changes (fixing personal relations, finding a new, less stressful job, etc.).

Read also: The problem of premature ejaculation – how to prolong sexual intercourse?

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