Understanding the Factors, Diagnosis and Treatment Involved in Premature Ejaculation

There are many possible factors for premature ejaculation that involve the past and present sexual relationships as well as childhood experiences. The diagnosis is made after a physical exam and evaluation of the situation and relationship. The treatment can include methods, techniques and medication.

The factors for primary premature ejaculation can be:

* A deep-seated emotional disturbance

* A behavior (conditioned response) that results from teen masturbation practices, family incest, sexual assault or a serious disturbance within the family

There are two types of premature ejaculation primary and secondary. Primary occurs when the male's only experience with coitus is that of not being able to control his ejaculation. Secondary premature ejaculation is usually performance anxiety related.

Performance pressure can come from fear of not being able to satisfy the partner, being overly worried about non-sexual events or anxiety over previous erectile dysfunction. A partner who belittles the male or has difficulty achieving a climax and turns to blame him for her inability can also lead to feelings of inadequacy that can lead to penile dysfunction. Inter-relationship issues are almost always a part of the secondary premature ejaculation experience.

Sex therapy individually or as a couple with a trained sex therapist is usually a part of the treatment plan and can be very successful. It is usually all that is needed in cases of secondary premature ejaculation.

During the appointment, the doctor will want to rule out other causes for the premature ejaculation such as anorgasmia or severely delayed orgasm in the female partner. It is important that the sexual response of the partner be considered when trying to figure out the factors of premature ejaculation.

One possible factor is that the man is confusing premature ejaculation with what is called "pre-come" which is actually lubricating fluids that are expressed from glands during the excitement phase of sexual excitement. If this turns out to be the case, the doctor will explain to the male what "pre-come" is and how to recognize it and to differentiate it from the actual ejaculate that occurs during coitus.

Erectile dysfunction (ED) is a clinical symptom for some men who are experiencing premature ejaculation. It is important for the doctor to be able to medically determine the presence of these two penile difficulties and to determine if they are both present, which one occurred first.

Laboratory testing which may include checking the serum testosterone level and the prolactin level (blood test) may be a part of the process especially if the doctor suspects that erectile dysfunction is involved.

Tests to determine the presence of depression will also be conducted which may include a blood test.

Vibrational threshold testing and nerve conduction times may be done voluntarily to help give more detailed in-depth information about the functioning of the penis.

Several methods may be taught during sex therapy that will help to teach the male how to control ejaculation. These methods will most likely include the "stop-start" and the "squeeze-pause" techniques.

Treatment usually includes a combination of therapy (individual or couples) which will address any anxiety or depression issues, or issues with unresolved sexual misconduct directed towards the male during his youth. Issues of behavior modification stemming from habits forged as a teen such as getting into the habit of speeding up ejaculation due to being pressured in the process of not getting caught will need to be corrected and new habits formed regarding the timing issue.

Relaxation techniques may be taught as well as whole-body sexual stimulation. These techniques will be taught in sex therapy as a tool for helping the male to control his ejaculate.

If the male suffers from anxiety or depression medications may be prescribed and closely monitored by the doctor. Antidepressants are also prescribed as well as a tool for delaying the ejaculation as well as topical anesthetics used for the over sensitized penis.

All three elements, factors, diagnosis and treatment are important to the process of helping the male to regain control over his ejaculation.