Patient's question:
What are the causes of premature ejaculation?Doctor's answer:
Premature ejaculation refers to ejaculation occurring before the penis enters the vagina or shortly after, when the female has not yet reached orgasm and the male's sexual intercourse duration is less than 2 minutes. This leads to sexual dissatisfaction. Generally, 30% of men experience this condition. Although it is a minor issue, it can reduce sexual quality and may also lead to other sexual dysfunctions such as erectile dysfunction. It is generally considered that premature ejaculation occurs when a man, after achieving an erection, ejaculates before entering the vagina, or immediately after entering without thrusting, causing the penis to naturally become flaccid and enter a refractory period. Clinically, ejaculation before the penis enters the vagina is diagnosed as premature ejaculation. If a man enters the vagina and quickly ejaculates after only a few thrusts, it is also defined as premature ejaculation.Guidelines:
1. Psychological factors (approximately 50%)
Premature ejaculation caused by psychological factors can also be referred to as psychological premature ejaculation. The psychological factors that trigger it in men are diverse.
It is important to note that the tension men experience during sexual activity persists and does not change immediately due to changes in the sexual environment. Additionally, long-term sexual failures can create a negative psychological cycle for the patient.
2. Organic disorders (approximately 10%)
Many male diseases can lower the excitability of the ejaculation center, making ejaculation more likely. Examples include urethritis, seminal vesiculitis, prostatitis, and other inflammatory conditions.
3. Excessive prepuce (approximately 40%)
Premature ejaculation caused by excessive prepuce (approximately 40%) occurs when a man has an overly long penis prepuce or tight underwear, leading to excessive stimulation of the glans and resulting in premature ejaculation.
Premature ejaculation has various causes, but they can be categorized into two types:
(1) Psychological factors (psychogenic): Over 80% of premature ejaculation cases are caused by psychological factors. Nadels on (1978) reported that psychogenic cases account for 85% of premature ejaculation patients. Examples include reunions after a long separation, the honeymoon period, excessive excitement or tension, extreme fatigue, depression, alcohol consumption, irregular sexual habits, poor marital relationships, a husband's underlying hostility or resentment toward his wife, or excessive fear, admiration, or (insecurity) toward her. Common psychogenic causes include:
- Some men worry excessively during intercourse, fearing early ejaculation and disappointing their partner.
- Some men, due to misunderstandings about sexual knowledge, unjustly doubt their sexual ability, leading to constant self-doubt during intercourse, especially those who believe their penis is small or feel physically weak.
- Marital dissatisfaction, such as suspicion, jealousy, or excessive respect for one's partner, can also lead to premature ejaculation.
- Some men place excessive importance on sex, have overly high expectations, or worry excessively about occasional premature ejaculation, which can increase psychological stress, create a cycle of tension, premature ejaculation, more tension, and further premature ejaculation, ultimately solidifying the condition.
(2) Organic diseases: Examples include congenital genital deformities, phimosis, inflammation of the glans or prepuce, urethritis, penile inflammation, multiple sclerosis, spinal tumors, cerebrovascular accidents, epididymitis, and chronic prostatitis, all of which can reflexively affect the spinal center and cause premature ejaculation. Certain systemic diseases or physical weakness can also disrupt sexual function, leading to premature ejaculation.
Lifestyle Care:
Premature ejaculation has many causes, and appropriate strategies should be adopted based on the specific etiology. First, it is essential to promote sexual education and gain a comprehensive understanding of the sexual history of different couples. Based on the patient's specific situation, guiding advice should be provided to overcome psychological anxiety. Adequate pre-intercourse relaxation time is crucial, and the man should appropriately divert his attention to avoid excessive tension. Both partners should work together and employ various behavioral therapies to prolong the time before ejaculation. Medication should also be used in conjunction to ensure both partners have sufficient time to reach sexual arousal and pleasure during intercourse.
The above suggestions address the question of "What are the causes of premature ejaculation?" and are hoped to be helpful. Wishing you good health!