The cause of premature ejaculation is not clear and the disease is believed to be mainly a psychological problem. To understand how premature ejaculation can be successfully treated, we need to present some facts related to ejaculation and its mechanism.
The mechanism of ejaculation is actually quite complicated and is associated with three different simultaneous events:
- release of semen from the prostate (seminal emission),
- propelling the semen out the prostate and penis (ejaculation ),
- and prevention of semen going backwards into the bladder (bladder neck closure).
In a very simple representation, the male ejaculatory mechanism consists of two reflexes: the glans-vasal and urethromuscular. Glans-vasal reflex seems to bring the semen to the posterior urethra (the emission phase of ejaculation) and then the urethromuscular reflex ejects it to the exterior (ejection phase of ejaculation).
Deeply involved in mechanism of ejaculation is the paired, striated muscles at the base of the penis called the bulbospongiosus. Once the seminal fluid reaches the bulbous urethra, the bulbocavernosus muscle contraction (BCM) compresses the urethra and expelled its contents.
This introduction was necessary because any dysfunction of all mentioned above seem to induce ejaculatory disorders and any treatment is close related to this dysfunction.
- Squeeze Technique aims to educate bulbocavernosus muscle to eliminate involuntary contractions that may cause the ejaculation with minimal sexual stimulation. This technique described by Masters and Johnson is very successful if the sufferer has a willing and understanding partner. The person with premature ejaculation is stimulated by his partner to the point of imminent ejaculation. Just prior to ejaculation, the partner squeezes the penis in its base to prevent ejaculation. Once the sensation of impending ejaculation has subsided, the process is repeated. Gradually, over time, a man can prolong his time until ejaculation.
- “Stop and start” method This involves sexual stimulation until the man recognizes that he is about to ejaculate. The stimulation is then removed for about thirty seconds and then may be resumed. The sequence is repeated until ejaculation is desired, the final time allowing the stimulation to continue until ejaculation occurs. To be successful this method also claims the partner co-operation.
- Reducing the stimulation For men with premature ejaculation a number of creams are available that can partially anesthetize (numb) the penis and reduce the stimulation that leads to orgasm. Another option is to use one or more condoms. However, either of these techniques may interfere with the pleasure experienced during sex.
Drugs
Alternatively, your doctor may prescribe medication that helps to delay ejaculation. Delayed orgasm is a common side effect of certain drugs, particularly those used to treat depression. When this type of medication is given to men who experience premature ejaculation, it can help to postpone orgasm for up to several minutes.
