Premature Ejaculation Treatment

Summary: 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.

Premature ejaculation's origin is yet unclear. Many however firmly believe in the psychological nature of this issue. In order to figure out how tackle premature ejaculation successfully, one needs to line up some basics about ejaculation mechanics.

The mechanism of ejaculation is indeed not a simple one; in an attempt to simplify matters, one can associate it with three distinct events taking place at the same time:

• the prostate releases the semen (seminal emission),
• the semen is squeezed out of the prostate and penis (ejaculation),
• the bladder closes in order to avoid semen to reflow backwards into it(bladder neck closure).

For the sake of simplicity we can say that the male ejaculatory mechanism is brought up through two reflexes: the glans-vasal and urethromuscular. The former is responible for bringing the semen to the posterior urethra (the seminal emission phase of ejaculation) while the latter,urethromuscular reflex, pumps it to the exterior (ejection phase of ejaculation).

The main muscle acting in the process of ejaculation is the bulbospongiosus, a paired, striated muscle at the base of the penis shaft. After the semen is flown into the bulbous urethra, the bulbocavernosus muscle contraction (BCM) squeezes the urethra and expells its contents.

Yes, I know, this could sound a bit too academic but keep this picture in mind as basically any unwanted behavior of your "sexual reflex" can be traced back to any or both of these two phases.

• Purpose of the (nearly ubiquitous) Squeeze Technique is to train the bulbocavernosus muscle to eliminate involuntary contractions that may cause ejaculation even with minimal sexual stimulation. This approach - reported by Masters and Johnson - can work quite well if the person with premature ejaculation can count on awilling and understanding partner. The premature ejaculation sufferer receives stimulation up to the point of imminent climax. Just before release, the partner squeezes the penis head - the glans - in its base; this action has the power to interrupt the ejaculation reflex. Once the sensation of impending ejaculation has subsided, one can restart the stimulation and repeat the process again. Gradually, with practice, a man can train his body to prolong his time until ejaculation. This technique has however a major drawback: the effect of the squeeze goes most often beyond merely attenuating the urge to blow and many report losing erection.
• "Start and Stop" technique . This involves sexual stimulation until the man perceives that he is about to climax. The stimulation is then ceased in order for the arousal to go down to more manageable levels. These steps can be reiterated until ejaculation is desired, the final time allowing the stimulation to continue until ejaculation occurs. Needless to say, to function this method also needs a highly cooperative partner.
• Most often premature ejaculation occurs because the body somehow can't cope with certain levels of stimulation; a "brute force" approach is therefore to lessen the stimulation. For this purpose a number of creams are on the market that can partially anesthetize (numb) the penis and reduce the stimulation that leads to orgasm. Another option is to use a thicker or more condoms. However, it is quite logical that these techniques may negatively affect the pleasure of the sex act.

Drugs

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