Sexual Health Data Verified

Assessment methods of Premature Ejaculation

Written by
Dr. Ashok Kumar Choudhary
and medically reviewed by iCliniq medical review team.

Published on Oct 19, 2013 and last reviewed on Sep 07, 2018   -  3 min read

Abstract

Abstract

Premature Ejaculation is a common problem characterized by short lasting sexual activity.

Assessment methods of Premature Ejaculation

Rapid or premature ejaculation is characterized as ejaculation occurring without voluntary control and with minimal sexual stimulation.

Premature ejaculation is diagnosed by two different dimensions: ejaculatory latency or voluntary control.

According to ICD-10 classification system, ejaculation must occur ‘within 15 seconds of the beginning of intercourse,' while DSM-IV is equivocal on duration, stating that ‘ejaculation occurs with minimal sexual stimulation before, on, or shortly after penetration'.

ICD-10 makes no mention of voluntary control, while DSM-IV explains that ejaculation occurs ‘before the person wishes'. Both classification system, require the man to be distressed for at least 6 months, and both require the clinician to make a judgment regarding the independence of this condition from other mental, behavioral, or physiological disorders. The 15 seconds duration may though many man complaining that it is absurd, I like to clear here that it is required in associatition of distress felt my men in regard to this condition. Those who oppose defining rapid ejaculation in quantitative terms argue that the salient parameter should be voluntary control and hope most of readers belong to the opposition group.

Theory

The prevailing opinions regarding the cause of rapid ejaculation have typically assumed that the dysfunction was either psychological or learned, depending upon the theorists' assumptions about how the mind operates.

  • Some believe that a lowered ejaculatory latency stems from
  • anxiety, general hostility toward women,
  • interpersonal conflicts with a particular partner,
  • or conditioning patterned on furtive masturbation practices,
  • early hurried sexual experiences with prostitutes,
  • or hasty lovemaking in the backseat of a car. Once established, performance anxiety was thought to maintain the rapid ejaculatory pattern.

Anxiety Is Not a Singular Concept. Anxiety may refer to a phobic response such as being fearful of the dark wet unseen vagina. It may also refer to affect, such as the end result of conflict resolution where two contradictory urges are at play, for example the man is angry at his partner but feels guilty about directly expressing his hostility. Anxiety may refer as well to a preoccupation with sexual failure and poor performance. As the man contemplates another sexual experience, his anxiety leads to an avoidance of any future sexual opportunity.

McCarthy suggests that this performance anxiety has two discrete dimensions: a cognitive component where the man watches himself, thus removing himself from awareness of his arousal level, as well as an emotional component consisting of fear of failure.

Separating rapid ejaculation into lifelong and acquired groups may prove helpful in clarifying the etiology of the dysfunction. A subgroup of lifelong rapid ejaculators may have a biological vulnerability, while those with acquired symptoms may not. The development of rapid ejaculation requires an examination of recent psychosocial stressors, medication, or surgery. It is often a consequence of erectile failure. Men develop performance anxiety regarding their erectile reliability and rush intercourse thinking that they have limited time to ‘complete the act'. With these thoughts, this additional dysfunction appears and men become even more anxious about sexual interactions.

Assessment :

  • Rapid ejaculation is best assessed along both dimensions of ejaculatory latency following vaginal penetration and degree of voluntary control. Questions are asked about how long it takes the man to reach orgasm under each of the following circumstances: with masturbation, partner hand and/or mouth stimulation, and intercourse.
  • Some men have inordinately high expectations, for instance ‘I should be able to last 45 minutes', and falsely label themselves as rapid ejaculators. Education often reverses this misattribution. The man's level of sexual experience is reviewed, as is the duration of his current relationship.
  • Young inexperienced men routinely ejaculate quickly, while men anxious to please new partners often encounter transient problems. Factors that improve and worsen performance are noted, such as coital positions. Next, the man's degree of voluntary control is examined, and which factors improve or worsen it are noted, such as distraction.
  • The clinician reviews whether the dysfunction occurs under all circumstances or only with specific partners. If this is an acquired disorder it is important to ascertain the life events temporally related to the onset of the problem, for example mother-in-law coming to live with the family. It is also necessary to gauge whether rapid ejaculation is the primary problem or is secondary to erectile dysfunction, in other words whether it occurred after the man began having difficulty achieving an erection.
  • The quality of the non-sexual relationship is also studied, with particular attention to the partner's response to the dysfunction and her level of expectation. Finally, it is worthwhile enquiring about the partner's sexual functioning because sometimes rapid ejaculation disguises a partner's dysfunction, that is to say it is an adaptive response to the partner's sexual aversion.
  • Organic factors are seldom implicated; however, trauma to the sympathetic nervous system during surgery for aortic aneurysm, pelvic fracture, prostatitis, and urethritis can induce rapid ejaculation. Additionally, drug withdrawal from narcotics or trifluoperazine has been associated with this symptom.
 

This is a sponsored Ad. icliniq or icliniq doctors do not endorse the content in the Ad.

Last reviewed at:
07 Sep 2018  -  3 min read

RATING

15

Tags:

Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers


Is there something as sexual compatibility with a partner?

Query: Hello doctor, When it comes to physical intimacy, my partner enjoys having sex with me. I am a male. For me, it seems blunt. In spite of the erection, my penis seems less sensitive and there is very little excitement. Is there something like sexual compatibility? That is, is one only compatible wit...  Read Full »

Can Anxiety And Stress Cause Frequent Urination?

Query: Hello doctor, I am a 34 year old male. I had anxiety issues since childhood. I have been jumping from one idea to another for a long time but it has been three years I have an issue with frequent urination. It started in a bad time for me when I was obsessing that I have HIV. No burning, just sligh...  Read Full »

An Insight into Mental Health

Article Overview: There is an urgent need in many countries to increase the awareness regarding mental health. The most important task now is to make people understand the concept of mental health correctly and learn how to deal with it and get better. Read Article


Dr. Ashish Khandelwal
Psychiatrist

A 23-year-old boy, working at a private institution had gradually reduced his interactions with family and friends. He started becoming irregular at work. He used to lie down in his room during the day and not talk to anybody. One day, he was found hanging from his ceiling fan. There was a 20-year-...  Read Article

Popular Articles Most Popular Articles

Do you have a question on Mental Health or Anxiety?

Ask a Doctor Online

* guaranteed answer within 4 hours.
Enter Your Health Query
You can upload files and images in the next step.

Fee:  

 


Disclaimer: All health articles published on this website is not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.