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Assessment Methods of Premature Ejaculation

Published on Oct 19, 2013 and last reviewed on Dec 30, 2021   -  4 min read

Abstract

Premature ejaculation is a common problem characterized by short-lasting sexual activity. The ejaculation will occur with minimal sexual stimulation earlier than one would like.

Contents
Assessment Methods of Premature Ejaculation

What Is Premature Ejaculation?

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

What Are the Symptoms of Premature Ejaculation?

The main symptom of premature ejaculation is the failure to delay ejaculation for more than one minute after penetration or masturbation.

Premature ejaculation can be classified as:

How to Assess Premature Ejaculation?

Two different dimensions diagnose Premature Ejaculation:

According to the ICD-10 (International Statistical Classification of Diseases and Related Health Problems) 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 or shortly after penetration.

ICD-10 does not mention voluntary control, while DSM-IV explains that Ejaculation occurs 'before the person wishes.' Both classification systems require the man to be distressed for at least six months. Both require the clinician to judge the independence of this condition from other mental, behavioral, or physiological disorders. The 15 seconds duration may make many men complain that it is absurd.

I want to clarify here that it is required to associate distress felt by men regarding this condition. Those who oppose defining rapid Ejaculation in quantitative terms argue that the salient parameter should be voluntary control and hope most readers belong to the opposition group.

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:

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 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.

It was suggested 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, and 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 erectile reliability and rush intercourse, thinking they have limited time to 'complete the act.' With these thoughts, this additional dysfunction appears, and men become even more anxious about sexual interactions.

What Are the Assessments Done for Premature Ejaculation?

Serum levels of follicle-stimulating hormone, prolactin, luteinizing hormone, total and free testosterone, thyroid-stimulating hormone, free triiodothyronine, and thyroxine were measured to diagnose premature ejaculation. Usually, these levels will be lower in men with premature ejaculation, according to the premature ejaculation diagnostic tool. But, still, the relationship between these findings has to be determined by more extensive studies.

What Are the Risk Factors Associated With Premature Ejaculation?

Various factors can increase the risk of premature ejaculation, including:

Conclusion:

Since premature ejaculation is recognized as a disorder caused by psychogenic and biological etiologies, it is important to assess patients with potential causes. An assessment of premature ejaculation should be made to know the possible cause, to prescribe an appropriate treatment. Various treatment options are being developed, but there are no licensed medications to treat premature ejaculation. Treatment is not always necessary for premature ejaculation. But if required, it may include psychological counseling for both the man and his partner and medications to prevent premature ejaculation. When the cause is multifactorial, a combination of treatments may be required, with the value of psychotherapy.

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Last reviewed at:
30 Dec 2021  -  4 min read

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