-IBIS-1.5.0-
tx
reproductive system
premature ejaculation
diagnoses

definition and etiology

definition:
Consistently reaching orgasm so rapidly that it significantly lowers the man's own enjoyment of the sexual experience, impairs his partner's pleasure, or both. A shortened version may be ejaculation before the individual wishes. It includes a continuum of severity from ejaculation before coitus, to ejaculation within 7 minutes of beginning intercourse. The normal biologic response for men is to reach orgasm by 2 minutes after penetration has been made. Since most women cannot reach orgasm within 2 minutes, most men learn to retard and extend emission. Men with premature ejaculation are unable to control their emission in this way.

etiology:
Premature ejaculation is common in the adolescent. It can be brought on or aggravated by various emotions: feelings of guilt or sin about sex; fear of being discovered (during sex or masturbation: adolescent concerns that can follow an individual into adulthood); anxiety over getting a sexually transmitted disease or regarding performance. Somatic problems as the cause are rare, although an overly sensitive penile gland, or a low amount of vaginal lubrication producing more friction during intercourse, can be factors. Researchers believe that between 25-50% of Americans have a problem with premature ejaculation, although for some it is an occasional episode.

signs and symptoms

signs and symptoms:
male presents with premature ejaculation and:
• Physical examination, unless there is underlying pathology, is unremarkable.
• Gentle probing for a psychological reason for the problem may be helpful or may be reserved for a specialist in the field.

lab findings:
• There are no laboratory tests to perform, although a 3-cup urinalysis is recommended if prostatitis is a possibility.

course and prognosis

The course depends on the degree of pathology involved and the willingness of both partners to work on the problem. With an understanding and patient partner, sexual techniques designed to promote controlling premature ejaculation, and/or psychological counseling, the condition can satisfactorily resolve.

differential diagnosis

• Prostatitis
• Neurological disorder


footnotes