There Are Many
Different Possible Causes Of Premature Ejaculation
It has been suggested that one
of them is that a man's nervous system is
physiologically predisposed to trigger a quick
ejaculation. This viewpoint seems to originate in
the fact that research done in the latter half of
the 20th century revealed that 75% of men ejaculated
within two minutes of intercourse beginning. In
fact, the majority of primates ejaculate much faster
than this: within 10 seconds of intercourse
starting.
From these observations,
scientists concluded that it must be normal for men
to ejaculate very quickly, and that what we call
"premature" ejaculation is in fact normal, has
physiological origins, and may even represent an
evolutionary advantage.
If so, this would make those
men who have greater control of ejaculation the
minority in society, and the whole question of what
is "normal" in terms of ejaculatory latency time
(that's the time between penetration and the man
ejaculating) would be turned on its head.
Physical Or
Emotional Causes?
However, the fact that it
takes a long time for the human female to respond to
sexual stimulation from the penis thrusting in the
vagina, and the fact that a significant number of
men (between 30 and 50%) have very good control of
their ejaculatory latency - in other words, they can
choose when they ejaculate during intercourse -
without experiencing symptoms of delayed ejaculation
strongly suggests that quick ejaculation is not in
fact normal for the human male.
While the debate
rages on, what we can say with certainty is that
some men do appear to have a faster bulbocavernosus
reflex, although whether this is due to
hypersensitivity in the nervous system, or simply
due to the fact that they are more emotionally
aroused before sex commences is unclear.
You may be puzzled by that
last remark about a man being more aroused before
sex commences. What it means is that premature
ejaculation is often observed to be the product of a
high level of anxiety around sex, and possibly also
fear, guilt or shame.
Although these are emotions,
or feelings, and may appear to have little to do
with your ejaculation, the fact is they stimulate
the nervous system in a way very similar to sexual
arousal. This means that when you're experiencing
high levels of emotion before you start to engage in
sexual play with your partner you're likely to
experience a more rapid increase in the level of
your sexual arousal than a man who is calm and
relaxed when he begins sex play.
This is one of the reasons why
anxiety, especially "performance anxiety" around not
ejaculating too soon, or about pleasing a woman, can
be a major cause of rapid ejaculation. It
follows, therefore, that any man who is experiencing
anxiety will benefit from techniques that enable him
to reduce his level of emotional arousal before he
starts intercourse.
Physical Tension Is A Cause Of Premature Release
Oddly enough, the level of
physical tension in a man's body can also be a
trigger for rapid ejaculation. As most people know,
one of the components of orgasm is a buildup of
tension in the muscles of the body, which is
"explosively" released at the moment that orgasm
starts.
So just as emotional arousal such as high
anxiety can trigger a premature ejaculation, so can
tension building up in the muscles of the body: both
of these things take a man nearer to his point of
ejaculatory inevitability faster than when he's
relaxed physically and mentally. (The point of
ejaculatory inevitability, also known as the point
of no return or PONR - is that moment when you know
you're going to ejaculate and nothing can stop it).
As you may have realized, therefore, any techniques
that enable a man to control his level of physical
tension during sex will also be helpful in giving
him greater control over his ejaculation.
Of course at this point the
question arises of what we mean when we speak of
"premature" ejaculation. Although there is a page on
this website devoted to the definition of what is
called premature, early, or rapid ejaculation, there
are two ways of looking at the problem.
Is It About The Duration Of Intercourse?
The first is about time: the
length of time for which a man can make love before
he ejaculates. In general, this is a lot shorter
than most people believe: as I mentioned above,
research in the 1950s demonstrated that about half
to three quarters of men ejaculate within three
minutes of intercourse beginning, and there's a lot
of evidence to suggest that nothing much has changed
in the sixty years or so since that research was
carried out.
However, we also know that
three minutes of intercourse is insufficient to
satisfy most women, and that men who ejaculate in
this way tend to lack any degree of control over
when they actually ejaculate. Now, the concept of
control over the timing of your climax is an
interesting one, not least because it's sometimes
difficult to understand for men who don't have it.
The simplest way of explaining it is to say that a
man who has good ejaculatory control can thrust in
his partner's vagina during lovemaking without going
over his point of no return, his point of
ejaculatory inevitability, until he chooses
to do so - and he chooses to do so by increasing the
level of stimulation that he's receiving, for
example by making harder or deeper thrusts, or by
engaging in some kind of behavior that provides more
sexual stimulation.
So the concept of ejaculatory
control is really the same as the concept of choice
- that is to say, a man can take sexual stimulation
at a certain level without feeling that he's going
to ejaculate uncontrollably. This also gives us a
clue to another aspect of any treatment program for
premature ejaculation: a man needs to decrease the
rate at which he responds to sexual stimulation, or
needs to increase his ability to tolerate continued
sexual stimulation without reaching his point of no
return.
Or Is It About Being Able To
Choose When To Ejaculate?
Definitions of premature ejaculation have been
put forward that focus on both the time period for
which intercourse lasts before the man ejaculates,
and the degree of control that a man has over his
ejaculation. But when you think about it, these two
things are inextricably linked: if he has control,
he can naturally continue making love for longer,
and he's only ever likely to ejaculate prematurely
if he's extremely aroused before sex starts.
In this way, the concept of
"premature" comes to mean that the man really lacks
control over when he comes during sex. It follows
that an early ejaculation is likely to leave the
woman dissatisfied, because in general most women
want an extended period of penetration with their
partner inside them, and it's also possible the man
will be left dissatisfied after intercourse that
lasts for only a few minutes because he may believe
that his rapid ejaculation means he's no good as a
lover. And he may feel bad about his "performance",
too.
It's certainly true that men
who have good ejaculatory control tend to feel much
more sexually self-confident, and I've noticed in my
work with men that this confidence generally extends
into their everyday lives. There's something
quintessentially masculine about being able to
control your ejaculation - especially if you can
control it to the extent that you can take your
partner to orgasm during intercourse before you
allow yourself to release and enjoy your orgasm and
ejaculation.
(Now, it's important to add at
this point that only a minority of women are able to
achieve orgasm by the man's thrusting during
intercourse, although my suspicion is that a great
deal more women could do so than in fact actually
do, simply because most men can't maintain
intercourse for particularly long periods of time.)
More Reasons Why Men
Ejaculate Quickly
So what other possible
causes
of premature ejaculation might there be? We've
already considered the possibility of a physical
reflex due to a sensitive nervous system, although
it has to be said that evidence for hypersensitivity
of either the penis or the nervous system as a cause
of premature ejaculation is distinctly thin on the
ground, not to say nonexistent.
Those who work in the field of
male sexual dysfunction, like me, would probably
almost all agree that the major cause of premature
ejaculation, in over 90% of cases, is psychological
and emotional. That could be either a high level of
anxiety before or during sex, or some other emotion
that makes a man ejaculate quickly, such as anger,
fear, guilt or shame: any of these can contribute to
emotional arousal and so make a man much more
sensitive to sexual stimulation.
Some obvious causes of these
emotions are things like depression, lack of
confidence, negative feelings a man has about his
body (or his penis), unrealistic expectations of his
own sexual performance, any kind of internal
conflict between him and his partner, and any issues
within the relationship that cause emotional
distress or difficulties. We're talking about things
like mutual misunderstandings, lack of
communication, unresolved emotional conflicts,
discomfort with sex or intimacy, and indeed any
other issues that arise in the natural order of
things in a relationship between a man and woman.
One of the interesting things
is that there's no particularly significant single
problem that causes a man to ejaculate quickly. Having said that,
there are several common patterns.
First of all, a
lot of men with premature ejaculation are
hypersensitive to their partners, and they often fear
"failure" (sexual failure)
and in particular they fear that that they will disappoint
her sexually. Men with premature ejaculation are
sometimes self-blaming
and apologetic in the face of partners who are either
sexually naïve and shy, or aggressive and conflictual.
Another group of men tend to
be rather self-absorbed and unconcerned with their
partners' sexual satisfaction, describing premature
ejaculation as a normal response in men, causing the
women to feel abandoned and ignored, a situation
which will only cause more conflict. Certainly any
couple where there is unresolved relationship
conflicts including rejection, blaming, criticism,
and in particular a struggle in the balance of
autonomy and power may well experience a dynamic
where one partner feels abandoned and becomes
hostile.
In such situations premature
ejaculation is more an indication of the state of the
relationship than anything to do with a man's sexual
performance. It's also possible for a woman to use premature
ejaculation as a way of hiding a problem she has
with her sexuality or sexual responses. If she isn't
particularly interested in sex, she might even
encourage your partner to ejaculate quickly, telling
him to "get it over with".
And she may do the same if she
experiences any kind of pain or dysfunction from
intercourse itself. And indeed if she's anorgasmic,
she may place responsibility for this on the man,
describing his ejaculation as premature, and
claiming that she would achieve greater sexual
satisfaction and reach orgasm during intercourse if
only he could gone for longer, even though this is
probably not true.
It's also undeniable that some
men with premature ejaculation aren't particularly
knowledgeable about their own sexual responses,
their own sexuality, and their partner's
body and sexuality. And many men to hold unreasonable
expectations about sex, and to lack the essential
skills which allow him to control his ejaculation
and also the pleasure his partner satisfactorily.
None of this is to criticize
men who have premature ejaculation: it's a
complicated condition, and that's why any kind of
treatment program must be
tailored to each individual's
situation. For example, if a man is either unable to
focus on his own sensations of sexual arousal or he
anticipates failure, he may be helped with some simple
techniques which will allow him to develop a greater
awareness of how aroused he is during intercourse,
so that he can do something about it before he
ejaculates.
The Complexity Of
Sexual Dysfunction
What complicates the situation
is that while there are multiple causes for
premature ejaculation, there is also an interaction
between these things. Cause and
effects are hard to separate. In other words,
the psychological effect of believing that you need
to, have to, or are compelled to satisfy a woman,
and more particularly that it is your responsibility
to take her to orgasm, will naturally interact with
the biological mechanisms that control your
ejaculation.
And such interaction of
different factors will certainly affect
communication with your partner! Such intermingling
of different aspects of your physiology, personality
and your relationship's unique psychology is quite
normal; it is one of the reasons why rapid
ejaculation can feel so confusing to the man who
experiences it.
Nonetheless it is possible to
figure out what's causing your premature ejaculation
and you can certainly stop it. And there are various
ways of looking at premature ejaculation that will
help you make more sense of it.
The first of them is the
cognitive behavioral model which recognizes that
every man experiences a combination of cognitions
(i.e.
thoughts), behaviors (i.e. actions), and emotions
(i.e.
feelings). These are basically the ideas, beliefs,
observations and reasoning that you have about sex,
the behaviors that you engage in during sex, and
the
feelings that you experience both before during and
after sex.
Your feelings can motivate you
to take action, and they also influence the thoughts
you have. These can be positive or negative
depending on how you experience them.
To make this clearer, any man
who has chronic premature ejaculation (which
means he comes quickly every time he has sex) may be
perceived by his partner as selfish and rejecting of
her desires, leading her to feel dismissed and
uncared for. Of course, the man may not intend to be
selfish. In fact he may actually be deeply disturbed
and upset about his failure to maintain control
during intercourse - and he probably does not even
know how to stop premature ejaculation. He may be
very annoyed about the fact he cannot last longer in
bed, and he may be anxious about disappointing his
partner.
Yet, if he rolls over and
goes to sleep after ejaculating quickly, because he is
both ashamed and disappointed about his sexual
abilities, his partner will naturally conclude that he doesn't
care about her, possibly not realizing that he
actually feels frustrated with himself and is
focusing on his failure.
While he feels ashamed and
guilty, his partner is probably feeling angry and
discounted. This is because the majority of women will experience a
man who doesn't seek professional help for chronic
premature ejaculation as being insensitive to their
feelings, which may hurt deeply. This hurt can become
apparent as anger or rage, which in turn may lead
the man feel he's being betrayed and misunderstood.
He will certainly experience a lack of support from his
partner, yet support is the4 thing he most craves.
So this simple scenario serves
to demonstrate how a series of complex cognitions,
behaviors and emotions can not only cause, but also
maintain and even make premature ejaculation worse.
For example when a man begins to fear ejaculating
quickly, the anxiety that generates is almost
certain to make him ejaculate more quickly. This
means another important aspect of any treatment
program for premature ejaculation is to stop these
patterns of thinking and behavior and change them to
more reasonable ones associated with positive
feelings.
 
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