Premature ejaculation (PE) refers to the persistent or recurrent discharge of semen with minimal sexual stimulation before, on, or shortly after penetration, before the person wishes it, and earlier than he expects it. In making the diagnosis of PE, the clinician must take into account factors that affect the length of time that the man feels sexually excited. These factors include the age of the patient and his partner, the newness of the sexual partner, and the location and recent frequency of sexual activity.
Premature ejaculation (PE) is a common complaint. The available evidence supports the notion that control and modulation of sexual excitement is learned behavior. If someone has learned it incorrectly or inadequately, they can relearn it. PE is only rarely caused by a physical or structural problem; in these cases it is usually associated with other physical symptoms, usually pain. In rare cases, PE may be associated with a neurological condition; infection of the prostate gland; or urethritis (inflammation of the duct that carries urine and semen to the outside of the body). With the rising prevalence of substance abuse, an increasing number of cases of PE are being diagnosed in patients withdrawing from drugs, especially opioids.
PE may be of lifelong duration or develop in later life, especially if a difficult interpersonal relationship is
I KEY TERMS
Abstinence—Refraining from sexual intercourse £ for a period of time.
H Ejaculation—The discharge of semen by the male <u reproductive organs.
Glans—The tip of the penis.
Prostate—A muscular gland surrounding the urethra in males at the base of the urinary bladder. The prostate gland secretes the fluid that combines with the male sperm cells to form semen.
Semen—A thick whitish fluid containing sperm, produced by the male reproductive organs.
Urethritis—Inflammation of the urethra, which is the duct that carries urine and (in males) semen to the outside of the body.
one of its causes. Although PE is commonly associated with psychological symptoms, especially performance anxiety and guilt, these symptoms are its consequences rather than its causes. Once PE is firmly established, however, the accompanying psychological factors, especially in combination with sexual overstimulation, may form a self-perpetuating cycle that makes the disorder worse.
Premature ejaculation is common in adolescents where it may be made worse by feelings of sinfulness concerning sexual activity, fear of discovery, fear of making the partner pregnant, or fear of contracting a sexually transmitted disease (STD). All of these may be made worse by performance anxiety. Adults may have similar concerns as well as interpersonal factors related to the sexual partner.
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