Urology premature ejaculation treatment

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How does ejaculation occur?

Ejaculation, controlled by the central nervous system, happens when sexual stimulation and friction provide impulses that are delivered to the spinal cord and into the brain.

Ejaculation has two phases:

Phase I: Eimisson

The vas deferens (the tubes that store and transport sperm from the testes) contract to squeeze the sperm toward the base of the penis through the prostate gland. The seminal vesicles release secretions that combine with the sperm to make semen. The ejaculation is unstoppable at this stage.

Phase II: Ejaculation

The muscles at the base of the penis contract forcing semen out of the penis (ejaculation and orgasm) while the bladder neck contracts. Orgasm can occur without the delivery of semen (ejaculation) from the penis. Normally, erections are lost following ejaculation.

What is premature ejaculation?

Premature ejaculation (PE) is characterized by a lack of voluntary control over ejaculation. Many men occasionally ejaculate sooner than they or their partner would like during sexual activities. PE is a frustrating problem that can reduce the enjoyment of sex, harm relationships and affect quality of life. Occasional instances of PE might not be cause for concern. However, when the problem occurs frequently and causes distress to the man or his partner, treatment may be of benefit.

What causes premature ejaculation?

Although the exact cause of premature ejaculation (PE) is not known, new studies suggest that serotonin, a natural substance produced by nerves, is important. A breakdown of the actions of serotonin in the brain may be a cause. Studies have found that high amounts of serotonin in the brain slow the time to ejaculation while low amounts of serotonin can produce a condition like PE.

Psychological factors also commonly contribute to PE. Temporary depression, stress, unrealistic expectations about performance, a history of sexual repression, or an overall lack of confidence can cause PE. Interpersonal dynamics may contribute to sexual function. PE can be caused by a lack of communication between partners, hurt feelings, or unresolved conflicts that interfere with the ability to achieve emotional intimacy.

Can premature ejaculation develop later in life?

Premature ejaculation (PE) can occur at any age. Surprisingly, aging appears not to be a cause of PE. However, the aging process typically causes changes in erectile function and ejaculation. Erections may not be as firm or as large. Erections may be maintained for a shorter period before ejaculating. The feeling that an ejaculation is about to happen may be shorter. These factors can result in an older man having an ejaculation earlier than when he was younger.

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