The so-called "early ejaculation" (Ejaculatio praecox-EP)
is the most common sexual disorder in men.
definition, premature ejaculation is a permanent or often recurring
ejaculation with sexual stimulation before or within one minute after
penetration into the vagina, the inability to always or in most cases
delay ejaculation, and the resulting psychological stress,
disappointment and avoidance of sexual activity.
ejaculation is not considered a sexual disorder until the above
criteria are met. The causes lie in a neurobiological phenomenon,
which can lead to rapid ejaculation, and are not purely psychological
all their differences, most definitions of ejaculation praecox have
the following three points in common:
- Insufficient control of ejaculation
- Suffering in one of the partners (regardless of whether heterosexual or homosexual)
- Shortened intravaginal latency (within one minute)
are the causes of ejaculatio praecox?
the disorder can be attributed to an organic trigger, e.g.
inflammation of the urethra or prostate. In most cases, however, no
purely organic cause can be found for ejaculation praecox.
Ejaculation is a multifactorial process involving various centres in
the brain, spinal cord and peripheral nervous system.
a long time, ejaculation praecox was almost exclusively attributed to
psychological causes. For example, a conditioning through "negative"
experiences in the area of sexuality, which resulted from fast,
fleeting sexual contacts, or a "too early" beginning of
sexual life. Also "too little" sex was seen as a trigger.
personal sexual experience can be a factor in premature ejaculation,
as can fear - be it of sexual failure, emotional attachment or
unwanted fatherhood. Therefore, it is now assumed that psychological
components such as excessive sexual performance thinking, the idea of
being a bad lover, or the fear of "coming too early" again,
are more likely to "suffer" premature ejaculation again and
the meantime, scientific research increasingly regards premature
ejaculation as a neurobiological phenomenon: According to this
explanatory approach, the sexual dysfunction is caused by
irregularities in the household of brain neurotransmitters and by
changes in the sensitivity of the receptors of these
neurotransmitters. This is supported, on the one hand, by a family
accumulation of neurotransmitters and, on the other hand, by the fact
that some drugs that interfere with the household of
neurotransmitters have been shown to be effective in treating this
is ejaculation praecox diagnosed?
diagnosis "Ejaculatio praecox" is based primarily on the
information provided by the persons concerned. During the interview,
the doctor should therefore ask the patient in detail about his or
her sexual life. The open question about sexuality and satisfaction
with sexual life makes it possible to obtain important information
during the anamnesis.
the case of heterosexual men, the time between insertion of the penis
into the vagina and ejaculation should be addressed. If the IELT is
regularly less than one minute, it is defined as early ejaculation in
connection with psychological stress.
should be distinguished whether it is a primary ejaculatio praecox,
i.e. it has always been like this, or a secondary form, i.e. it has
only occurred over the years. The differentiation is important, since
the therapy options can change in such a way.
diagnostic procedures, such as laboratory tests of blood or urine,
serve above all to exclude underlying diseases (e.g. prostatitis,
etc.) which can cause ejaculation praecox.
can premature ejaculation be treated?
differentiating between primary and secondary ejaculation praecox,
the therapy options should be discussed after intensive consultation
with the patient. The only drug approved to date for the treatment of
EP is dapoxetine, a serotonin reuptake inhibitor (SSRI), which has
been shown in many studies to significantly prolong IELT. This drug
must be taken one to three hours before sexual activity.
principle, sexual therapy is also useful for the problem of
ejaculatio praecox. Experience has shown that many patients seek a
quick solution, which is why in many cases it is offered in
conjunction with medication.
medicines, such as the use of PDE-5 inhibitors, local anaesthetic
ointments, opiates, etc., are possible, but the best results have
been described with SSRIs. At the same time, in the case of the
latter therapy options, it is important to point out to the man that
these drugs are off-label applications and that the preparations are
generally not approved for them.
the problem an issue!
ejaculation is undoubtedly one of the problems that can lead to
considerable suffering. Although it is the most common sexual
disorder in men, many believe to be alone with this problem and try
to spread the mantle of silence about it. In this context, openness
is important in many ways.
the one hand, it is important to be open towards one's partner. For
example, it can be clarified whether what one perceives as "too
early" is also classified as "too early" by the other
person - or whether one is possibly wrongly worried. Furthermore,
admitting one's insecurity and tackling a possible problem together
has often proven to be a first, decisive step towards a solution. In
addition, by dealing with the problem together, damage can be averted
from a relationship.
But it is not only in the partnership that the open word is required - it is also important to address the difficulties in controlling the orgasm reflex to the doctor. Last but not least, because there are possibilities of treatment, patients should not be afraid to seek professional advice. Urologists, sex clinics or specialised counselling centres can serve as contact points.