We recently received an excellent question from one of our readers, about what are the causes of premature ejaculation. Also he asked an excellent question whether there any physical contributions involved in PE issues. In this piece I look to explain and answer this question:
“Hello, I suffer from PE, I read that some of the main reasons are psychological or physical. I have a slight backbone pain and I have heard that the pelvic base weakness may cause some issues so can it be the reason why I suffer from PE or is there something else to consider? What are the main reasons of PE? And what do you think I should do?”
It is understandable that you might wonder if premature ejaculation might have physical causes because ejaculation is a bodily function and so it may seem intuitive that there might be something physically wrong with you if you suffer from premature ejaculation. Also some of the treatments that are offered for premature ejaculation are physical or pharmacological in nature and so it is not surprising that people might conclude that the causes are physical.
One of the recognised side-effects of a group of anti-depressants, called Selective Serotonin Reuptake Inhibitors (SSRIs), is delayed ejaculation and so they have been tried as a treatment for premature ejaculation. Some men find they can last longer if they use these drugs. It does not mean that depression or serotonin levels are the cause of premature ejaculation and unfortunately it is very likely that you will ejaculate faster when you stop using the drugs because you will not have learnt how to control when you ejaculate.
Similarly some men report improvement when they use desensitizing or anaesthetic gels which can dull penile sensations but this does not mean that premature ejaculation is caused by an over-sensitive penis. I do not believe it is necessary to dull your arousal during sex to overcome premature ejaculation – it is quite possible to learn to control ejaculation even when highly aroused and like antidepressants these desensitizing treatments only can help in the short term and are not a permanent solution. There is no convincing evidence that I have seen which supports the idea that the causes of premature ejaculation are physical including back problems or muscle weaknesses. Spinal cord injuries could affect penile erections and ejaculation as they would bladder control but that is easy to exclude as a cause.
The most convincing explanation (in my opinion) is that some men have not learned to develop ejaculatory control and quick ejaculation has become a learnt or conditioned response that can be maintained by both anxiety and avoidance of sexual activity.
There is research evidence to show that there is a relationship between frequency of sexual activity and ejaculatory control. Meaning that less frequent sexual activity is associated with faster ejaculation.
This is likely to be important in premature ejaculation because men with the problem often understandably avoid sex and so their faster ejaculation can be partly maintained by their avoidance of sex. So reducing avoidance of sexual activity is an important part of behavioural treatment for premature ejaculation.
The ability to control when you ejaculate depends on attentional awareness of your arousal level and knowledge of techniques to vary your arousal level. Both can be learnt. There is very good evidence that sex therapy approaches using behavioural programmes that teach men these skills work very well and offer a lasting solution.
I would encourage anyone suffering from premature ejaculation to try this treatment approach with a qualified sex therapist instead of pursuing pharmacological solutions.
The post What are the causes of Premature Ejaculation? appeared first on Confident Sexual Health.
