Definition of Premature Ejaculation
Variation in the time between penetration and ejaculation - and
premature ejaculation itself - is a common and normal. However, when the
time before ejaculation is really short at every attempt at intercourse,
the cause of the early ejaculation may be
neurobiological, medical and/or psychological. Premature ejaculation has
invoked many different theories,
approaches and treatment methods but few of them have been shown to
work.
At the heart of the debate is the need to
find a reliable definition of the term premature ejaculation. In this
context we may need to distinguish between premature ejaculation as a complaint
and PE as a syndrome.
As a complaint, premature ejaculation may
just be a part of the normal
variation of time to ejaculation in different men, or it may be the
result of some kind of medical condition. What this means in practice is
that men who only occasionally come too soon could be said to have natural variable
premature ejaculation, while in those men where early ejaculation is present from the first sexual encounter and
occurs every time they have sex, and maybe very soon after penetration,
there is a diagnosis of lifelong premature ejaculation to be made. On
the other hand, men who say that they have premature ejaculation but who ejaculate
after a reasonable time, for example perhaps 5 to 10 minutes after
penetration, may be diagnosed as having premature-like
ejaculatory dysfunction. (This seems to me to do nothing more than
satisfy the scientists' need for classification - it does not seem like
a helpful category. Surely men who last ten minutes in bed are normal
and do not have any kind of premature or early ejaculation?)
Certainly men who fall into this latter
category seem to have more of a psychological problem than a real one,
and probably need counseling,
and education about what is normal during sex.
Those men who
have lifelong premature ejaculation and are
desperate to last longer in bed and
indeed to last longer during sex
generally may find a cure explained on this
website.
An alternative treatment
which
has been proposed is treatment with drugs.
The Diagnostic Manual of Mental Disorders
Definitions of PE tend to be subjective, though the DSM (fourth edition,
revised text) also known as the DSMIV-TR, published by the United States
Psychiatric Association, defines it as persistent or recurrent
ejaculation after minimal stimulation before, on, or just after
penetration and before the man wishes it.
The DSM goes on to acknowledge the subjective element in this definition
by acknowledging that the doctor must recognize those factors which
affect duration of the excitement phase of sexual intercourse: these
include age of the sexual participants, newness of the sexual partner or
situation, and how often the man has had sex in the recent past.
So in other words, premature ejaculation
can be though of as only occurring when an early ejaculation causes distress or interpersonal
difficulty. That's an interesting concept, because
not being able to last long enough in bed is for many men a really
distressing situation. Indeed, most men who come
quickly would be extremely grateful for any cure which enabled them to
last longer during sex. According to the ICD (10th edition) which is
issued by the World Health Organization, premature ejaculation is the inability to
delay ejaculation enough to enjoy lovemaking, and takes the form of ejaculation before
penetration or very soon after the
start of intercourse, though they define it as within
15 seconds of intercourse starting, which seems to be extremely
restrictive. Many men who cannot last longer than a minute would
consider themselves to have premature ejaculation. In any event, what is
clear is that satisfying intercourse is often not possible regardless of
how long the man lasts before he ejaculates.
So on the one hand we have a definition which speaks of fifteen seconds
of sex before ejaculation; on the other we have a definition which
requires a man to experience distress during sex. Both of these
definitions are subjective, of course, and the absence of a time cut-off
point which all can agree on makes them of potentially limited use.
After all - doesn't a man know when he has premature ejaculation?
I think the answer to this is - no, not
always, for he may not know how long the average time between
penetration and ejaculation actually is, nor may he know how his sexual
performance compares to other men's, and he may be under pressure form
his partner because, for example, of her failure to reach orgasm during
intercourse, while in fact his sexual performance is quite normal.
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