Introduction
The precociousness of male ejaculation is not an uncommon disorder, upside down. Given the delicacy of the subject, it is necessary to premise that for many men premature ejaculation is an absolutely solvable problem. In this article we will analyze the different types of premature ejaculation, trying to examine with an objective and impartial eye the causes responsible for this disorder that torments many men closely.
Classification
First of all, premature ejaculation must be classified according to the moment of onset of the disorder (during the subject's life), to the situation in which it occurs and according to the timing of ejaculatory precocity.
It is defined as primary premature ejaculation when it appears during the very first sexual relations: the young man, sexually inexperienced, has not yet acquired complete mastery of his body, therefore an early ejaculatory precocity could be considered almost normal on the occasion of the first reports. So much so that, it is estimated, 70% of patients suffering from premature ejaculation complain of the disorder during their first sexual intercourse.
The secondary premature ejaculation, which afflicts the remaining 30% of men with ejaculatory precocity, arises following a period of appreciable sexual activity.
Depending on the situation in which the disorder appears, the situational premature ejaculation is distinguished, which occurs in relation to the partner and - as the term suggests - based on the situation that is established between man and woman, and premature ejaculation generalized, which occurs whenever a situation of intimacy is created with the partner.
A further classification of premature ejaculation is carried out based on the timing of the precociousness of the ejaculatory act: we speak of mild premature ejaculation when this occurs within 10 coital movements (the coital movement expresses the duration of containment of the penis in the vagina) or within 2 minutes from penetration; the average premature ejaculation occurs within 8 coital movements or before the 30 seconds from the beginning of the penetration. Finally, severe premature ejaculation, in a sense, represents the most severe form of the disorder: in this case, the man ejaculates even before penetration, or after 3 thrusts, or even before the 15 seconds from the beginning of penetration.
In some men, ejaculation, in addition to being premature, occurs in the absence of orgasm (anorgasmia).
Causes
In light of recent clinical observations, the thesis has been confirmed that, often, men subjected to premature ejaculation perceive a notable decrease in erotic sensations, just a few moments before the climax of excitement (which corresponds, that is, to the approach of the orgasm): in such circumstances, these men claim to perceive a kind of genital anesthesia .
Now let's see what are the causes attributable to premature ejaculation. First of all, it is good to distinguish two types of causal factors: on the one hand there are physical as well as organic causes, on the other those of a psychological nature, sometimes much more complex than the previous ones. Very often, in almost all cases, premature ejaculation is governed by both types of causes, which makes the most suitable therapeutic choice even more difficult.
- Physical-organic causes
The physical causes must be diagnosed by the urologist, while the psychotherapist or sexologist has the duty to analyze the other complex class of etiological agents.
Among the main physical-organic causes, vesiculitis, urethritis and prostatitis stand out. Searching even more minutely among the causes of urological nature, the short frenulum and the hypersensitivity of the glans are, without doubt, the most frequent.
But also multiple sclerosis, degenerative disorders and the abuse of drugs, drugs and alcohol are factors that can contribute to the appearance of premature ejaculation: although it is clear that these latter elements are related to the ejaculatory precocity, the mechanisms that regulate the all have not yet been clearly demonstrated. However, it seems that the most immediate explanation is directed to a remarkable modulation of local neuro-vascular responses.
- Psychological causes
Who, better than Freud, would know how to analyze the male psyche during sexual intercourse? According to Freudian thought, the psychological causes that trigger male premature ejaculation date back to "man's sadistic, intense and unconscious impulses towards women ": we try to translate the Freudian theory, with the most correct interpretation. The instincts of which Freud speaks represent feelings and emotions that go well beyond the male will, are innate impulses, "unconscious", precisely: the man ejaculates prematurely almost to punish the woman, to deprive her of physical pleasure.
Regardless of Freud, sometimes premature ejaculation is a reflection of the so-called "performance anxiety", a very frequent phenomenon among sexually immature young men.
Another psychological theory, considered to be the cause and cause of the ejaculatory precocity, concerns male pre-orgasmic perceptions: during intercourse, the male is not able to control the ejaculatory stimulus and ends the relationship much earlier than the female partner, after few moments from penetration.
It is clear that stress also heavily influences premature ejaculation, a condition that is also closely linked to erective dysfunction.
