And then you have premature ejaculators who do not consult their doctor: apart from those who can truly be said to be premature ejaculators with all the suffering that involves for the couple but who do not dare to speak about it, there are also individual cases of men who spend several minutes satisfying their partner during foreplay despite only maintaining a penetration for one to two minutes; there are also those who do not suffer from a short and sweet-type sexual relationship, without thinking about the satisfaction of their partner. It is only when there is frustration and suffering present that it is possible to try to understand the reasons and rectify the situation. Sometimes, this is truly down to the too-short duration of thecoitus, but sometimes it is the entire love-making ritual that is at fault”.
Men are more frustrated than their partners
The suffering felt by men due to premature ejaculation can be considerable. Apart from the sexual frustration itself, the difficulty can cause a loss of self-esteem, anxiety or even depression. “Moreover, the man who suffers from the condition may tend to avoid sexual relations because they make him feel a failure. The impact this can have on partners is also important: studies show that the partners complain of being sexually dissatisfied themselves and are often affected by sexual problems too, such as problems related to achieving an orgasm. However, it must be said that not all partners of men affected by premature ejaculation suffer from these problems; even more importantly, the men concerned have a tendency to overestimate their partner’s suffering… This may be because they transpose their own level of frustration onto their partner. When questioned about the issue, women often affirm that they suffer more from the frustration they witness in the man because of premature ejaculation than the actual premature ejaculation itself”, continues Philippe Kempeneers.
He also points out that his patients sometimes try to solve the problem by themselves by trying other remedies before consulting their specialist: “This includes the consumption of alcohol or drugs for half of the men concerned; almost one-third affirm that they have applied creams that are supposed to delay the ‘crucial’ moment… More than 60% interrupt all sexual stimulation, two-thirds attempt to concentrate on non-erotic thoughts and the same proportion ejaculate preventively, before having sexual relations, for example by means of masturbation, hoping that the ‘second performance’ will last longer. These are usually not real solutions: there is no control over the ingredients used in these creams sold over the internet; alcohol is the enemy of control with regard to ejaculation which means that the use of alcohol is unlikely to lead to an improvement; lastly, a prior ejaculation could prevent the individual concerned from being able to achieve a second erection in the minutes that follow…”
Influencing the causes?
Could the answer to premature ejaculation lie in dealing with the underlying causes? This would probably be ideal if the causes could be identified because here too, there is no consensus with regard to the precise causes, but rather on the risk factors as Philippe Kempeneers established by his work.
Firstly, there is a biological factor, like the action of certain neurotransmitters, on the time lapse before ejaculation: the serotonergic and dopaminergic pathways play a role as do certain oxytocin receptors. “However, the sensitivity of these neurophysiological systems varies from one man to another, in accordance with genetic factors in particular. A study found that 28% of the problem is down to heredity, and this applies to all forms of premature ejaculation”.
Hormones also play a role: the higher the levels of testosterone, the greater the risk of rapid ejaculation. Hyperthyroidism, urinary disorders or certain neurological conditions could also influence the rapidity of the ejaculation reflex. And finally, there are emotional factors such as irritability and anxiety which appear to be linked to premature ejaculation. But which one causes which? Researchers have good reason to think that anxiety increases the rapidity of ejaculation but it is also the result of repeated experiences of premature ejaculation. It is possible that weak concentrations of serotonin are the cause of two phenomena, premature ejaculation and anxiety without there being any connection between the two.
There are also learning-related factors: “Today, there is a belief that premature ejaculation results more from (?)a lack of learning thanfrom dysfunctional learning . A biologically normal reflex is not necessarily optimal from a pleasure and relational point of view. In these conditions, men must learn to delay their ejaculation”.
