The definition for premature ejaculation has been debated over the years but many experts in the field currently rely on the International Society of Sexual Medicine (ISSM) definition which identifies the following criteria:
• Ejaculation which occurs always or nearly always before or within one minute of vaginal penetration.
• Failure to delay ejaculation during nearly all episodes of vaginal penetration.
• Personal distress, bother, frustration and/or the avoidance of sexual encounters.
Premature ejaculation may be classified as 'lifelong' (primary) or 'acquired' (secondary):
• Lifelong premature ejaculation is characterised by onset from the first sexual experience and remains a problem during life.
• Acquired premature ejaculation is characterised by a gradual or sudden onset with ejaculation being normal before onset of the problem. Time to ejaculation is short but not usually as fast as in lifelong premature ejaculation.
The European Association of Urology (EAU) points out that the ISSM definition only applies to men with lifelong premature ejaculation who have vaginal intercourse. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) is due to publish a new definition in May 2013.
Premature ejaculation can be due to over excitement or increased sensitivity triggering an orgasm sooner than a man would like.
Some men may have a more sensitive penis than others.
Anxiety may be to blame for premature ejaculation for some men, who may speed-up intercourse because of worries they will lose their erection before orgasm.
Being nervous about having sex with a new partner or the surroundings or concern about being discovered having sex may contribute to premature ejaculation.
Other causes include stress, depression, problems with relationships and previous sexual problems or experiences.
Some medical conditions may affect ejaculation for older men, including diabetes, prostate gland problems, narrowing of the arteries and some neurological conditions.
There are a number of proven treatment strategies for premature ejaculation:
• Behavioral Techniques
• Psychological Counseling
• Reducing Penile Sensation
• Medicine (Viagra, Cialis, etc.)
The choice of PE treatment is best guided by taking into consideration the efficacy of the therapies, potential causes that may be addressed and what you and your partner are comfortable with. You should be fully aware of the risks and benefits of each treatment option for controlling ejaculation.