Mechanism of Ejaculation:
The glans carries the nerve endings
that feel physical stimulation. The impulses are transmitted to the
spinal cord to the ejaculation center which relays the impulse to
the outgoing nerves that set ejaculation to start after a certain
amount of stimulatory impulses.
This normally occurs after a variable
period that is a minimum of 3-5 minutes. This period usually becomes
longer with advancing age.
The volume of the ejaculate varies
from 2-5 cc. This too decreases with age, and so does the force of
ejaculation that may finally be lost in the elderly and semen is
more or less spilled rather than ejaculated. This is natural.
Semen is white. Prosemen is
transparent. Prosemen is the scanty fluid that comes out of the
penis at sexual stimulation and is different from semen that is
ejaculated at the end of intercourse.
What is Premature Ejaculation / Rapid Ejaculation?
Premature ejaculation / Rapid
ejaculation is inability to delay
ejaculation until satisfaction of the female partner. This has no
time limit and it depends on the interaction of the male and female,
but a duration of intercourse of 3-5 minutes is within normal.
Premature ejaculation / Rapid ejaculation?
The main causes of Premature
ejaculation / Rapid ejaculation are
infections of the prostate or seminal tract, hypersensitivity of the
glans or the dorsal nerve that conveys sensation from the glans, or
lack of experience with faulty method of sexual intercourse such as
too rough intercourse without adequate foreplay and in the absence
of lubrication of the vagina.
What is the treatment of
Premature ejaculation / Rapid ejaculation
1-Treatment of Infection:
Infections, especially those of the
prostate, can cause premature ejaculation. They may or may not be
associated with painful urination or ejaculation. They may also be
associated with genital infections of the female partner.
When infection occurs,
antibiotics are necessary to cure it. However, in many instances,
bacteria can escape the effect of some antibiotics but remain sensitive
to others. Culture and sensitivity is when an infected sample (semen,
prostate, urine..etc) are examined in the laboratory for the effect of
various antibiotics on the bacteria within, to determine which
antibiotic is more effective in treating the infection.
Frequently, infection is
detected in both partners; the male and female. This is because the
prostate contributes to part of the semen volume and is transferred
at sexual intercourse to the lady. Antibiotics may this be necessary
for both partners.
The glans carries the nerve
endings that feel physical stimulation. The impulses are transmitted
to the spinal cord to the ejaculation center which relays the
impulse to the outgoing nerves that set ejaculation to start after a
certain amount of stimulatory impulses. The spinal ejaculation
center is under control of the brain. The brain in turn is under
control of stimulatory and inhibitory chemicals (neurotransmitter).
"Serotonin" is a neurotransmitter that inhibits the sexual wave in
the brain, and if in excess will cause the brain to inhibit the
ejaculatory center in the spinal cord with a resultant delay in
Inhibitors (SSRI's) is a category of medications that increase
serotonin in the brain. The are originally used as anti-depressants,
but are also used under medical supervision for delaying
ejaculation. Medical supervision is important to determine the dose
and combination of medications so that the inhibitory effect of
SSRI's will not abolish sexual behavior all together.
Local anesthetics are used
to decrease the sensitivity of the glans and thus delay ejaculation.
They are available as sprays, gels and ointments. They have to be
applied to the penis after erection occurs and not before that,
since if they are applied too early, erection may not occur at all.
They should also be left on the glans before intercourse for a few
seconds for their effect to start, otherwise they will be washed
away by the friction that occurs upon intercourse. A downside of
local anesthetics is that they may cause temporary anesthetization
of the female genital track if applied in excess.
Condoms protect the glans
from feeling part of the physical stimulation, thus they can delay
ejaculation to variable degrees depending on their thickness and
whether or not they contain anesthetic medication.
Two surgical procedures are feasible
for delaying ejaculation. Both procedures can be performed
stand-alone or in combination:
The dorsal nerve of the penis conveys
sensation from the glans to the ejaculatory center of the spinal
cord. It courses on the upper surface of the penis as two trunks
that branch into a number of branches as they approach the glans. If
one or more of those branches is cut, sensitivity of the glans will
be decreased but still preserved. This is performed through a 5-10mm
incision on the upper surface of the penis, and requires 15-30
minutes operative time, and requires no hospital stay at all.
A number of "Fillers" can be
injected into the glans to
increase its volume and improve its cosmetic look. These fillers
have been found to decrease sensitivity of the glans. Thus, glans
augmentation can be performed to increase the size of the glans and
decrease its sensitivity. The procedure takes 15-30 minutes
operative time and requires no hospital stay. Fillers are
self-absorbed and disappear within 1-5 years following injection,
but they can be re-injected whenever they are absorbed, every 2-3
years for example.
Correct Sexual Technique:
1-The speed and force of intercourse
are detrimental for the speed of ejaculation. Slow down!
Keep intromission at a low rhythm
until the moment you see your partner close to orgasm: Speed up.
Until then, maintain a slow rate, and make it even slower upto
stopping temporarily if you feel that you are close to ejaculation
before you desire to.
Some men can have ejaculation delayed
if they or their partners squeeze the glans firmly between thumb and
3-Ejaculation Delaying Exercises:
The muscle responsible for delaying
and preventing ejaculation is the same one used to stop urination
while urine is already flowing. This muscle can be contracted and
relaxed voluntarily (at one's wish). Every muscle can be
strengthened by contracting and relaxing it repetitively. Thus, if
one contracts and relaxes this muscle repetitively (50 times for
instance) on daily basis for a couple of months, this muscle will be
stronger and one gains control over ejaculation.
4-The female has the same set of
muscles that are capable of stopping urination. In the sexual
context, these muscles are used to tighten the vagina around the
penis. The lady can control those muscles and relax them to widen
the vagina and decrease stimulation of the penis in order to prevent
ejaculation from occurring prematurely. The male partner may require
the vagina to tighten up when he desires to ejaculate or if he feels
erection is fading. This can also be dome. Special signs and words
can be agreed upon by both partners for the coordinating the balance
between contraction and relaxation according to the desires of both