A study of nearly 200 Dutch men found those who climaxed too soon during intercourse had a version of a gene that controls the hormone serotonin. Men with this version ejaculated twice as quickly as other men in the study. Serotonin levels are what control the rapidity of ejaculation, say the Utrecht University researchers told the Journal of Sexual Medicine.

In a paper published in the Journal of Sexual Medicine the researchers at Utrecht University reported that it was the serotonin levels that control the rapidity of ejaculation. Premature or rapid ejaculation affects between 30 to 40 per cent of men, although experts have disagreed on its exact definition. In May, the International Society for Sexual Medicine suggested that it meant orgasming within 60 seconds of having sex and feeling distressed and embarrassed afterwards.

The volunteers in Dr Marcel Waldinger’s study were 89 men who had so-called primary premature ejaculation, meaning they had always suffered from it from their first sexual contact onwards. For a month, their female partners were asked to use a stopwatch at home to measure the time until ejaculation each time they had intercourse. Premature ejaculation is definitely not purely psychological.

The results were compared with 92 men with no history of such problems. In the men with premature ejaculation, serotonin appeared to be less active between the nerves in the section of the brain that controls ejaculation.

In the men with premature ejaculation, serotonin appeared to be less active between the nerves in the section of the brain that controls ejaculation.

Dr Waldinger says this low activity of the hormone means nerve signals do not transfer in the normal way in these men.

“This contradicts the idea, which has been common for years, that the primary form of premature ejaculation is a psychological disorder,” he said.

The findings also mean that in future it may be possible to treat the condition with gene therapy, he said, changing the premature ejaculation gen.

Paula Hall, a sexual psychotherapist for Relate, the relationship counsellors, said: “Premature ejaculation is definitely not purely psychological.

“But there can be a psychological element. The acid test is how much control they have on their own. If the problem only occurs with their partner then it is more likely to be psychological.”

She said men with primary premature ejaculation tended to be fast reactors generally.

“These men have very quick reflexes. They may be excellent at playing tennis or computer games, for example.”

Currently there is no medication for the condition on the market.

Treatments involve counselling and the use of anti-depressants - not for depression but for their unexpected yet desirable side effect of delaying ejaculation.

“Before the man didn’t care about the lasting time of the coitus, neither about the control of the ejaculatory reflect. Sexuality was contemplated just as a part of the reproduction of the human being and not as a form of expressing affection and a way of communication with your partner.

In the 60’s with the impact of the contraceptive pill and the incorporation of women to the job market, a huge change in the sexuality appears; nowadays it is considered a relation based on the pleasure, though it can be linked to a reproductive goal.

- In the 70’s the premature ejaculation began to be considered among the sexual dysfunctions. Now, male are must satisfy their couples and so they set themselves to make the sexual relation as long as possible.

A premature ejaculator is defined as a man who can’t control the voluntary ejaculatory reflect, leaving unsatisfied his sexual partner in more than a 50% of the relations.

Today, sex is so common, without that old mistery, that has lost its sense. Teenagers are exposed to sexual experiences without being ready for them, not only for a lack of education, but also because the lack of real affection. This is tremendously stressing for the man, who wants to be good enough and even better, not understanding sex as a consequence and not as a goal.

- It is wide common among teenagers the masturbatory games in groups, where who is the fastest ejaculator is praised. That aspect, added to some wrong popular ideas, as the one that says that the faster you are the more sexual relations you have, make the concept of sexuality a total unknown for them.

- Doctor Muldman adds: “Those men, in general, tend to a use very short preliminary games afraid of loosing their erection. The couple, then, doesn’t reach an adequate level of excitation to get the orgasm with the penetration. In many cases, male blame women about that. They commonly become very tense and are totally scared of those erotic games, as they don’t want to get to excited and ejaculate without the penetration of their couples, and so the experience is usually mechanic and not very natural. They concentrate on the ejaculation so much that they don’t allow their couple to touch them and are distant for them.

The woman starts developing a great resentment, because she feels that this is a lack of affection to her. There is then a communication breakdown in the affection, sensuality and the erotic games. The man is disappointed and his own masculinity is devalued, and that can only carry to a psychological impotency.

The famous sexologist William Reich in his book “The function of the Orgasm” affirms that the premature ejaculation is lived as an evacuation of the insatisfaction. In the most serious cases, the seminal fluid is liberated with no control at all and pression on the penis, with is completely flaccid. “It is the worst humiliation that can face a man in front of his partner”, says the sexologist.

How to last longer?

That dysfunction has a solution, changing the interpsyche condition that is planted in the mind of the ejaculator. And so as he can control the reflect better the perception of himself changes and his psyche is powered. It is even believed that there is a connection between the eneurisis, not controlling the urine at childhood, and the issue of the premature ejaculation, as they are both a lack of control over your corporal fluids and have a mental cause.

Source: www.estilosdevida.cl (Estilos de vida)

Premature ejaculation is the most frequent sexual dysfunction among male, even more than erectile dysfunction. Since not a long time ago, professional were convinced that the cause of that came from a psychological origin, but nowadays experts are considering more probable the biological and genetic heritage factors.

“There is a genetic component linked with PE, premature ejaculators fathers will have a higher probability of having children with that problem too”, say urologists Tomás Olmedo and Cristián Palma from the Hospital Clinico of Chile University.

During a long time, experts used for dealing with that illness medicine that delayed the ejaculation and psychological treatments. However, in December 2002 appeared a publishment in the “Journal of Urology” from Holland where they demonstrated that PE is a heritable neurological pathology.

After that research, other studies have reaffirmed that thesis, though more of them are not totally sure of their conclusions. However, after that there has been a kind of unanimity among some experts that assure that the dysfunction is due to a lack of a neurotransmissor called seretonine. When the organism has enough seretonine, the nervous system is more relaxed and slower on the reflect answer, but when there is a lack of it, it simply explodes.

Treatment

Considering this as a base, the treatment for dealing that illness is trough a medicine that avoids loosing that seretonine. And so, what were are looking for is that the male is capable of producing a bigger amount of that substance and can control the ejaculation.

Urologists from Chile totally share that thesis. “Premature ejaculation would be a product of the hyper sensibility of a receptor called 5HT1A, with activation decreases the seretonine in the neurotransmission. So, the therapy is based fundamentally in a pharmacological treatment. Especially, using antidepressant medicines. It is demonstrated that the chronicle use of that medicines increases the amount of serotonine. In some research made on in vitro animals, the result was variable, but it has about a 60% of efficiency when the treatment is the right one and the patient follows it”. Those experts also add that it is also important to consider treating and following the couple of the patients.

Advices, chats and group therapies help a lot, and also psychotherapeutical interventions. The problem is that very few studies have evaluated its effectiveness.

Do I have the problem?

That dysfunction was first considered after the 70’s, once women started having more freedom in the sexual aspects, and so started to demand a bigger “efficiency”.

In Chile, there are no statistics, but globally 30% of male suffer that problem, while 70% might suffer it occasionally along their life.

However, short lasting in your sexual relations is not a synonym of PE. There is a specific definition for that problem: every man with less than a one minute ejaculatory intravaginal time in the 50% of his sexual relations”.

That handicap in controlling the ejaculation and so, not allow your couple achieve the climax, is showed in male among every age. There are two kinds of PE. Primary, which has always existed and so the patient has never controlled it. And secondary, which appears in a specific time of the life of the patient.

The effects of the premature ejaculation in your couple are devastator, like an earthquake.

“Most are unhappy with their sexual life and some of their partners insecure about their sexuality and guilty. The most important thing is that the intimate relation losses his sense, with has a huge impact on both of them”, say specialists from Chile.

Source: Carmen Eugenia Bravo (La Nación)

Introduction

Premature ejaculation is one of the most usual sexual dysfunctions among men. Selective inhibitors for the serotonine gaining (ISRS) have been used for that indication. Dapoxetine it’s an ISRS with a short-medium lifetime, developed for that use.

Objective

Study the efficiency and tolerance of dapoxetine at the treatment of fast eyaculation.

Study profile

• Type of study: clinical essay
• Area of the study: treatment
• Ambit of the study: comunitary

Methods

In that study are reunited the results of two clinical essays ran with the same methodology. There were 2.614 patients with PE, that agreed with the principles of the DSM-IV, 16-year-old or more, with a stable couple, and lasting less than 2 minutes in the 75% of the relations they had the previous 2 weeks before the study.

Patinents with a erectile dysfunction were excluded, and also those who used any kind of ISRS or tricycles antidepressants, and those with psychiatrics illnesses, or under any other PE treatment or whose couple had feminine sexual dysfunction.

Randomly, to all the patients was distributed a placebo or dose of dapoxetine from 30 to 60 mg. It was recommended to all the patients having more than 6 sexual relations a month during the 12 weeks of the study and take the medicine 1-3 hours before that relation. Efficiency was measured on the 4th, 8th and 12th week. The main variable was the lasting time of the intravaginal ejaculation on the 12th week. As a secondary variable was used the score of the premature ejaculation profile, a questionnaire that rates the seriousness of the PE and how much satisfaction have the patient and his couple achieved during the sexual relations.

Results

2,614 patients participated in the study. There were no relevant differences among the participants of the 3 groups. The average age was 40 year old and the average duration of the problem was 16 years. In the 65% of the cases it was a primary PE.

The lasting time of the relation was increased in the 3 groups, but it was significantly higher in the groups that used dapoxetine, and also the dose of 60 mg was more efficient than the one of 30 mg. The percentage of patients that showed a lasting time higher than 3 minutes was also bigger in those who used the 60 mg dose, and of course still bigger than in those who only took a placebo. Differences appeared after the first dose and were independent of the seriousness of the PE. However it was recommended to take the medicine 1-3 hours befote the sexual relation, it was also efficient when taken Orly 30-60 minutes before it and more than 4 hours after swallowing it. The control degree of the ejaculation and the satisfaction also increased in the patients after taking dapoxetine.

Secondary effects that appeared more frequently affected to the digestive system (nausea, diarrea) and in the central nervous system (headache, dizziness, and somnolence). Nausea affected to the 20% of the patients that took a 60 mg dapoxetine dose. Those secondary effects made 5% of the patients give up on the treatment. The 3% of them who took dapoxetine suffered a sexual dysfunction, in comparison with the 1,5% that suffered that in the group of those who only took a placebo.

Conclusions

The authors concluded that dapoxetine is an efficient and well-tolerated treatment for PE.

Interest conflicts

Some of the authors received any kind of honorary from pharmaceutical laboratories.

Comentario

PE is one of the most frequent male sexual dysfunction. However, its frequency is not easy to establish, because there is not an accepted universal definition. The main measure for that problem is the lasting time of the relation (TLEI). Research made for studying its distribution among the population show that the TLEI has a right slanting distribution, with a central reservation of 5.4 min, with no objective measure to establish normality. The percentile 0.5 corresponds to the 0.9 min and the 2.5 with the 1.3 min. Based on those results, some authors set the definition of the PE in less than 1 min and probable in less than 1.5 minutes. The seriousness of that problem would be defined for the psychological issues associated to it.

Antidepressants like clomipramine or the ISRS are effective for delaying ejaculation in patients with PE, but some research say that the time needed between taking the medicine and the sexual relation was too long, which could be a handicap and also its use provoked many secondary effects after the took.

And so, it would be useful to have an ISRS with a quickest effect and a smaller life. Dapoxetine is an ISRS designed for that. In that study has been proved that it is a useful medicine. But there were those secondary effects and also we need to consider that the definition of PE was not the best (TLEI<2min.).

Bibliography

• Waldinger MD, Zwinderman AH, Schweitzer DH, Olivier B. Relevance of methodological design for the interpretation of efficacy of drug treatment of premature ejaculation: a systematic review and meta-analysis. Int J Impot Res 2004; 16: 369-381.
• Waldinger MD. Towards evidence-based drug treatment research on premature ejaculation: a critical evaluation of methodology. Int J Impot Res 2003; 15: 309-313.
• Waldinger MD. Lifelong premature ejaculation: definition, serotonergic neurotransmission and drug treatment. World J Urol 2005; 23: 102-108.

Dr. Helen S. Kaplan, a well-known expert, suggested another definition for that problem in her book “Premature Ejaculation”, which was accepted for the WHO: “the fundamental characteristic of the premature ejaculation is that the man does not have an adequate and voluntary control of the ejaculation, resulting on an involuntary climax”.

Perhaps that definition is not precise enough and can make us be mistaken. It should be tinged. It talks about an adequate control (and not an absolute control) which is the most important difference. When the excitation of the male comes to that “no return point”, it is not possible to have any kind of control and the ejaculation is imminent. The time that a man needs to get an erection after ejaculating is what it’s called “refractory period”, and it’s different from one man to another and it’s longer as the man ages. Most young people, however, can recover the erection even before his penis is out of the vagina. And so it is said that thing of “two or three in a row!” associated to the excitement of the mix of youth and sex.

It is not enough one or two episodes of a bad interpreted PE to consider that you are actually a premature ejaculator. If a young man has sexual relations every two or three weeks it is normal that he ejaculates quickly. It is due to a high level of excitement and that precipitates the orgasm. The good point is that being that age you can repeat soon the experience! So a quick ejaculation must be considered a sign of intense attraction, a tribute for that desired person.

Besides, we must remember that the penetration is not the only way of satisfying your couple, not even the most wanted for most women to achieve and orgasm (you can read further about that on the promotional chapter of the ebook “Premature Ejaculation Help!”. As people age, the refractory pulse serenades. It is possible not willing to repeat, but you get more control and maintain your erection longer. From a medical point of view, it is better to talk about control of the ejaculation and not about premature ejaculation, because it is usually the problem that those young people are facing.

Have you ever lived a PE episode? Did you have any partner with that problem? What happened? How did it end? How did you feel? Can you recognise the point of no return? Do you think it is not possible to do it “twice in a row”?

In ten questions we ask and answer the most frequent interrogants on premature ejaculation. After reading it, you’ll be nearer to confront and solve the problem.

1. What is premature ejaculation?

We talk about premature ejaculation when a man ejaculate too quickly but he wants to last longer. But what is “too fast”? What is normal? Is there a minimum time considered? In practice, only what you and your partner matter: so, we talk about premature ejaculation if it takes place before the couple desires. The ejaculation may even come up before penetration. A man who does not have this problem is able to control when he wants to ejaculate, in order to delay the moment of the orgasm for him and his partner. 10 keys on premature ejaculation.

2. Is it the same thing premature ejaculation, rapid ejaculation and pre cum?

No, the first two term are the same thing, but prem cum is pre-ejaculatory semen. It is the fluid that ejaculates from a man before the climax.

3. Affects many men?

More than one in three men are facing this problem. Studies conducted in this regard speak of a 36-38% of men. Some happens occasionally and others routinely.

4. Is this a disease?

No. It is not known exactly why some men easily control their ejaculation while others can not. Recent studies suggest that the brain neuromediadores play an important role in the ability of delaying the ejaculatory time. Stress and anxiety also accelerate ejaculation but are not solely responsible for this problem. Other causes could be bad maturbatory habits (masturbation doing too fast) or bad coiuts habits (doing sex too quickly when the man was young). A bad masturbatory practise (just for getting to the climax as fast as possible) can have fatal consequences for whom that practises it, based on the fact that he won’t develop control mechanisms that help him to identify the feelings that precede orgasm and therefore control his ejaculatory reaction.

5. Is it a hereditary problem?

Although it has discussed this possibility, there is no study that has confirmed this hypothesis.

6. Does Circumcision solve premature ejaculation?

For a long time it was thought that circumcision solve this problem. However, there is evidence that it has no influence. The idea was based on the decreased sensitivity in the glans, which should curb the excitement. However, there are so many early eyaculadores among circumcised men as among those who are not.

7. Can we deal it with drugs?

Yes, certain antidepressants have proved effective in delaying the time of ejaculation. But only serve to treat the symptoms, not the cause of the problem, when treatment usually ends the problem reappear. Some men found insufficient the effect of these drugs, think they do not pose a significant delay ejaculation.

8. Are there tricks that allow delaying ejaculation?

Thinking about something else, masturbate before sex, do it twice in a row, controlling breathing… some of these tricks are completly false and others may work but are not definitive. To think otherwise allows decrease in sexual arousal and delaying ejaculation but different experts assure that the only thing that is obtained is the decrease the cortical control of the ejaculatory reflects, making it even less lasting. Other myth is that having a sexual encounter after a first ejaculation is an effective solution. But it is not for those people that for their age or characteristics have problems on achieving a second erection. We must not forget that a man needs a recovery period after orgasm.

9. Are there other therapies besides medicines?

Yes. The learning methods of controlling ejaculation are very effective. But requiring perseverance and collaboration of the couple for exercises. ‘Training’ either you get very good results. The best idea is to call upon the expertise of a sexology but there are books that can help you in knowing more details and exercises in order to overcome the problem.

10. Can a woman live with this problem?

Of course. If we take into account the percentage of men who suffer from this problem, we get the number of women who share. Many couples agree to live with it. There are many ways to get pleasure outside the penetration. Moreover, neither men nor women choose their partners solely by their sexual skills. Furthermore, there are exercises (like the ones described on this e-book) that can help the couple in order to control the ejaculation.

If you are a woman, there are several things you can do for making your partner feel more comfortable while he is having some of those problems (like premature ejaculation, or also related to a dysfunction or retarded ejaculation).

Now, let’s take a look at what problems might men suffer from, and we will also advice you just to make you ready to help him and solve them together.

Lack of interest

Your partner doesn’t look much interested on having sexual relations.

It is certainly a problem. So most men think that having a powerful and prolonged erection is their duty, it might be confusing and frustrating not feeling excited in front of a woman and her attributes.

In that case, being the woman, you shouldn’t take it on the bad way and, for instance, ask him “what’s wrong? Don’t you like me anymore?”. Think that he will be very sensate and probably thought about it time long enough.

What you must do is wait until the right time, when you were both in a good mood and relaxed, and then try to talk it together and very tactfully. Try to making feel secure and so he will explain you all his doubts. This is the right way for initiating a real conversation, from whom you could both take profits, and so it will be easier to talk about those aspects of your common life and make stronger your relationship.

Try to listen carefully and don’t misunderstand his comments. Repeat with your own words, during the conversation, what he is telling you so that no misunderstandings were allowed.

What to do

• If it’s a physical problem, then ask him to go to the doctor, a specialized sexologist. The doctor will need to revise his lifestyle, medicaments that is having and his health in general. Go together with him so you can be a moral support.
• If the problem is emotional (afraid from loosing your love, stressful life due to the job, anguish, confusion,…). Talking to him often can be handy, but it might be also needed to go to a psychologist it it’s a deep problem. You must always look confident and eliminate tensions from his life. If he is very stressed due to work issues, plan some holidays it you can allow it, or making him slow down so that he can employ that new spare time with doing some relaxing activities.
• Your relation is not as passionate as before? It is Orly a matter of boreness? When was the last time you made a new and different activity? Are you both trying to keep it the passion on? It is always good to go and do something different and profitable for you both.

Remember, communication between you and your partner is highly important.

20 members from the best experts in sexual health, created by the ISSM (an international society of sexual medicine) established that definition for the PE; a sexual dysfunction that affects to the 30% of men.

According to TOI from Orlando, the eminent American urologist Ira D. Sharlip, main author of the research, set up that definition for the EP (the nightmare of million of men around the world) after studying hundreds of international research published about that matter. The team that developed that research is published in the Sexual Medicine Diary and also in the American Urologist Association during its annual conference in Florida.

Dr. Sharlip said, “the definition of the PE is a sexual dysfunction in which the ejaculation happens after a minute after the penetration in the vagina almost in every sexual relation. Previous definitions didn’t quantify the limit time and many men who usually achieved orgasms soon thought that they had PE, provoking a huge anxiety, depression and stress.

Now, and always according to Dr. Sharlip, hopefully a larger amount of men who ejaculate in less than one minute will consider the PE as a medical condition and look for a treatment, no longer suffering in silence.

He also assures that this definition will help the companies that make medicines and sexologists that are offering a therapy to identify the real patients of PE. In September 2006, ISSM first considered having a proper definition for the PE. And so, that committee with 20 members from every continent was created. The group of experts set up that the factors that define the PE are: ejaculating too soon, inability to delay the ejaculation, and the negative consequences of EP.

“We have studied hundreds of PE researches published, especially 20 of them which were focused in objective measures to determine PE. The committee went to Amsterdam in October just to get to the final definition”. “Men that suffer PE must be treated immediately with a combination of psychology and medical therapy”, said Dr. Sharlip.

Reacting to the research, Dr. Vikram Sharma, urologist in the Hospital Max, told to TOI that the most common thing would be reduce the wrong diagnose of PE around the world. Some studies in India has shown that 10% of the adult men in the country suffer from any kind of sexual dysfunction and a large amount (almost 7%) could be PE.

According to Dr. Sharma, PE affects more often to men among 19 to 26 year-old and decreases about a 50% after being 30.

“Until now, when a patient complaint of PE or achieving the orgasm in less than 5 minutes, the first thing we did were counselling. However, now we know exactly what is PE and we can intervene more quickly”, said Dr. Sharma.

Experts say that PE is humiliating and most of them look for help too late.

Taoists sexual arts rose its higher point between the end of the Han dynasty and the end of the Tang dynasty (1000 a.c.). So, while Europe was suffering the Middle Age and looking for the afterlife, a lot of peculiar sexual practises were been performed in China. However, censorship arrived soon (not due to Christians, which where far away from there) but for Confucio and its puritanism that considered sex as a taboo. But, luckily or not, a lot of scripts were kept in Japan and so those sexual practises are well-documented.

The main aspect of Taoism is that there is a mysterious force surrounding us called “chi”and its part of everything. “Chi” connects with us through a substance called “Jing”. This is something like an energy bar in a videogame; when the bar is empty the character dies. That “Jing” is also related with the flow of the liquids of the body, and the one with the biggest amount of “Jing” is the sperm. So it is necessary to avoid defecating, urinating and even more ejaculating. We don’t need to say that following these rules can be highly unhealthy.

Right, once we have assimilated those concepts, let’s go on learning how to become immortal, just follow those easy steps (do not try it, please!):

• For avoiding that our energy bar goes down, we must never ejaculate, or at least very rarely. It is not that sex is forbidden. In fact, Tao advices practising it a lot, but always holding the sperm. To do that it is needed to press between the scrotum and the anus and so get an reactionary ejaculation. Taoists thought that doing that sperm travelled to the brain, feeding it with its Jing.
• To refill the energy bar, practise a lot of sex, creating more and more Jing.
• Sexual postures are very influencing and there were some specific postures more advisable than others, sexual tantric postures, in order to create more Jing.
• The best tantric sexual relation must start with the penis totally flaccid and shrank into the vagina and must be retired erect and without ejaculating.
  We shall avoid producing any kind of excrement and so we must live from air and eat only our saliva. Breathing is important and the Yen must have the ability to recycle its own air. If you want to achieve immortality, train everyday holding your breath us much us you can and everyday a bit more than the previous one.

As we said before, don’t try it at home!

It is the elder representation of the male sexuality and was discovered in Germany, into a cave. The penis of 7,87 inches and 1,18 inches of diameter is exquisitely sculpt on stone and was made out of 14 fragments founded in the same place. Its extraordinary facture, the well-polished surface and the measures (close to the ones of a penis), made the scientifics thought that it is really an erotic sexual toy from the past times.

Dutch scientifics were absolutely astonished after founding that beautiful sculpture. The stone was found on the cave of Hohle Fels, near Ulm (Suabia) by a team from the University of Tübingen. Professor Nicholas Conard explained to BBC that “representations of women with marked sexual attributes are widely documented in numerous places, but male representations are very, very rare” and that “besides being a representation of the male reproductive system, it could have also been used for notching silex, due to some scars on its surface”. Researchers also explained that the unmistakable form of the object and its well-polished surface, besides some rings sculpt on it, leave no doubt about the symbolic nature of the object.

The place where it was found is one of the most notorious in Central Europe and there has been found many pieces from the Upper Paleolithic. That period is commonly related to the expansion of the Homo Sapiens, it is to say, groups of human beings with psychical characteristics practically identical to us.

The group from Tubinga, which was excavating in Hohle Fels, had already found 13 pieces of the stone penis, but only last year, after founding the fragment number 14, could the puzzle be resolved. All the pieces were found in the same place, deep inside a series of caves not very accessible, where are numerous signs of “modern” human being activities.

Symbols like that one, made out of stone and even elder were previously found in France and Morocco, but the one found in Hohle Fels is unique. “Feminine representations are common in many places –said Conrad- but representations of male genitals are very strange”. The stone penis of Hohle Fels is at an exposition called “Glaciar Art: decidedly male” of the Prehistoric Museum of Blaubeuren.