To Overcome Rapid Ejaculation We Need To Know What It Is!

Is There An Accurate Definition of Premature Ejaculation?

Diagnosis & Definition

Premature ejaculation is often defined by two things - first, the time between penetration (intromission) and ejaculation is two minutes or less (though some experts use three minutes as a cut off point), and second, there is distress of some kind for either the man or his sexual partner because lovemaking is so brief.

From the man's point of view, this means he has reduced control over ejaculation; he is dissatisfied with intercourse, and he or his partner are distressed about it.

substantial self control is needed for a man to delay ejaculation Since many men do not apparently mind that they can make love in bed for so short a length of time - less than two minutes - before they ejaculate, the added factor of "distress" is needed.

In reality, substantial overlap exists between men who say they have premature ejaculation and those who don't when the length of lovemaking alone is used alone as a defining feature of the condition.

When men are asked to estimate how long they are capable of making love for, they are found to overestimate the time somewhat: men with PE think they can make love for 2 minutes, when the actual average is 1.8 minutes.

Men without PE estimate their capacity at 9 minutes when they can actually make love for 7.3 minutes. A massive difference in duration, really, and one which is very likely to affect the ease with which a woman can come during intercourse.

By these criteria, premature ejaculation is present in at least 35% of males over 18 years of age. It's also not surprising to find that premature ejaculation is the most common male sexual dysfunction with erectile dysfunction and decreased libido close behind.

Men who can't control ejaculation in the bedroom are obviously much less happy about the quality of their sexual relationship, the duration of sex, and the period of time they spend with their partner.

So according to the definition of PE in the DSM IV, coming too soon has to cause distress and/or interpersonal problems to be considered early ejaculation, which is - to say the least - a very subjective definition, An untimely coming, one might say!

Of course, both the DSM IV and ICD-10 methods of defining PE are opinion-based, and do not have the backing of controlled clinical and epidemiological research studies.

So that means the DSM IV definition of prematurity has little value as a diagnostic test for predicting PE. The key thing here, as you may have realized, is that there is no definition of the time between penetration and ejaculation (also called the intravaginal ejaculatory latency time or for short the IELT).

And this means that men who "last a long time during sex", i.e. who can thrust for up to 20 minutes or even longer between penetration and ejaculation, may, according to the DSM IV, have premature ejaculation if they simply have some doubts or worries about how long they can last. Confused? Go to bed and put an ice-pack on your head! Lie there for as long as you want, but don't get up prematurely!!

Worse, there are plenty of men who last for a long time in bed and yet who complain that they have premature ejaculation. All in all, the unspecific and vague DSM IV definition is unhelpful in clinical practice and does not aid research into new methods of treatment.

A New Definition

The DSM IV definition of premature ejaculation emphasizes the subjective nature of premature ejaculation as a "complaint" from which men suffer. And the imprecise nature of the term "interpersonal distress" leaves the definition open to further subjective interpretation.

But worry no longer! Proposals for a new definition have been put forward: an approach which would elevate premature ejaculation from the subjective sense of "I'm not lasting long enough in bed" or "how can I last longer during sex" to a so-called syndromal approach which incorporates carefully conducted clinical studies which measure the time between penetration and ejaculation.

Premature ejaculation as a discrete clinical entity, a medical syndrome, was first described in 1943 by Schapiro, who drew a distinction between what was to become known as lifelong premature ejaculation and acquired premature ejaculation. More recently, Waldinger and Schweitzer suggested the existence and definition of a third premature ejaculation syndrome called "natural variable premature ejaculation".

And, in order to help the classification even further, Waldinger also suggested that a fourth premature ejaculation syndrome be called premature-like ejaculatory dysfunction - this is the condition experienced by men who last long enough while bedding a woman but who still claim they have premature ejaculation!

Delayed Ejaculation

Delayed Ejaculation Treatment

Definition

Delayed Ejaculation

Porn and Delayed Ejaculation

Let me try and make all this clearer:

Lifelong PE

This is easy to recognize from the following symptoms:
a man's ejaculation occurs too early on almost every occasion he and his partner have sex
the problem is not limited to one woman but happens almost every time the man has intercourse with any partner
the man has premature ejaculation from the first time he has sex onwards
up to 80% of men ejaculate within 30-60 seconds of penetration and the other 20% ejaculate within 1-2 minutes
in 70% of these men ejaculation remains very quick throughout life; in another 30% it may get even faster with age
a number of men ejaculate during foreplay, before they have penetrated their partner or as soon as their penis touches their partner's vagina.

Acquired PE

Acquired premature ejaculation is different. It shows the following symptoms:
early ejaculation starts at some point in a man's life
the man has usually experienced normal ejaculation before the start of his complaint
the premature ejaculation comes on either suddenly or gradually and may even be secondary to something like erectile dysfunction or prostatitis. It may also be caused by thyroid dysfunction, psychological problems and relationship issues.
Acquired premature ejaculation can be treated by addressing the underlying cause. A physical examination and a blood and/or urine test are always necessary.

Natural Variable PE

In natural variable premature ejaculation, the ejaculation time varies, and the rapid ejaculation occurs occasionally or regularly in various situations or circumstances. Duration aside, this is rather like a normal variation in sexual performance, and it involves the following symptoms:
rapid ejaculations are not consistent and happen irregularly or unexpectedly
a man's capacity to control ejaculation may be less than normal or lacking, but a diagnosis can be made without this symptom
reduced control of ejaculation is linked to a short or normal ejaculation time of less than 1.5 minutes
Men with this type of premature ejaculation usually cope well, but need to regain sexual confidence, for which therapy is helpful, because the problem is related to situational problems and should be quickly reversible
treatment with ejaculation-delaying drugs is not needed

Premature-Like Ejaculatory Dysfunction

Premature-like ejaculatory dysfunction is a syndrome in men who say they have premature ejaculation despite the fact that they last as long as most men in bedding - 3-6 minutes - and they may even be capable of prolonged sex of up to 20 minutes.
it is more a psychological condition than a true pathology
it is often caused by psychological and/or relationship issues
men with this condition think they regularly or sometimes ejaculate far too soon during sex
they may become obsessed with their supposed early ejaculation or lack of control, even though their IELT is in the normal range
they may or may not lack the ability to stop ejaculation at the point of no return, the so-called point of imminent ejaculation, but this is not a prerequisite for the diagnosis
they don't have another emotional disorder which explains the way they are behaving
assurance that ejaculation time is inside the normal range and telling them emotional issues are most probably the cause usually helps, if not, counseling, sex-education, and psychotherapy of uncertain duration are needed.

With information from Marcel Waldinger's work on PE.