Premature ejaculation (PE), often also called rapid ejaculation, is

among the most widespread sexual dysfunction in men below 40

years. Broadly, premature ejaculation may be described as the
occurrence of ejaculation before the desires of both sexual partners
are fulfilled. This definition, however, does not exactly specify the
duration of the sexual intercourse and reaching an orgasm, both being
variable and relies on several aspects characteristic to the individuals
involved in the sexual activity. In fact, every male have experienced
premature ejaculation at some point or the other in his life, and, hence,
an occasional happening is not a matter of worry. However, if
premature ejaculation occurs over 50 per cent of ventured sexual
intercourse, it may be said that there is an ineffectual relationship
necessitating medical treatment.
Making the issue more comprehensible, let’s suppose that a male
reaches orgasm after eight minutes of sexual intercourse. This cannot
be called a case of premature ejaculation provided his partner
frequently climaxes in five minutes and both are content with their
timings. On the other hand, another male may prolong his ejaculation
to 20 minutes, but this may still be regarded as premature ejaculation
provided his partner requires 35 minutes of stimulation before
reaching her orgasm. Thus, it is apparent from the second instance
that premature ejaculation is a relative issue depending on the
partners engaged in the sexual act.

Premature Ejaculation Statistics-

According to the National Health and Social Life Survey (NHSLS),

around 30 per cent of all males in the United States suffer from
premature ejaculation. In fact, many professionals treating premature
ejaculation in the U.S. put the figure at 70 per cent saying that most
men are not willing to admit the problem owing to embarrassment. On
the other hand, the American Urological Association says that
premature ejaculation affects between 27 per cent and 34 per cent of
males of all age groups. In fact, premature ejaculation has been found
to happen at any age in a male's life, but is more common in younger
males – aged between 18 and 30 years. It has also been noted to occur
as a secondary condition to impotence in men aged between 45 and
65 years. Although there are no available data for Asia, Australia or
Africa, the European nations and India report statistics comparable to
their American counterparts.

Premature Ejaculation Categorization

The condition of premature ejaculation may be divided into three

categories – constant and regular ejaculation with minimal sexual
stimula
tion before, on or shortly after penetration before the person wants to,
distinct suffering or owing to problems in the relations between two
persons and not entirely due to any express consequences. On the
other hand, the human sexual reaction too may be categorized into
three segments – libido or sexual desire, excitement or sexual arousal,
and orgasm or climax. Moreover, premature ejaculation may be
primary or secondary.
Primary premature ejaculation is applicable in the case of men who
have had the disorder ever since they were competent of functioning
sexually, i.e. after the puberty period. On the other hand, secondary
premature ejaculation refers to the sexual dysfunction in a man who
had earlier enjoyed a satisfactory stage of ejaculatory control and for
causes unidentified, the individual endured premature ejaculation
later. In fact, premature ejaculation is considered to be a psychological
crisis and does not manifest any identified organic disease relating to
the male reproductive tract or any recognized abrasions in the brain or
the nervous system. The organs that are expressly affected by
premature ejaculation comprise the male reproductive tract – penis,
prostrate, seminal vesicles, testicles and their limbs, segment of the
central nervous system, the peripheral nervous system regulating the
male reproductive tract as well as the reproductive tract of the female
sex partner that may not be effectually aroused for an orgasm.

Premature Ejaculation Grades

There are basically four grades of premature ejaculation. The hazard of

this male sexual dysfunction is that it develops rapidly going from one
grade to another in a matter of few months.

Grade 1
This is the most docile grade of premature ejaculation and is believed
to be the beginning of the sexual dysfunction. This grade is mainly
related to ‘primary ejaculators’ or those who had control over
ejaculation in the past. In this grade, premature ejaculation occurs
sporadically in moment's emotional tension.

Grade 2
This grade is common in secondary premature ejaculation or those
who have never had control over their ejaculation. In this grade,
premature ejaculation occurs more or less every time and the duration
of the sexual act is between 1 to 5 minutes.

Grade 3
Those who don't overcome premature ejaculation on grades 1 or 2
develop grade 3 fairly fast. Psychological aspects like performance
anxiety are attached to the dysfunction making it chronic. In this grade
premature ejaculation occurs always and the subject ejaculates
instantly after penetration.

Grade 4
Grade 4 is when the sexual dysfunction becomes a disorder. Men who
suffer from grade 4 premature ejaculation are inclined to avoid sexual
encounters and could even develop into a psychological impotence
‘erectile dysfunction’ where the mind refuses any kind of sexual
activity to avoid more frustration and suffering. In this grade
premature ejaculation occurs every time and the man ejaculates
directly before or right on penetration.

Premature Ejaculation Reasons

Historically, premature ejaculation problems has been believed to be a

psychological disorder. One theory is that males are conditioned by
societal pressures to reach climax quickly because of fear of discovery
when masturbating as teenagers or during early sexual experiences "in
the back seat of the car" or with a prostitute. This pattern of quick
realization of sexual release is difficult to change in marital or long-
term relationships. The fact that female arousal and orgasm require
more time than male arousal is being increasingly recognized, and this
may result in increased recognition and definition of premature
ejaculation as a problem.
Many have doubted whether premature ejaculation is purely
psychological. A number of investigators have found differences in
nerve conduction/latency times and hormonal differences in men who
experience premature ejaculation compared with individuals who do
not. The conjecture is that some men have oversensitivity of their
genitalia, thus preventing down-regulation of their sympathetic
conduits and delay of orgasm. Lately a certain group of nerves in the
lumbar spinal cord has been identified as the possible originator of
ejaculation. This nerve site is thought to be linked to excitatory and
inhibitory dopamine pathways in the brain, which play significant roles
in sexual behavior. This information is providing the basis for
development of medications like Dapoxetine or Priligy specifically
targeting delay of ejaculation.

Premature Ejaculation Impact

In case premature ejaculation happens too early prior to the sexual
intercourse and the couple is attempting a pregnancy, it is impossible
to achieve pregnancy unless the partner (female) uses simulated
insemination. In addition, premature ejaculation is likely to leave both
the partners emotionally and physically frustrated. Premature
ejaculation is prone to have a direct impact on self-respect, marital
function, and may also result in depression or other anxiety issues.
Nevertheless, studies have not taken into consideration the link
between premature ejaculation and sexual satisfaction or relationship
satisfaction in couples who have not sought sex therapy. Hence, there
is no evidence that premature ejaculation is an obstacle to a satisfying
sexual relationship. Interestingly, observations made by men and
women on men's ejaculatory behavior often don't correspond. In
general, women see premature ejaculation as less of a problem than
the men do. And how women see men's ejaculation, i.e. as a problem
or not, seem to be largely influenced by whether they perceive the
man as having premature ejaculation.