Science: What exactly is premature ejaculation?

  In male clinics, patients often ask this question: Doctor, am I premature ejaculation or not? What exactly is the cause? Perhaps you can’t get a satisfactory answer to such a question, so why is it? Is the doctor unwilling to talk about it? Is it because the doctor does not want to talk about it? Doctors do not know? The following we will talk about this problem.  In fact, the definition of premature ejaculation is not as simple as you might think. There are many doctors who have tried to give a clear statement about what premature ejaculation means and give a clear definition of premature ejaculation, but most of these definitions have failed.  Here are some common definitions of premature ejaculation: In 1970, Mastors and Johnson’s definition: Premature ejaculation is defined as less than 50% of the frequency at which ejaculation is maintained during intercourse to the satisfaction of the spouse.  In 1973, OBLER defined premature ejaculation as “premature ejaculation when the male ejaculation lasts less than 2 min.  In 1974, Kaplan, an American sexual medicine specialist, defined premature ejaculation as the inability to achieve orgasm as desired due to the male’s lack of the ability to regulate ejaculation at will, and considered it normal to have the ability to maintain ejaculation for more than 5 minutes after penetration, or for both partners to feel satisfied without being affected by the male partner’s efforts to delay ejaculation.  In 1984, the American Psychiatric Association’s DSM-III-R criteria defined premature ejaculation as the occurrence of ejaculation upon vaginal penetration as desired or with minimal sexual stimulation.  The American Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Revised (DSM-IV-TR) PE defines ejaculation as always or frequently occurring before, during, or shortly after vaginal penetration with minimal sexual stimulation, when such ejaculation is not desired by the patient. The clinician must take into account various factors that affect the duration of the arousal phase, such as age, the novelty of the sexual partner or the environment of intercourse, and the frequency of recent sexual intercourse.  In 1997, the American Urological Association proposed the following definition: Ejaculation can be considered premature when one of the two partners is dissatisfied with the ejaculatory latency or attempts to prolong it.  WHO International Classification of Diseases, 10th edition (ICD-10) PE is defined as the inability to delay ejaculation to fully enjoy sex, as evidenced by ejaculation occurring a short time before or after the start of intercourse (if a time limit is needed: within 15s before or after the start of intercourse), or when the penis is not fully erect and not yet able to engage in intercourse. This is when PE is not caused by a prolonged lack of sexual intercourse.  The Second International Conference of Experts on Erectile Dysfunction defined PE as ejaculation before or shortly after vaginal penetration, with slight stimulation, ejaculation earlier than desired, resulting in annoyance or distress for the patient, who has little or no active control over ejaculation.  In October 2007, the International Society of Sexual Medicine adopted a new definition of PE for the first time using evidence-based medicine: PE is a male sexual dysfunction characterized by the following features: ejaculation always or almost always occurs before or within 1 minute of vaginal penetration; inability to delay ejaculation for each or almost every vaginal penetration; negative consequences such as pain, annoyance, frustration, and/or avoidance of sexual intimacy, etc.  As you can see, I do not have no definition for premature ejaculation. However, the actual clinical application of these definitions can be quite difficult, so much so that doctors sometimes have no way to say what is considered premature ejaculation. So why is this?  The definition of premature ejaculation is that the feelings of the spouse must be taken into account, but defining premature ejaculation by the feelings of the spouse alone will ignore the experience of the man himself. Some definitions focus on the satisfaction of the spouse during intercourse, admittedly, men have the pleasure of orgasm as soon as they ejaculate, but women must be stimulated for a long enough period of time to achieve. But if the woman’s feelings alone are taken into account, will this be enough? Men Road difficult will not need the enjoyment of the sexual process? The answer is definitely no! Besides, the definition of premature ejaculation by the woman’s satisfaction is difficult to operate clinically, and many times patients do not come to the clinic together as a couple. In addition, sometimes the wife can’t tell how many times she is definitely satisfied and how many times she is definitely not satisfied! Or maybe the wife is satisfied, the man is not satisfied and how?  2, the definition of premature ejaculation should have a sexual intercourse time limit, so that doctors can better determine who is premature ejaculation and who is not! Perhaps such a definition is easier to operate, you readers probably think so! Is that the case? This is not the case at all.  There is a huge difference in how people behave sexually. This is not only in terms of the location of sexual intercourse, the choice of context, but also in the sexual action itself, the position, the sound made, the speed and amplitude of the action, etc. are very different from each other. The same applies to the speed of ejaculation during intercourse, which varies greatly from person to person. Some people take longer to ejaculate during intercourse, while others do not. The actual time required for sex is also different, some people feel that 5 minutes is already long, while others feel that 10 minutes is not enough. If you take into account the expected time of the spouse on the time of intercourse, then it is even more difficult to define this.  In view of this situation, we may wish to make some suggestions: 1, sexual intercourse is an activity that brings pleasure to both spouses, when you or your spouse feel less satisfied, consider seeing a doctor.  2, don’t ask the doctor how long is considered normal, you and your lover’s feelings are the most genuine. The definition of premature ejaculation as 1 minute or as 10 minutes does not change anything about your own feelings.  3. Don’t pay too much attention to the duration of intercourse. Time and erection hardness are important, but the emotional experience of lingering during intercourse is more important.  4, as with erectile dysfunction, a regular sex life and a good couple relationship is a prerequisite for measuring whether there is premature ejaculation. Don’t use masturbation, prostitution, or promiscuity to measure your sexual function.