next day This issue, many men suffer from not knowing much about it, then an article on this topic:
What is it?
the RAE's dictionary defines cum like "Run quickly and force the contents of an organ, cavity or reservoir, including the semen of men or animals" [1] and early "Process appearing earlier than usual " [2] .
There are several synonymous terms of premature early, such as premature ejaculation, rapid ejaculation, premature inappropriate, lack of control over ejaculation and ejaculatory control inappropriate or poor. Until
investigations Kinsey (1948), in the West the man was not concerned about their coital duration nor the speed of your ejaculation. Prior to the seventies, premature ejaculation was considered a subtype of impotence, was defined as "the inability to practice normally vaginal intercourse. Includes erectile dysfunction and ejaculation " [3] . While for others "the psychological impotence can affect ... preparatory acts, the erection (which may be incomplete or absent), ejaculation (may be delayed, selective or early) and orgasm disorders (which may be total or partial). " [4]
Following the studies of Masters and Johnson in the sixties and seventies, premature ejaculation is recognized as a separate problem of impotence, however, comes the difficulty of defining with precision.
Throughout history, it was defined according to various criteria, which pointed to coital duration (30 seconds), the number of moves penile intravaginal, or the percentage of orgasms achieved by their partner.
For some authors, is that premature ejaculation occurs before penetration, the semen being ejaculated outside the vagina. Thus Kusnetzoff, makes a distinction between early and rapid ejaculation. "The ejaculation may occur before vaginal entry (premature ejaculation true) or almost immediately after entering (premature ejaculation)" [5] . But for others, it would be a premature ultraprecoz.
There is a theoretical line that understands how to premature ejaculation that occurs outside the vagina or the few moments of penetration. Huguet Gindin and make a difference between what they call ejaculation ante portas ("before the door") or femoral inter ("between the legs") which "includes the cases of premature when it is about to enter the penis. The ejaculate is between the legs or buttocks of the couple [6] with premature ejaculation, where the most common is that ejaculation and orgasm occur shortly after the introduction of the penis, in less than twenty seconds and no more than ten to fifteen moves. However, essential characteristic is the inability to decide when to ejaculate or have voluntary control and not the time or the number of movements.
Another theoretical line [7] , focuses on the issue of control over the ejaculatory reflex by man. Among the main authors who follow this line are:
Helen Kaplan, which states that a man with orgasmic phase has no control over orgasm. "The crux of prematurity is rather the absence of voluntary control the ejaculatory reflex, regardless of whether this occurs after two or five pulses, whether occurring before a woman reaches orgasm. We can therefore say that there is premature ejaculation when orgasm occurs in a manner reflecting, that is, when it is outside the control of the individual volunteer once reached an intense level of sexual arousal " [8] .
Masters, Johnson and Kolodny follow this theoretical line when defined premature ejaculation as "ejaculation during foreplay uncontrolled love, or when the man attempted penetration, or shortly after starting sexual intercourse" [9] .
But for others, the essence of the diagnosis, definition and classification of early ejaculation, is in the view "subjective" of at least one member of the couple:
is how to Alex Comfort, called early "to ejaculation occurring sooner than we want both components partner " [10] .
A more complete definition of this line is what gives the American Psychiatric Association (APA) in the DSM-IV, where it refers to premature ejaculation saying that "the essential characteristic of premature ejaculation is the onset of an orgasm and persistent or recurrent ejaculation in response to minimal sexual stimulation before, during or shortly after penetration and before the person wishes it " [11] .
Masters, Johnson and Kolodny distinguished according to the intensity of the problem, the most serious cases where premature invariably comes from before the introduction of the penis into the vagina, a less extreme cases where the ejaculation occurs when penetration attempts or within a few seconds after the same, while the mildest form is one in which people help themselves until they are practicing vaginal intercourse, but lost control after a few penile intravaginal movements. The themes of
control and subjectivity can be seen in the definition given Gindin and Huguet, to qualify as early ejaculation when "occurs much earlier than the person wants. Is defined by the absence of voluntary control. " [12] .
According to Masters, Johnson and Kolodny, "have a long pattern of rapid ejaculation is clearly a hallmark of premature ejaculation. For this reason, men who have trouble controlling the speed of your ejaculations only under certain circumstances not really suffer this dysfunction " [13] .
I do not entirely agree with any of the definitions as both biased above. With regard to focusing on time, I agree with Masters, Johnson and Kolodny, who claim to be considered as the trigger for premature ejaculation which it occurs "soon after the penetration is something under discussion. Some couples think that sex is supposed to end in about ten to twenty seconds and are perfectly happy with that situation, while other couples feel anxious or disappointed if the man is not able to endure fifteen minutes of vigorous intercourse stunts " [14 ] . In relation to all voluntary control, these authors criticize the party referred to ejaculation occurs before the person who wants , since for them the ejaculation is "the end of the reaction shows that usually is not subject to strict control of the will, reason, despite the fact that many men want to have a greater say in their sexual restraint, in this case the desire or will not do much to determine whether there is a problem " [15] .
will consider for an adequate definition of premature ejaculation the three key aspects of the tenets of the great majority of the authors mentioned above, but in an interrelated way. Ie, finding involved a combination of aspects relating to the subjectivity of the couple, the duration of intravaginal intercourse and control, but the latter on the degree of excitement, not the ejaculation reflex itself.
According to the above, consider as to that premature ejaculation before penetration or what the couple considers a short time afterwards, in which man has no voluntary control of arousal level prior to the time of inevitabildad the ejaculatory reflex and that at least one member experiences it as a problem.
Types Premature ejaculation can be classified on two criteria, one of a temporary nature (primary or secondary) and a descriptive (temporary or permanent, occasional, situational, occasional, selective, etc.)..
How many?
"Although no precise statistics on the frequency of this problem, there is consensus that the most common male sexual dysfunction" [16] .
Research into the prevalence of this dysfunction have given different results depending on the definition of base used and the type of sampling. So indicating the percentages vary, the ends, that between 15 and 75% [17] of men suffer from premature ejaculation .
However, the vast majority of studies [18] opinion that the problems of premature ejaculation are present between 35% and 40% of men, although the latest [19] the order figures are between 15 and 20%.
Who are they?
Kaplan's research as well as Masters and Johnson, and Hunt report found no significant differences in the average duration of intercourse of the various educational and occupational levels, while differences due to demographic and socioeconomic factors were statistically insignificant. While, according to Gindin and Huguet (1993), for CETIS, premature ejaculation affects the young, and is presented in descending order in the following activities: students, professionals, executives, employees and workers, and finally , workers in the field of computing.
How are they? Roberto
Rosenzvaig classifies premature ejaculation, according to their degree of awareness of the problem in three groups:
1. Egosyntonic composed , which are those who consider themselves as 'normal' and do not have any conflict or his style, nor with their sexual performance. "For them, the woman is tantamount to a sexual object more or less passive which met quickly, ending the relationship with ejaculation. Correspondingly to this macho attitude, there is a type of woman who accepts that role full scene dependent and seamless. Often fake orgasm or just accept being a mere receptacle genital part of the relationship without much pleasure. " [20]
2. Composed men who are aware of their inability to control and explain it as a personal reaction unsatisfactory but inevitable. It is very likely that men in this group develop compensatory sexual activities such as increased oral or manual stimulation your partner before and after intercourse, or repeated acts of intercourse.
3. Egodystonic composed that "properly detected and symptom as a problem, likening it as a disturbing element of relationships." [21]
How can it be explained?
According to the theory psychotherapy, premature ejaculation can be regarded as a symptom of entry into the unconscious and "it would be sadistic hostility toward women, representatives, ultimately, of the mother. The unconscious attempt of premature ejaculation, according to this theoretical construct, is degrading to women and deny pleasure " [22] . Thus, the symptom it to fulfill its purpose and maintain unconscious conflict. Within this view, others speak also of rebellion against a controlling mother.
According to authors of systemic theory, premature ejaculation would be a transaction between different systems of the partner, being in the service of power struggles between the partners. Other authors of this current, would be a metaphorical expression of other conflicts of the spouses consider premature ejaculation as a sexual symptom of a deeper disease, they find unspeakable or extremely painful to face. For Ana María
Cirio, in premature ejaculation is a vicious cycle that determines a cool response from women, and at the same time, it facilitates the response of the manifestation of premature ejaculation. Thus the companion, affected by this problem, involved causing or maintaining the symptom. "Often women's anger against the rapidity of ejaculation, believing it to be thoughtlessness and selfishness. In the couple established a circle of guilt and anger that is far from enjoying sex ... This concept leads us to consider premature ejaculation (as other sexual problems) a symptom of a family under stress due to personal problems, marital, family, social or cultural ... As systemic therapists, we emphasize the interaction of the couple on dysfunctional patterns that are repeated in the relationship, and they play an important role in maintaining sexual problem " [23] .
Some theoretical lines of couples therapy argue that premature ejaculation is the product of unconscious aggression and power struggles of the couple, and is supported by the persistence of conflict situations. The non-aggression management-fighting system determines that the symptom persists and does not change. Gindin and Huguet (1993), there are in agreement, believing that these therapeutic schemes forget that premature ejaculation is a problem that the subject has or had with all the women who accompanied him sexually.
According to the so-called common-sense theories, premature be premature to excessive sensitivity of erotic perceptions, but for most authors, this statement is absolutely false. Causes
To date, there is no certainty regarding the cause or causes of premature ejaculation. However, it is possible to say that "99% of premature ejaculation is purely psychogenic." [24] Being very few cases of premature ejaculation in which the source of your problem is somatic.
accordance with the above, we can mention as the most common organic causes urogenital diseases of the posterior urethra and prostate cancer, neurological disorders, degenerative disorders, vascular disorders, drugs (antidepressants, antihypertensives, stimulants), hormonal imbalances and diseases that affect the reflex mechanisms of ejaculation.
being the most common psychological causes, the immediate cause is always present in the premature ejaculation is a perceptual deficit of sexual feelings. Other commonly mentioned causes can be: antisexual messages in childhood, lack of sexual information, pressure from the couple's troubled family environment, anxiety, stress, fear of failure, difficulty in controlling stimuli.
To Gindin and Huguet, "the real causes of premature ejaculation are basically two bad anxiety and learning. The two interact and mutually reinforcing " [25] . In turn, Masters, Johnson and Kolodny agree with that statement, suggesting that the most important in the development of premature ejaculation are "(1) early sexual experiences that conditioned rapid response, or (2) anxiety is activated situations of a sexual nature " [26] .
These authors argue that since the first experience for most ejaculatory men was the result of masturbation or wet dreams, gave them no reason to slow the pace of their first sexual encounters to suit your partner. This sort of rapid ejaculation conditioning continues in many cases during adolescence or early sexual encounters with peers, in which non-coital sex play also gave great importance to rapid ejaculation, and the same applies to the first intercourse experience tend to repeat the scheme: "Many teens try first insight into hasty circumstances (for example, in the back seat of a car), where they are afraid of being discovered and where the anxiety, guilt and excitement combine to make the rapid ejaculation is something very common " [27] . Thus Masters, Johnson and Kolodny conclude that, apparently, an early conditioning of this type is one of the main ways to evolve a scheme of premature ejaculation of a lifetime.
The role of anxiety may also be important in premature ejaculation. Joseph Wolpe established that anxiety causes changes in electrical and chemical types in the nervous system, which would accelerate the ejaculatory reflex. At the same time, performance anxiety or performance, combined with efforts aimed at containing the sense of urgency to ejaculate, which usually end up being in vain, because anxiety actually aggravated the loss of control.
A vicious circle can be seen in certain cases of premature ejaculation, where the pressures of performance and anticipatory fear of failure, not only self-reinforcing and increasing in severity, but often progress to reach a secondary impotence. It can also happen that by using techniques useless [28] to distract, so try to delay ejaculation, set out or lose control over pre-ejaculatory reflex sensations or slow the urge to ejaculate and lose the erection. "This pattern of performance anxiety leads to a spiral of fear of failure, and failure, and increased anxiety for the implementation and ongoing failure of erection." [29]
Thus, according to several authors, the main cause of the rapid ejaculatory response is due to the way it develops the first intercourse of man, either by anxiety, discomfort, lack of experience, ignorance or fear. Failure to comply in the first relationship with social expectations and their own, generate performance anxiety on future occasions. Location that makes you forget, in most cases, it is an issue where the trial, error and success are essential requirements and which has not had previous experience and learning.
To Gindin and Huguet, the male tries to "manage the anxiety that awakens the sexuality raising defenses against the collection of intense erotic sensations that precede orgasm [30] . Not perceived the warning signs of premature and producing an involuntary discharge. The origin of this inhibition of the perception of the inevitability of ejaculation can also be a lack or excess of concern for the enjoyment of women.
According to these authors, the first sexual relationship is a crucial experience for men, where the penetration trigger an instinctive gesture program, followed by 10 to 15 moves fast, leading to ejaculation. Conclude that the faster this first experience, the greater the possibility that this symptom remains stable in the subject's life.
also argue that the high frequency of observations of premature ejaculation, particularly in young men, highlights the emergence of a critical phase of learning in men : "over 80% of the consultants studied by us, whether or not premature ejaculation be-reported that first intercourse was with premature ejaculation, with less than 15 coital movements. It seems that there is a genetic marker that allows for this possibility, then modified over time and learning of the subject " [31] .
Semans essential for premature ejaculation is the presence of a reflex mechanism too quickly. Thus, to treat this disorder, its main aim is to prolong the neuromuscular reflex mechanism of ejaculation. For Helen Kaplan
premature ejaculation is the result of poor training of men this disorder, as "not pay attention to their sexual feelings, because they get distracted with doubts about his ability, with an excessive preoccupation with his partner, or because they feel anxious when the pleasure of sexual arousal is too intense." [32] "These men too excited, anxious, or guilty focus on their negative feelings and are disconnected from their erotic feelings. Avoid prolonged periods of excitement, and never fail to be familiar or comfortable, or allowed to truly enjoy the natural feelings of intense erotic pleasure that appears immediately before the climax sexual. " [33] For this, she said that learning to control the ejaculatory reflex, we must learn to concentrate on their own feelings at the time of a sexual encounter. Premature ejaculation
Many feel guilty or ashamed of their sexual pleasure product of messages received in childhood that indicated that sex is offensive, sinful and harmful. These beliefs may accompany a person throughout his life even though intellectually you know that are wrong or even if not completely unaware of these feelings and beliefs.
Although most premature ejaculation are all partners, There is a group that loses the ejaculatory control certain types of couples. Within this group are those who ejaculate quickly before a woman or with a woman demanding that estimate. On the other side are those who control ejaculation women against sexually passive, unfamiliar or which they consider inferior. Only a few, with sadistic tendencies, have better control and enjoy sex more when they hurt or dominate a partner.
Masters, Johnson and Kolodny asserts that "it is very common for a man who has little or no difficulty maintaining ejaculatory control with your regular partner ejaculates at a rate almost giddy with a new" [34] . This may be because most psychological excitement of being with a new person, undoubtedly contributes to a hasty reaction, where the increased performance anxiety often plays a role in this case. Another example occurs when a man attempted penetration for the first time after not having had any sexual activity for a long period of time.
One interesting hypothesis is posed follow, for it "premature ejaculation using the photo-like fantasies to masturbate, and do not break. In contrast, people with good ejaculatory control fantasy type film used and make pauses during masturbation " [35]
Strassberg, Kelly, Carroll and Kircher, cited by Wincze and Carey [36] determined that while premature ejaculation masturbated in 3 1 / 2 minutes and had a intravaginal coital activity less than 2 minutes, control subjects in 9 masturbate and perform sexual intercourse 12 minutes.
What they do
The fact that the couple to recognize the existence of the problem is a step fundamental, because this often causes havoc on their relationship. The requirements, questions, searching for who or what is to blame Repetitive failures are permanent.
A man who has premature ejaculation, usually have no problems with erection, which will often be extremely fast, and its preliminaries will be short for fear of losing such erection, which makes the woman can not reach a state high excitation and, therefore, can not reach orgasm through penetration. Product
sexual stereotyped role, often the man does not want to reason and understand that the reason why his wife does not reach orgasm, ejaculation is their own inefficiency. Moreover, in many cases, the man not only does not recognize its share of responsibility for the dissatisfaction of their partners, but also puts the blame, saying that she "is not normal, is ill." In the same vein, some even come to convince women that their sexual act is flawed because of them, and tell them to be addressed, because they work seamlessly with other women.
A lot of men find it difficult to take responsibility in this problem. It is not surprising that some premature ejaculation reach the query after having developed major complications resulting from premature ejaculation, such as the emergence of such problems erect or their partners have sought their solution in other sexual orgasm.
's wife, partner or companion of man with premature ejaculation may have trouble achieving an orgasm, and premature ejaculation after a man "is keen" that the sexual act to continue. Some, after ejaculation, they use digital or oral stimulation of the clitoral area, and compensatory behavior behind the excuse that his wife is "too slow", but most, hiding behind the myth that sex should be spontaneous and in ancient psychological concepts considered as valid and only mature orgasm vaginal, no worry that your partner has an orgasm. This leaves women tense, nervous and irritable, especially to her husband, who is seen as "selfish." In these women, it is possible to observe, over time, the appearance of an inhibition in orgasm and inhibited sexual desire.
Women are used when a premature ejaculation approaches them, felt her breasts and buttocks, barely permeates an erection, ejaculation almost immediately, and turned to sleep. Therefore, some women feel terribly hurt, rejected and depressed by the lack of ejaculatory control your partner.
For its part, the man is frustrated with a sense of failure, insecure, with a general feeling of inadequacy and guilt, anxious, and feeling his own pleasure as a limited and too short. Especially if it comes to premature ejaculation "verge." Following
develop an anticipation of failure in future intercourse, showing the defensive, blaming over and coming to the avoidance of sex. Thus, they begin to doubt its effectiveness as lovers, their sexual performance, his own masculinity and eventually, if not turn to a specialist, increases the deficit of credibility in themselves, leading to develop, in cases erectiva extreme dysfunction.
Many men with premature ejaculation ejaculation resist, they can cause damage, in many ways, even more sex. First, his body tightly separated from her lover during foreplay and foreplay, fearing extravaginal get too excited and ejaculate, so the couple's sexual reciprocity is blunted, becomes unnatural and mechanized. While women often do not know the reason for the coldness and distance from your partner, you feel rejected.
Other men, meanwhile, are so focused on preventing their premature that they are unable to enjoy themselves or to give pleasure their partners. Many of these men did not allow his wife to touch them, pat or kiss her genitals, resulting in an inhibition of sexual experience. Sexual penetration movements are awkward and tense, making the relationship fail.
"Two concerns have become almost obsessive in the case of the man: the first is to satisfy your partner, which leads to over-reliance on the female orgasm, which happens to be the parameter of 'good sex'. The second is the constant monitoring of performance during sex, which produces the opposite effect: instead of extending the duration of intercourse for the reduced primarily because it includes sexual play very limited opportunities and innovations, apart from self-observation, really obsessive traits. " [37]
"The man with sexual problems, either ejaculatory or erectile not be abandoned, relax, prepare to enjoy the experience. It has a strong concern that 'steals' almost all the attention that his partner needs . Some wives, highly sensitive and with many years of knowledge of her husband, described this very clearly: they feel abandoned, have a feeling of sharing a bed with two people: one, the husband properly said the other, 'the problem' with which the husband is more intimately connected with it " [38] .
Sometimes a man has been blaming both premature ejaculation, which begins to avoid sexual intercourse with his wife and vice versa. So that sexual activity becomes sporadic, and because the cycle for the next relationship will deepen. Both will be more tense, more anxious and therefore ejaculation comes more rapidly, increasing more and more the problem.
The role of the couple is that both men Women must quickly assess the man's ejaculation. While some women take little to get an orgasm, it is almost impossible for women to get to it, with breakthrough times of very short duration of their partner.
assistance and cooperation of the partner is essential to solve the problem of premature ejaculation. Women should note the man's situation, which must be undertaken. In any sexual problems, the most important and significant is that the couple recognizes the existence of a problem and the steps needed to solve them. On the other hand, the share of the couple in the therapeutic process is so important that it becomes an instrument essential to improve treatment success.
Gindin and Huguet (1993) outlines the various routes of natural evolution may follow premature ejaculation:
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Stay for a lifetime, without further consequences brief sex, anxious and unpleasant for both members partner.
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Cause crisis in the couple, marital conflict emerging product claims of women for sexual pleasure.
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cause other dysfunctions such as anxiety erectiva dysfunction.
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That one or both partners circumvent sex.
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Improvement of premature ejaculation by the mere passage of time.
- Search
one or both members of a simultaneous relationship.
One advantage
There are times, however, that premature ejaculation is functional to the couple, whether they are having sex in places "inappropriate" ( as fanciful as elevators) or in the case of couples where the woman sees sexuality as an obligation or a burden. In both situations, of course, the shorter the better.
by Mr. Andrés Moltedo Perfetti, Psychologist degree from the Catholic University of Valparaiso and the Graduate Program in Human Sexuality at the Universidad Diego Portales (Santiago de Chile). Member of the Chilean Society of Human Sexuality. APROPO
