Sympathetic motor neurons control the emission phase of ejaculation reflex, and expulsion phase is executed by somatic and autonomic motor neurons. It involves closure of bladder neck, followed by the rhythmic contractions of the urethra by pelvic-perineal and bulbospongiosus muscle and intermittent relaxation of external urethral sphincters. It involves deposition of fluid from the ampullary vas deferens, seminal vesicles and prostate gland into the posterior urethra. The physical process of ejaculation requires two actions: emission and expulsion. Acquired PE may occur due to psychological problems - such as sexual performance anxiety, and psychological or relationship problems - and/or co-morbidity, including Erectile dysfunction, prostatitis and hyperthyroidism. The pathophysiology of lifelong PE is mediated by a complex interplay of central and peripheral serotonergic, dopaminergic, oxytocinergic, endocrinological, genetic and epigenetic factors. PE has been classified into four subtypes - lifelong, acquired, variable and subjective PE. PE may be caused by prostatitis or as a medication side effect. Other researchers have noted that men who have premature ejaculation have a faster neurological response in the pelvic muscles. The nucleus paragigantocellularis of the brain has been identified as having involvement in ejaculatory control. However, studies have been inconclusive in isolating the gene responsible for lifelong PE. Scientists have long suspected a genetic link to certain forms of premature ejaculation. Several physiological mechanisms have been hypothesized to contribute to causing premature ejaculation, including serotonin receptors, a genetic predisposition, elevated penile sensitivity and nerve conduction atypicalities. Many theories have been suggested, including that PE was the result of masturbating quickly during adolescence to avoid being caught, performance anxiety, passive-aggressiveness or having too little sex but there is little evidence to support any of these theories. The causes of premature ejaculation are unclear. Compared with men, women consider PE less of a problem, but several studies show that the condition also causes female partners distress.
Men with PE often report emotional and relationship distress, and some avoid pursuing sexual relationships because of PE-related embarrassment. The opposite condition is delayed ejaculation. Men's typical ejaculatory latency is approximately 4–8 minutes. Īlthough men with premature ejaculation describe feeling that they have less control over ejaculating, it is not clear if that is true, and many or most average men also report that they wish they could last longer. The International Classification of Diseases (ICD-10) applies a cut-off of 15 seconds from the beginning of sexual intercourse. There is no uniform cut-off defining "premature", but a consensus of experts at the International Society for Sexual Medicine endorsed a definition of around one minute after penetration.
It has also been called early ejaculation, rapid ejaculation, rapid climax, premature climax and (historically) ejaculatio praecox.
Premature ejaculation ( PE) occurs when a man expels semen (and most likely experiences orgasm) soon after beginning sexual activity, and with minimal penile stimulation.
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