Premature Ejaculation: Causes, Symptoms and Treatments

In recent years, the medical world has improved its recognition and understanding of male sexual dysfunction, including the problems men can experience when engaging in sexual intercourse. Premature ejaculation is one form of sexual dysfunction that can adversely affect the quality of a man's sex life.
Reaching climax and ejaculating semen during penetrative sex is the typical route by which babies are conceived, but premature ejaculation does not just complicate reproduction, it can also adversely affect sexual satisfaction, both for men and their partners. The information here aims to demystify premature ejaculation and outline active treatment options for those cases where it is desired.

Fast facts about premature ejaculation
Here are some key points about premature ejaculation. More detail and supporting information is in the body of this article.

• In medical terms, premature ejaculation is a form of sexual dysfunction where a man has always, or consistently climaxes and ejaculates before or very soon after sexual penetration, causing distress. Under strict criteria, premature ejaculation is relatively rare.
• Cases of premature ejaculation that do not meet the strict medical criteria for the sexual disorder are more common and are defined simply as a man climaxing and ejaculating sooner than he or his partner desire. Often, a man's partner is less concerned than the man himself.
• In the majority of cases, an inability to control ejaculation is rarely due to a medical condition, although doctors will need to rule this out, including checking for erectile dysfunction
• Most cases of premature ejaculation have psychological causes - ranging from common anxieties about sex and relationships resulting in a temporary problem, to more serious psychological factors contributing to a persistent problem.
• Premature ejaculation can lead to secondary symptoms such as distress, embarrassment, relationship stress, anxiety and depression.
• Treatment options range from reassurance from a doctor that the problem can go away in time, through home methods of "training" the timing of ejaculation (alone or with the help of a trusted partner), to talking therapies and couples counselling.
• Drug options are available, there are currently no medicines approved for use in treating premature ejaculation.
• Doctors may consider offering "off-label" prescription of a certain type of antidepressant to help with premature ejaculation, but such medication can have side-effects. Additionally, some men find it helpful to apply a local anaesthetic cream to their penis to delay ejaculation by decreasing sensation.

What is premature ejaculation?

Premature ejaculation is a form of male sexual dysfunction. From the point of view of the man and his sexual partner, premature ejaculation means the man having an orgasm or "climaxing" sooner than wanted.¹
Estimates of the number of men affected by premature ejaculation vary depending on how the problem is defined. A high proportion of men report being affected by premature ejaculation, whereas a very small proportion of men actually meet the medical criteria for the most persistent form.²

Medically, the most persistent form of premature ejaculation (primary or lifelong premature ejaculation) is defined by the presence of the following three problems from the point at which a man becomes sexually active:^2-4

• Ejaculation always, or nearly always, happening before sexual penetration has been achieved, or within about a minute of penetration
• The man finding an inability to delay his ejaculation every time, or nearly every time, he does achieve penetration
• Negative personal consequences, such as distress and frustration, or avoidance of sexual intimacy.

Premature ejaculation was once known, in Latin as ejaculatio praecox (the translation being "precocious ejaculation").² It is also called rapid or early ejaculation.
An internet search will also reveal a lot of slang or colloquial phrases for premature ejaculation, although these often have little bearing on the reality of lived experience and may instead reinforce false ideas that are harmful to men's mental health. For example, such slang terms can lead men to feel they are to blame, have failed, are alone in their problem, or cannot be treated, while the opposite is usually the case. Premature ejaculation can cause a lot of embarrassment in boys and men, with a significant degree of stigma often attached to male sexual performance.⁵

How many men experience premature ejaculation?

Information obtained through surveys puts the "self-reported" prevalence of premature ejaculation in men as somewhere between 15% and 30%.^2,6
However, the prevalence of medically diagnosed and diagnosable premature ejaculation is much lower.^2,6 This statistical disparity does not in any way diminish the suffering experienced by men who do not meet the strict criteria for diagnosis.^2,6
In one analysis of nearly 5000 men in nine Asia-Pacific countries, 16% of men met the criteria for a diagnosis of premature ejaculation (PE) on the five-question Premature Ejaculation Diagnostic Tool (PEDT).¹⁹ Probably PE was found in 15% of respondents, while 13% of men self-reported PE.

Interestingly, less than half (just 40%) of the men with PEDT-diagnosed PE self-reported the condition, and just 19% of those with probable PE self-reported having the condition. A large number of men (some 6% of respondents) had a negative PE diagnosis on the PEDT but reported PE.¹⁹
Primary or lifelong PE is the most persistent problem in men and describes a condition where men have rarely experienced sex without prematurely ejaculating. This is the least common form of the condition and is thought to affect around 2% of men.⁷
However, more loosely defined premature ejaculation remains the most common form of male sexual dysfunction - more common than erectile dysfunction.^6,7

Causes of premature ejaculation

Let's discuss the causes of premature ejaculation, from psychological factors to medical causes and erectile dysfunction.

Psychological factors

Most cases of premature ejaculation are not related to any disease and are instead due to psychological factors.
Examples of psychological causes of premature ejaculation include:^8,9

• Sexual inexperience
• Novelty of a relationship
• Overexcitement or too much stimulation
• Relationship stress
• Anxiety
• Guilty feelings
• Depression
• Issues related to control and intimacy.

These common psychological factors can affect men who have previously had normal ejaculation; such cases are often referred to as secondary or acquired premature ejaculation.⁷
Most cases of the rarer, more persistent form - primary or lifelong premature ejaculation - are also believed to be caused by psychological problems. The cause(s) of primary or lifelong PE can often be traced back to early trauma, such as:⁷

• Strict sexual teaching and upbringing - affecting young men who have been brought up under strict ideas that sex should be prohibited until marriage, for example, making enjoyment of sex more difficult because of a feeling that it is wrong or a sin
• Traumatic experiences of sex - anxiety and premature ejaculation can result from problems ranging from a loss of privacy when masturbating ("being caught" masturbating), to sexual abuse
• Conditioning - it is thought that early sexual behaviors can feed into later experiences of sex. One example is a teenager learning to ejaculate quickly to avoid being found masturbating. 

Medical causes of premature ejaculation

Biological causes of premature ejaculation are much less common than psychological ones. In rare cases, the cause can be more serious, such as nervous system damage as a result of surgery or physical trauma.¹⁰
The following are also possible medical causes of PE⁷ (doctors will focus on diagnosis and management of the underlying condition first and monitor for improvement in sexual function⁸):

Erectile dysfunction

Erectile dysfunction is a condition that doctors will want to rule out or treat first when working with a patient concerned about premature ejaculation.^6,7
Some men may confuse erectile dysfunction and premature ejaculation, believing themselves to have the former when they actually have the latter. This is because the penis normally loses its firmness after ejaculation.⁶
In some cases of erectile dysfunction, heightened sensitivity caused by changes to the normal pattern of nerve signals means that much less stimulation is needed to cause ejaculation.⁷
Finally, some studies have found an association between levels of serotonin - a natural neurotransmitter chemical involved in mood and depression - and ejaculation problems. Men with low brain levels of serotonin may have problems with premature ejaculation.¹⁰ However, the role of such factors remains largely theoretical, especially given that scientists still have a fairly poor understanding of the normal physiological processes that produce ejaculation.²

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5 Natural Impotence Remedies

Straightforward steps to stimulate your sagging love life 

"Impotence - that's what it must be!" He had a gentle Irish brogue and had well and truly labelled himself as "sexually dysfunctional". Philip had tried Viagra, but all it had done was produce a headache "like Nagasaki!"
"The thing is," he told me, "I need a natural remedy for impotence. Can you help me?"
What did I do to help Philip with impotence? Well, you can read about some of the approaches in my article "Male Sexual Enhancement Techniques" - such as how to maximize your psychological attitude to sex, as well as some exercises you can do to strengthen erections (here's a hint: they don't involve gym membership). But here are some other tips and techniques to help rectify the 'collapse of stout party' and get you relaxed and hard during lovemaking.

Impotence - the natural 'curse'

Failing to achieve an erection that is strong enough or sustained enough to allow for normal lovemaking is known as impotence. It can happen once or many times and the majority of men (regardless of what they may tell one another) experience it at some time. As I pointed out to Philip, actually all men are meant to be impotent for much of the time. When we are in meetings at work, doing sports, reading a weather report, or wearing Speedos on the beach, not having an erection is a good thing.
When we're under attack or feel threatened, sexual arousal is meant to switch off fast. It's a myth that men are - and always should be - capable of instant sexual arousal (regardless of, say, problems in a relationship). But repeated failure to achieve erection during foreplay can start to feel like a real problem for many men; especially if it's a problem that spans different relationships.
So what causes impotence? Well, impotence can be caused by physical or psychological factors or, of course, a combination of both. It's good to know what's been causing it.

1) Check whether there are physical causes for the impotence

Do you regularly wake up with an erection? If so, then it's unlikely the cause of impotence is physical, as all seems to be working from a 'mechanical' point of view. Illnesses such as diabetes or conditions such as high blood pressure can cause impotence, as can injury or rapidly declining hormone levels. The blood needs to circulate well in order for erections to occur, so any condition which restricts circulation, such as smoking, may prevent erections. Additionally, overindulgence in alcohol may cause 'brewers droop' by interfering with testosterone levels.
Impotence can also result as a side effect from some medications, such as antidepressants, so if you suspect there may be some medical cause for impotence, consult your doctor. Also take a look at your lifestyle. Are you drinking too much? Not exercising? Getting too little rest? Smoking like a steam train? Sexual health is a by-product of living well.

2) Don't think yourself into impotence

Robin Williams once reputedly said: "God gave men both a penis and a brain, but unfortunately not enough blood supply to run both at the same time."
After laughing at this quote, I thought about it. (Don't you just hate it when people think about something before laughing at it?) On the face of it, this remark seems disparaging toward men. And it's often said that men give pet names to their penises because they "like to know who's dictating their behaviour". But actually women are led by their sex drives just as much as men sometimes and can also make "mistakes", ending up in bed with "the wrong man". We are all, to some extent, led by our desires.
I reckon the usefulness of Williams's remark (apart from the humour : ) ) is to highlight that over-analysis of sex can spoil it completely. "Will I/won't I achieve an erection?" is just too much pressure. The fact is that when enjoying sex, we really don't need to be thinking too much. When you focus on physical closeness and the enjoyment of being together naked, an erection becomes a by-product of the experience, not the end in itself. Stop trying to get an erection and focus on physical closeness - if an erection happens, it happens. But this is easier said than done, so...

3) Use self-hypnosis to relax about your sexual performance

It's easy for me to say: "Don't worry about whether you get hard or not!" But, of course, much impotence is caused by worrying, and stress switches desire off pretty rapidly. Self-hypnosis is a wonderful way to help you change your mindset and help you experience sex beyond concern with penile mechanics. In ancient China, the eunuchs reputedly made the best lovers because (without the use of a penis) they used much more imagination during lovemaking. To get a feel for self–hypnosis, listen to this short and free hypnosis audio.

4) Remember: impotence happens in context

If you've been experiencing impotence, it may be that you are bored in your relationship or with your lover and need to spice things up a bit. As the old joke has it: "Please don't come to bed yet; I haven't had a chance to think of anyone!"
Perhaps there are resentments in your relationship or your lover pressures you. Lovemaking isn't something you do to your partner, but with them. Give yourself a break sometimes - it would be amazing if a man didn't experience impotence in some contexts. It's not a reflection on you as a man, but perhaps rather your relationship or lifestyle.

5) Improve your circulation

Smoking is a very effective way of spoiling efficient blood circulation, which is why heavy smokers experience fewer erections than non-smokers. Any way you can improve blood circulation will strengthen your erections (as well as providing you with other obvious overall health benefits). Exercise, diet, and relaxation will all improve the flow of blood around your body. As will certain foods. For example, taking Ginkgo biloba for several months seems to have a hugely beneficial effect for many men (1). Eating garlic regularly may well have a similar effect (although taking it in tablet form may enable you to actually get close enough to use your erection!).
Take a look at my male sexual enhancement article for more tips on how to naturally overcome impotence and keep positive - because you can get your mojo back.

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Asthma Symptoms, Treatment and More

Asthma is a disease affecting your lungs. Asthma causes wheezing, shortness of breath, chest pain and coughing. In many instances, these symptoms appear mostly at night or early morning. Some people with asthma have these symptoms daily. People with asthma often have asthma attacks. An asthma attack occurs when something bothers your lungs. Airways become swollen and inflamed, which makes it hard to breathe. These attacks can be mild, moderate or severe. Even though you may feel fine, an asthma attack can occur anytime.

Asthma affects 25 million people in the United States, including 7 million children. Many children outgrow their asthma. For others, it becomes a lifelong condition. Most children develop symptoms before the age of 5. More boys have asthma than girls. In adults, there is no difference between men and women.

What Causes Asthma?

We don't know the exact cause of asthma. Researchers believe it results from several factors. Genes appear to be involved. For example, children of parents who have asthma are more likely to have asthma than children of parents who don't have asthma. Environmental factors also play a role. These factors are called "triggers." An asthma attack occurs when you come in contact with these triggers. Most people with asthma have allergies, which are also triggers.

Not all people have the same triggers. To help you identify your triggers, you should keep a diary and write down what you were doing before your symptoms got worse. If your asthma gets worse when you come in contact with a particular agent, then that agent is a trigger. According to the U.S. Centers for Disease Control and Prevention, common asthma triggers include: tobacco smoke, dust mites, cockroaches, pets, outdoor air pollution, mold, smoke from burning wood or grass and infections. Many other things can make asthma worse, including exercise, food additives, food preservatives, fragrances, medicines and emotions. Knowing and avoiding your triggers will help keep your asthma under control.

How Is Asthma Treated?

Asthma is treated with two types of medicines—a long-term medication and a quick relief medication. The quick relief medicine is also called a "rescue" medication. The long-term medication helps reduce airway inflammation. This medication reduces or even eliminates asthma symptoms. Most patients are given inhaled corticosteroids for long-term use. Quick relief medication is used when an asthma attack occurs or when symptoms suddenly get worse. You need to carry your quick relief medication with you at all times because an asthma attack can occur without warning.
Your treatment depends on the severity of your symptoms. Once you begin taking medication, your doctor will ask about your symptoms. He will also ask about any side effects that you may be experiencing. If symptoms are not under control, your doctor will adjust your dose or try another medication. The goal is to achieve maximum control with the least amount of medication.

What Is an Asthma Action Plan?

You and your doctor will create an asthma action plan. This plan describes your daily treatments and the time you should take your medication. It will also tell you which triggers to avoid. Your asthma action plan helps you identify if your asthma is getting worse. The plan gives you instructions as to when you should call the doctor or 911.

Your asthma action plan also tells you how to measure and record your peak air flow. You will be given a small handheld device along with instructions on how to use it. The device will measure how well air is coming out of your lungs. If your peak air flow measures at 80 percent or higher, your asthma is considered to be under control. If your peak air flow is between 50 percent and 79 percent, it means your asthma is not under control. If your peak air flow is less than 50 percent, you need to call your doctor or an ambulance.

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How to Reduce Breast Size Naturally Fast Without Surgery

To reduce breast size naturally fast without surgery might be one of the best decision you can make. You will agree with me that…
Big breasts are assets!!!
They turn heads around whenever you are passing by causing you to receive both deserved and undeserved attention.
Irrespective of how good that might seems, only the carrier of the big boobs understands the burden, stress and sometimes the pain she is going through.
There are two major ways to decrease breast size so as to get the perfect breast shape. It is either through surgery or through natural procedure.
While surgical procedures for breast reduction are costly and often come with various kind of risks and after-problems, Natural procedures are cheaper, with minimal risk and also fast acting.
This article takes a comprehensive look at the best and fastest home remedies for breast reduction.

How to Reduce Breast Size Naturally

It is important we discuss the composition of breast, causes of big breast and problems associated with large breast size before talking about the natural process of reducing big bust.

Breast Anatomy

The breast lies directly above the chest (pectoralis) muscle.
It is made up of fatty tissues (adipose tissues) and milk producing tissues (glandular tissues) and the ratio of fatty tissues to glandular tissues varies with individual. For example, at the beginning menopause, the fatty tissues in the breast increases while the glandular tissues diminishes.
It is however important to understand that the amount of fat determines the size and shape of the breast.

Problems Of Large Breast Size

While small breasts may cause aesthetic discomfort due to perceived failure to achieve certain beauty standards, large breasts have been associated with various forms of complaints and serious health problems.
Common problems of large breast include

• Back ache
• Neck pain
• Shoulder pain
• Numbness in the fingers and hand: often as a result of weight on the shoulders pulling on nerves behind the collar bone
• Migraine (headache)
• Short breath
• Chafing(a skin condition caused by skin rubbing)
• Heat rash
• Permanent indentation on the shoulders as a result of bra strap
• Limited physical activities: Aerobic activities such as jogging or running may be uncomfortable or impossible and lack of physical activity itself causes weight gain, bad physical condition and health problems
• Yeast infection
• Bad emotional condition: Apart from difficulty in finding fitting clothes, teenagers with large breasts are especially vulnerable to teasing which may lead to poor emotional condition and make them unhappy with their appearance

Causes of Large Breast Size

Increase in breast size is a normal development in the female. It often starts at puberty and may reoccur again throughout life time as a result of several reasons.
Breast size is essentially determined by a combination of genetic and environmental factors. While genes are beyond our control, lifestyle modifications may be effective in reducing bust size.
Knowing the factors responsible for your big breast will help to resolve the problem and reduce breast size faster.
Here are some common causes of big boobs.

• Genetic factor
• Weight gain
• Hormonal fluctuation
• Lactation
• Drugs side effect

Home Remedies to Reduce Breast Size

Best Type of Exercises to Reduce Breast Size

Since breast tissue are mainly composed of adipose (fat) tissues, therefore the best exercises to reduce breast size will be those which stimulate your metabolism to lose body fat. These exercises can also help make breast firm and get rid of saggy breasts

Cardiovascular training to reduce breast size

Doing daily cardio exercise for 30-60 minutes will help to burn fat from all over your body, enhance flat stomach naturally and gradually reduce the size of your breasts.
It is essential to focus on low impact cardio exercises since most women who have very large breasts simply can’t do high impact exercises like jogging or running.

Other cardio exercise to reduce breast size includes

• Walking
• Riding a bike
• Using elliptical machine
• Pilates

Furthermore, If you’re looking for something even more active and allows you to socialize then sports are also on the list of the best exercises, as they count as cardio as well
Good examples sports exercise for breast reduction includes;

• Swimming
• Boxing
• Hiking
• Kayaking
• Rebounding
• Water aerobics

Strength training exercise for breast reduction

In addition to cardiovascular training, you should also incorporate specific strength training exercises to your fitness routine, as this will help build and tone your pectoral muscles, which lies directly below your breasts.
Strength training such as bench press and pushups are among the best exercises to tighten up the chest muscles and help reduce breast size.
Good examples include;

• Pushups
• Barbell Bench Press
• Dips
• Pec Deck Butterflys
• Decline Dumbbell Flyes

However, to achieve the aim of breast reduction, it is important to keep the weight light and the repetitions high or else you’ll end up building up your pectoral muscles instead of tightening them

Diet Changes to Reduce Breast Size Naturally

Coupled with growth hormone, the main hormone that determines breast size is oestrogen. The more oestrogen you have in your system, the bigger your breasts tends to be
If you are serious about reducing the size of your boobs, it is important to do without birth control pills cos the major constituent of most of these combined pills is oestrogen. Apart from that, the pills tend to mess with your hormonal levels thereby causing hormonal fluctuations.

In addition, estrogen-like compounds (otherwise called ‘xeno-oestrogens’) from plastic packaging (which include plastic bottles) and industrial residues are also known to contaminate food and drinks.
As a result, It is recommended to drink mineral water from glass bottles whenever possible, and avoid processed foods packaged in plastic.
Meat and possibly some dairy products tend to contain oestrogen and should also be taken moderately.
Oestrogen is broken down in the liver, so anything you do to improve liver function might help.
Eating a diet based on whole-foods, fruits and vegetables (preferably organic) with plenty of water and very little alcohol should help to maximise your liver function and minimise the impact of oestrogen in your body.
Since the breast is composed of fatty tissue, it is important to maintain healthy weight and get rid of excess fat from the body by eating healthy and balanced diet.
Here are some healthy eating tips to lose weight and reduce breast size.

• Eat less fat and few calories
• Eat more vegetables especially cruciferous vegetables e.g, kale, broccoli etc..
• Take lot of fruits
• Get your proteins from seafood.e.g cod, tuna, salmon
• Take more nuts.e.g, walnut, almond

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