Premature ejaculation is one of the health problems of men often met, but it is still a state usually understood as arising from the mind, from stress, or from worry.
Clinically, premature ejaculation does not always arise from a single cause. In many cases it involves bodily mechanisms of several systems together, such as an over-sensitive nervous system, the sensitivity of the genitals, contracted pelvic muscles, or a hidden chronic inflammation, which are factors that can be examined, assessed, and cared for systematically.
This article will explain the 5 main causes lying behind premature ejaculation, so that men understand that their own symptoms may have their origin in the body, not merely in "not having enough fight in them".
What is premature ejaculation in medical terms?
In medical terms, premature ejaculation means that the time from penetration to the ejaculation of semen (Intravaginal Ejaculatory Latency Time, or IELT) is much shorter than normal, or that it occurs without the man being able to control the timing of the ejaculation.
Ejaculation is a complex response process of the nervous system, controlled by the central brain and the peripheral nervous system, which sends signals to the group of pelvic muscles, particularly the Bulbospongiosus and Ischiocavernosus muscles, whose function is to contract in order to expel the semen.
When the balance of the nervous system and the muscles in this area is lost, premature ejaculation arises.
The 5 causes lying behind premature ejaculation
1. Over-sensitivity of the sensory nerves (Penile / Glans Hypersensitivity)
In some men, the nerves around the head and the shaft of the penis may receive sensation more sensitively than the average level. When touched or stimulated, the brain therefore receives a stronger signal than normal and orders ejaculation to occur sooner than it should.
Men in this group usually feel that it is "too intense" from the first moment the genitals are touched, which is a physiological factor that can be examined and assessed.
2. Over-activity of the pelvic floor muscles (Pelvic Floor Hyperactivity)
Pelvic muscles with high tightness, contracting easily and releasing with difficulty, may twitch or contract immediately on only slight stimulation, with the result that some men cannot slow the timing of ejaculation.
This state is often found together with chronic pelvic pain syndrome (CPPS) or inflammation of the prostate. Some men may feel the twitching of the muscle around the perineum or the base of the genitals during sexual intercourse.
3. Hidden chronic inflammation in the pelvis
Chronic inflammation of the prostate or of the tissue in the pelvis may make the nerves in that area irritated and send distorted signals, with the result that the mechanism controlling ejaculation changes.
Those with pain while ejaculating or after ejaculation, dragging pain around the perineum, or problems of the urinary tract alongside, should have this state assessed before concluding that the cause of the premature ejaculation is stress or the mind alone.
4. Stress and anxiety before sexual intercourse (Performance Anxiety)
Anxiety before or during sexual intercourse can stimulate the sympathetic nervous system to work more, with the result that the body responds faster and premature ejaculation may occur more easily than before.
However, stress in this case does not have to be "the real root cause" in every man, but may be a factor overlapping with a bodily cause, making the cycle of the symptoms more severe or more easily repeated.
5. Factors together with erectile dysfunction (ED)
In some men, premature ejaculation may arise together with incomplete erection. Men who worry that they will lose their erection during sexual intercourse may ejaculate sooner without realising it, because the body responds by hastening the rhythm.
Assessing the real cause should therefore consider both premature ejaculation and erectile dysfunction together, so that the plan of care suits the particular character of each individual.
The signs indicating that the cause may be in the body, not the mind
Men with the following symptoms usually have physiological factors involved, namely:
- Ejaculating within 1–3 minutes, or ejaculating before penetration
- Being more sensitive to touch than normal
- Feeling the muscle twitch around the perineum or the base of the genitals
- Having pain, heaviness, or discomfort in the pelvis alongside
- The symptoms arising continuously, not only in certain situations
These signs may reflect that the premature ejaculation does not arise from the mind alone, but involves the nervous system, the pelvic muscles, or an inflammation that should be assessed in detail.
The approach to assessing the cause of premature ejaculation
Diagnosing premature ejaculation precisely requires assessing the nervous system, the pelvic muscles, and the structure of the reproductive system.
At PYONG MEN the approach to assessment consists of examining the level of sensitivity of the peripheral nerves, palpation to assess the tightness of the pelvic muscles, and palpation to assess the prostate, in order to distinguish an inflammation that may be hidden.
Assessment that covers several dimensions helps the doctor design a plan of care in accordance with the cause in each individual, instead of caring for the symptoms alone.
The approach to care at PYONG MEN
Care for premature ejaculation at PYONG MEN emphasises rebalancing the nervous system and training the control of the muscle anew (Neuromuscular Re-education), instead of depending on a local anaesthetic alone.
The main approach consists of using focused shockwave (Focused Shockwave) to reduce the sensitivity of the nerves, using magnetic technology (PMS) together with Biofeedback to train the control of the rhythm of contraction of the pelvic muscles, and techniques of releasing muscle knots where contracted muscle is also found.
The plan of care is designed according to the result of the assessment for the individual, so that it accords with the mechanism that is the cause of the symptoms in each man.
In brief
- Premature ejaculation in medical terms has 2 main mechanisms: over-sensitivity of the sensory nerves, and over-activity of the pelvic floor muscles
- Chronic inflammation in the pelvis, anxiety, and erectile dysfunction may be contributing factors
- Premature ejaculation is not a matter of the mind alone, but has physiological causes that can be assessed and cared for
- Precise assessment should cover the nervous system, the pelvic muscles, and the prostate
- The approach to care at PYONG MEN emphasises rebalancing the nervous system and the muscles, not merely suppressing the symptoms
Frequently asked questions (FAQ)
1. Does premature ejaculation arise from stress alone? Stress may be a contributing factor, but it is not always the only cause. Medically, premature ejaculation usually has physiological mechanisms involved, particularly the nervous system and the pelvic muscles.
2. Is ejaculating within 1 minute abnormal? A very short time to ejaculation, or being unable to control the timing of ejaculation, is a sign that should receive medical assessment, in order to find the cause lying behind it.
3. Is premature ejaculation related to erectile dysfunction? In some men, premature ejaculation and erectile dysfunction can be found together. The assessment should therefore consider both states at once, so that the care is comprehensive and matches the cause.
4. Can premature ejaculation be treated without a local anaesthetic? There are approaches that do not depend on a local anaesthetic, such as reducing the sensitivity of the nerves with shockwave, and training the control of the pelvic muscles with PMS Biofeedback technology. Their suitability depends on the cause in each individual.
5. What examination should be started with? The doctor usually assesses the sensitivity of the peripheral nerves, the tightness of the pelvic muscles, and palpates the prostate, in order to distinguish an inflammation that may be hidden.