A Review of the Ejaculatory Processby PEhomepage.com Editorial Team
Premature is often described as the most common sexual disorder in men. While definitions vary, most researches today have settled on a definition that includes short ejaculatory latency and distress on the part of the male and/or partner.
Before making assumptions about premature ejaculation, one must first understand the physiological process underlying ejaculation as it occurs.
The bladder neck is made of a thick section of muscles and lies closest to the ejaculatory ducts. During ejaculation, the smooth muscles that surround the urethra tighten and prevent semen from flowing back into the bladder. During the emission of seminal fluid, the smooth muscles in the prostate, the vas deferens and the seminal vesicles begin a series of “rhythmic contractions that result in seminal fluid being deposited into the posterior urethra.” Although men may have some control over the ejaculatory event prior to emission, once emission begins the reflex is involuntary and eminent.
From a neurological perspective, both the autonomic and central nervous systems are involved in ejaculation. Within the central nervous system, there are a variety of areas that could be involved in ejaculation, although only the hypothalamus has been pinpointed as playing a fundamental role. Most studies seem to indicate that the neurotransmitter serotonin inhibits ejaculation while dopamine acts as an “excitatory agent.”
Several theories exist as to why men may suffer from premature ejaculation and are unable to control ejaculation until a time that is sexually satisfying for both the male and his partner. Physicians generally classify premature ejaculation into two categories: primary and secondary. Men classified as primary have suffered with premature ejaculation since puberty while men classified as secondary at one point had some perceived control over ejaculation an the condition has developed since that time.
Control over ejaculation and the amount of distress accompanying it seem to be the most prevalent portions of defining the disorder for most men. Many researchers have focused on penile sensitivity while others feel that the underlying cause is psychological in origin. Those who feel that psychological origins are the primary cause feel that performance anxiety is the primary culprit, and thus, sex therapy is the ultimate resolution for the disorder.
It is difficult to deny, however, that men who suffer from premature ejaculation are able to respond to medication that inhibits ejaculation or at least delays it somewhat. What is clear, in light of both physical and psychological responses to treatment, is that a combination of factors contributes to the origin of the disorder. When determining whether or not a man has premature ejaculation or “normal” ejaculation is his distress and perceived amount of control over the sexual experience.
Source:
Schuster, Timothy, G., MD. “Premature Ejaculation.”
Urologic Nursing. 2006, 24 (4), p. 245-249.
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