Delayed Ejaculation. Part Two.

Refuse from alcohol
Alcohol stimulates the desire but prevents from its realizing. It delays ejaculation and many men are unable to orgasm being under its effects.

Pay attention to lubrication
Sometimes ejaculation not occurs because of poor natural lubrication in woman. In this case it is necessary to use special lubricants. However, the situation may be reverse where too much lubrication prevents from orgasm as it reduces the scrubbing effect. In this case it is necessary to stop, wipe penis dry and then continue sexual intercourse.

Increase the duration of sex play
Spend more time for foreplay – this would give pleasure to both of you. Especially, older men require this because in older age they need more physical stimulation for achieving erection and ejaculation than in youth.

Refuse from porn
Porn movies and magazines in this situation may do bad service. When the talk is about delayed ejaculation, the man is already aroused (there is no problems with arousal here) but he cannot orgasm. Nude scenes would provoke more arousal, from female point of view, inadequate one. She would think he orgasms with them and not with her. So you will be more disappointed because of this.

Reduce calories
Products with large amount of fats may tighten blood arteries which would break blood circulation into penis and would cause problems with ejaculation. Try to reduce the amount of fat food, eat more vegetables and fruits.

Look what medications you take
Some medications may cause problems with ejaculation. For example, antihistaminic drugs, medications treating blood pressure, some antidepressants. If you take regularly a drug and at the same time have appeared problems with ejaculations, it may be a side effect of the drug you take, so consult your doctor to find different drug which would have no effects on your sex life.

Delayed Ejaculation. Part One.

Ejaculation occurs not much rapidly as you and your partner wanted. There may be different causes for that: old age or medications such as antidepressants. Some think that the cause is condom, because its usage lowers penis sensibility. Others say condom helps them to orgasm faster. However, among young men most common the cause is excessive masturbation.

Delayed ejaculation may become a real problem when the couple tries to conceive a baby or has frequent intercourses. If male suffers from delayed ejaculation, then do appear problems with erection. This will make men's partner upset because she begins to think that she doesn't arouse him enough. You should know that all sexual problems concern both partners and the man should necessarily consult the doctor. Probably, only one visit to the sexologist will solve the problem.

Here are some tips to help men deal with delayed ejaculation.

Refuse from masturbation
This is the best solution for young men. When a man excessively masturbates, he works more intensively and longer to achieve ejaculation. Sometimes it leads to numbness of penis nerve endings which makes man less sensitive to gentle sliding into vagina. Besides this, excessive masturbation may make man achieve orgasm only during masturbation and not during sexual intercourse with a woman. Thus, the man would hardly find vagina able to squeeze his penis as strong as his own hand.

Put restrictions to your sex life
If you and your partner have too frequent intercourses, try to reduce them a little. Like excessive masturbation, frequent intercourses may lead to problems with ejaculation. Do not forget that each man has his own period for restoring.

Experiment
Try various sex positions and probably you would find most appropriate one for you. Most men consider that rear entry sex position gives greater sensation of narrowing because during frictions female pubic bones do slide on penis.

To be continued.

Ejaculatory Dysfunction

Ejaculatory dysfunction is common notion for a group of sexual pathologies that show with ejaculations disorders or its absence.

Forms of ejaculatory dysfunction

Anejaculation 
Anejaculation is a syndrome which is characterized with orgasm without ejaculation. In diagnostics it requires differentiation with aspermia and retrograde ejaculation.

Causes
1. pathology of nervous system resulting in ejaculatory duct disorder
2. ejaculatory duct obstruction

Risk factors

• spinal cord injuries
• diabetes
• vesiculitis

Premature ejaculation
Premature ejaculation is a condition characterized with ejaculation occuring after very few number of frictions during sexual intercourse or before penetration into female vagina

Causes
Premature ejaculation may have psychological or physiological causes. Most common psychogenic cause is excessive degree of sexual excitement specific essentially for men with little sexual experience  which occurs during first sexual intercourses. Among physiological factors most frequent cause is sensitive penis head which may be a normal individual indication of a male, or resulted from different urological diseases such as balanoposthitis.

Retrograde ejaculation
Retrograde ejaculation occurs when semen releases backwards into bladder. Most frequent cause of retrograde ejaculation is operation in neck of urinary bladder - transurethral prostatic resection and open adenomectomy.

Delayed ejaculation
Delayed ejaculation occurs when a male experiences difficulty to orgasm.

Short Coitus

Short coitus is a condition when sexual intercourse lasts long enough to be called premature ejaculation but its duration not satisfyes both partners. As a rule, short coitus lasts from 2-3 to 10-15 minutes.

Short coitus is not a disease but this condition can be corrected.  Causes of short coitus are not known yet. It may have the same causes as premature ejaculation but may not be as frank. Frequently causes are not connected with intercouse.

Not in all males this problem can be solved. When are found causes of this condition (hypersensitive glans, chronic vesiculitis) it is necessary to get rid of them. If causes are not found, you should follow common recommendations to increase duration of sexual intercourse.

How to increase duration of sexual intercourse?
1) Try to use condom. You may use 2-3 condoms in the meantime.
2) Try to think about abstract things during sex. Sometimes help thoughts about nasty things.
3) Make yoga exercises. It is necessary to learn to delay and start urination easily. Generally speaking, the connection between sphincteric mechanism of bladder and ejaculation is hardly known but this exercise helps in some cases.
4) You may try to masturbate before sexual intercourse, especially if you had last ejaculation long ago.
5) Most effective recommendation – make circumcision. It helps any man to prolong sexual intercourse by 2- 3 times.

What should you not do to delay ejaculation?
Do not squeeze urethra with your hands. Sperm remains in the back part of urethra, part of it goes again into seminal vesicles and other part of it goes into bladder. Permanent squeezing results in chronic conditions in prostate gland which may lead to chronic prostatitis. Also it affects work of prostate gland sphincteric mechanism which leads to retrograde ejaculation.

If you see that even after following these recommendations the problem is not solved,  you must go to the urologist.

Psychogenetic Forms Of Premature Ejaculation

Most common psychological cause of premature ejaculation is overexcitement and this occurs more frequently in young men who just have started sexual life. However, premature ejaculation occurs in adult men too. In a very strong sexual excitement rapidly is increased strain in a particular part of cerebral cortex which leads to quick ejaculation and orgasm.

Another cause of premature ejaculation is fear of sexual intercourse. For example, sexual intercourse is performed in a inappropriate place which not provides safety (outside, in the car, when parents disturb).In this situation man hurries to finish intercourse and accelerate ejaculation. It should be noted that this occurs often in young men, therefore causes of premature ejaculation here may be defined rarely.

Distinctive features of psychogenetic premature ejaculation:

• beginning of sexual life
• rare, irregular sexual life
• duration of sexual intercourse may be different with different partners
• it is impossible to perform second sexual intercourse because of lack of erection
• premature ejaculation often courses with erectile problems
• sometimes abstract thoughts help to prolong intercourse. Such thoughts often lead to loss of erection
• small amount of alcohol usually greatly improves situation

Often psychologic problems with ejaculation are solved quickly with age and further sexual life experience. However, sometimes problems just get increased making sex life difficult or even impossible. Premature ejaculation sometimes goes with erectile dysfunction or ejaculation delay.

Severe psychologic problems require help of experienced sexologist or psychologist. Great importance has partner's behavior – it is easier to solve problem together than alone. Sensitive and intelligent woman is able to lend man greater support than a good psychologist.

What Premature Ejaculation Is

Premature ejaculation is a condition when ejaculation occurs before penetration into female vagina or immediately after penetration. There is no exact definition of premature ejaculation. Many sexologists tried to link premature ejaculation with length of sexual intercourse, number of frictions and even with partner's orgasm but no one gave exact definition.

Who Suffer From Premature Ejaculation?
Mainly, these are teenagers at the onset of their sexual life. Premature ejaculation in teenagers may be connected with overexcitement or hypersensitiveness of penis head, and as a result ejaculation often occurs before penetration into vagina or after making just several movements. Frequently it quickly passes with experiences in sex life but in some cases it persists for a long time.

Seldom premature ejaculation occurs in older males. This may be premature ejaculation persisted from youth or one that has appeared in older age. It may have various causes. Let us see them.

Premature Ejaculation Causes
Premature ejaculation causes may be divided into two groups:
1) physiological – connected with health problems or peculiarities of structure and functioning of genitalia
2) psychological

There are two physiological causes:
- hypersensitive glans
- chronic vesiculitis

Next article will be dedicated to hypersensitive glans.

Erectile Dysfunction: What To Do?

More often men do not wake up during night ejaculations. Therefore, to find out if you have them or not you could need to perform special test. If you do not have night erection, doctor may search possible medical causes for that, starting from medications you take.

Viagra (Sildenafil) initially was created to treat ischemic heart disease, but during clinical tests patients noticed erection appearing. Besides Viagra there are also two medications: Levitra (Vardenafil) and Cialis (Tadalafil). Those three medications increase blood flow into penis and maintain erection enough for sexual intercourse. The effect of Viagra and Levitra appears in 1-2 hours after their taking. Thanks to Viagra, four in five patients get their sexual functions improved. The effect of Cialis keeps for 36 hours. To make those medications work, there is a need of sexual stimulation. Those medications have next side effects: headache, cold, indigestion.

After sexual intercourse occurs blood outflow from penis, and penis comes back in normal condition. Levitra improves erection in 85% of males. This medication helps to improve potency in diabetics and in those who has undergone operation on prostate gland. The medications are contraindicated for people with significant heart diseases, and also for people taking drugs containing nitrates and alpa-blockers. Acting one with another, those medications may provoke sudden lowering of blood pressure. Medications improving potency are dangerous for men who suffer from coronary heart disease, heart failure, and hypotension.

Before appearing on the market of medications mentioned above, the problem of erectile dysfunction was solved with the usage of injections which were made into penis before sexual intercourse. This method is still used today. In case of right usage, it is a quite effective procedure. Sometimes such injections and other medications do cause priapism (steady long-lasting erection). So they should be used attentively.

Erection may be kept with mechanic devises such as vacuum pumps assuring blood flow into penis, or rubber seals drawing on penis head and preventing blood outflow from penis.
Finally, special devises may be inserted surgically into penis. Those semirigid structures are quite firm for sexual intercourse but they are quite flexible to remain invisible underwear.

Premature Ejaculation

You are alone with your partner. The events develop quickly and you intend to prolong your pleasure. But everything ends up before its beginning...

It is normally when it occurs sometimes.  It may occur during foreplay or right after penis touches vulvar lips or enters vaginal opening of the woman. However, if it happens regularly it is abnormal and here we can talk about premature ejaculation.

First of all in this case do suffer man's self-rating and also relationship with his partner. It is not necessarily to bear with that because premature ejaculation can be treated.

What are the causes?
There is no unambiguous answer. There are several causes of premature ejaculation:
1. psychological factors (depression, stress, feeling of guilt, low self-rating, excessive nervousness owing to sex)
2. diseases (problems with thyroid gland, prostate infective diseases, changing of level of particular hormones and substances produced by brain).

Premature ejaculation of young people is connected with inexperience (they do not know yet their body very well). Some men have premature ejaculation as a result of erectile dysfunction.

Diagnosis
For premature ejaculation diagnostics the doctor should find out many things from the past and present patient's state of health and also all about medicines the patient is taking.  The doctor has to ask in details about sexual relationship with the partner.

It is very hard to talk about sexual problems with the doctor, but it is important to ask honestly his questions. Here is an approximate list of the questions:

• How long premature ejaculation is observed?


• Does this problem appeared recently or it exist from the very beginning of sexual life?


• Does the premature ejaculation occur every time or just sometimes?


• Does it occur with only one partner or with every women?


• How often do you make sex?


• Do you take drugs or alcohol?

To find out potential medical reasons of the problem the doctor can appoint complex examination.

How it can be treated?
The main method of treatment is psychological, sexual, pharmacological therapy. In some cases helps the only one way of treatment, in other cases it necessary to use them in complex.

Psychological therapy.
Speaking with psychologist often can be very useful.  Patient can come to consult the doctor along with his partner. Specialist will help to release stress and to improve quality of sexual life.

Sexual therapy.
There are some exercises that help to learn to delay ejaculation, that can be done alone or with the partner.
1. Compression method.  Partner stimulates your penis with her hand until erection.  When she feels that ejaculation is coming she compresses penis head for several seconds. Erection is coming down partially. In 30 seconds  partner stimulates penis again. It should be repeated several times and finally ends with ejaculation.
2. Interrupter method. Partner stimulates penis until ejaculation. At this moment she stops stimulation and waits until the man cools down. Then again she starts to eat penis with her hands. It repeats until ejaculation.

Pharmacological therapy.
1. Antidepressants. Drug side effect of some medicines belonging to that group (paroxetine, flouxetine) is orgasm delay. That is why they can be used on doctor's orders to treat premature ejaculation. If those medicines do not help then doctor prescribes another type of antidepressant called clomipramine.
2. Creams containing local anesthetic (for example, lidocaine) are used for many years to treat premature ejaculation. Cream application on head of penis opiates sensation and delays ejaculation. Before sex cream should be washed off to avoid its contact with woman's genital organs.