1
Premature (early) ejaculation
This is one of the sexual dysfunctions or sex-related disorders that was covered in
Chapter 14 of the coursebook. Premature, or early ejaculation was defined by Reichenberg
and Seligman (2016) as a phenomenon associated with men’s sexual functioning and entails
the uncontrolled ejaculation within one minute of virginal penetration and prior to a male’s
sexual satisfaction or at a time he least expects it to occur. The following is a preview of the
criteria used to diagnose this disorder, universally accepted etiology of the disorder,
evidence-based treatment options, a counselling intervention, wellness areas addressed and
multicultural implications of the disorder.
DMS-V-TR Diagnostic Criteria for the Disorder
Inability to sustain delayed ejaculation soon after virginal penetration (typically a
minute after onset of intercourse)
Symptoms are prolonged and witnessed over a period not less than 6 months
The condition produce distress contributed by loss of self-esteem affecting sexual
interests
The symptom occurs in most of sexual encounters, typically at least 75% of all
partnered sexual interactions (Reichenberg & Seligman, 2016).
Note: the condition is classified as either life-long or acquired. Life-long premature
ejaculation is that which has occurred since the onset of a person’s interactions, while
acquired premature ejaculation disorder is that which occurs in the course of a person’s
sexual life, after past of satisfying sexual experience (Reichenberg & Seligman, 2016).
Etiologic factors
The prognosis of premature ejaculation (PE) explained by a variety of factors believed
to lead to the onset and precipitation of this condition. Among them include:
Biological factors: Biological factors, including brain chemistry are reporting to
play role in the manifestation of the condition. Persons reporting low levels of chemical
serotonin in the brains tend to experience sexual problems, including shorter-time ejaculation.
Psychological causes: Sex outcomes are highly associated with psychological state,
given the connection between sex and state of mind. Skurat (2023) asserts that emotional and
mental issues play vital roles in the sustenance of a satisfying sexual life. Poor psychological
, 2
states (e.g. stress, anxiety, depression, lengthened grief, esteem issues etc.) may cause
consistent fatigue, lethargy and anhedonia, which leads to lower libido levels and premature.
More so, having an enduring post-traumatic stress related to sexual abuse may also increase
the risk of this condition.
Physical Health- Various illnesses have also been associated with premature
ejaculation problem. These include chronic illnesses, such as diabetes mellitus, metabolic
syndrome, obesity and endocrinal illnesses, such as thyroid disorders (Coskuner & Ozkan,
2022). Infections causing inflammations in the prostate or urethra may also lead to this
condition. Penis hypersensitivity may also cause excessive stimulation, leading to premature
ejaculation (Guo et al., 2017).
Evidence-based treatment options
Behavioral therapy-This therapy aims at promoting an individual’s ability to control of
orgasm, through sustaining control over stimulation and feelings. PE-focused behavioral
therapy can be conducted in various methods/approaches which include:
Start-and-stop method-The aim of this method is to promote the man’s ability to
control ejaculation. It involves the collaboration of sexual partners, where the women
stimulates her partner to a level close to orgasm, then stops for about 30 seconds until
the man is able to delay the orgasm and gains control to the response. This is repeated
a number of times (typically 3 or 4 times) before allowing orgasm. Partners practice
the method during their sexual engagements until the man achieves full or desired
levels of control.
Pelvic floor exercises: This entails practicing Kegel exercises to tighten the pelvic floor
muscles. This is mainly done through stopping urination midstream or holding gas
Medications: Oral medications, such as antidepressants, tramadol and other drugs used
for improving libido (e.g. tadalafil) may remedy the situation. Anesthetics (cream and sprays)
are also used to delay ejaculation.
Counselling intervention
Talking to a counsellor is an adequate way to relieve psychological and emotional
pathways to the problem of premature ejaculation. The counsellor may effectively help
overcome PE, especially is its primary contributor is relationship issues (e.g. troubled
Premature (early) ejaculation
This is one of the sexual dysfunctions or sex-related disorders that was covered in
Chapter 14 of the coursebook. Premature, or early ejaculation was defined by Reichenberg
and Seligman (2016) as a phenomenon associated with men’s sexual functioning and entails
the uncontrolled ejaculation within one minute of virginal penetration and prior to a male’s
sexual satisfaction or at a time he least expects it to occur. The following is a preview of the
criteria used to diagnose this disorder, universally accepted etiology of the disorder,
evidence-based treatment options, a counselling intervention, wellness areas addressed and
multicultural implications of the disorder.
DMS-V-TR Diagnostic Criteria for the Disorder
Inability to sustain delayed ejaculation soon after virginal penetration (typically a
minute after onset of intercourse)
Symptoms are prolonged and witnessed over a period not less than 6 months
The condition produce distress contributed by loss of self-esteem affecting sexual
interests
The symptom occurs in most of sexual encounters, typically at least 75% of all
partnered sexual interactions (Reichenberg & Seligman, 2016).
Note: the condition is classified as either life-long or acquired. Life-long premature
ejaculation is that which has occurred since the onset of a person’s interactions, while
acquired premature ejaculation disorder is that which occurs in the course of a person’s
sexual life, after past of satisfying sexual experience (Reichenberg & Seligman, 2016).
Etiologic factors
The prognosis of premature ejaculation (PE) explained by a variety of factors believed
to lead to the onset and precipitation of this condition. Among them include:
Biological factors: Biological factors, including brain chemistry are reporting to
play role in the manifestation of the condition. Persons reporting low levels of chemical
serotonin in the brains tend to experience sexual problems, including shorter-time ejaculation.
Psychological causes: Sex outcomes are highly associated with psychological state,
given the connection between sex and state of mind. Skurat (2023) asserts that emotional and
mental issues play vital roles in the sustenance of a satisfying sexual life. Poor psychological
, 2
states (e.g. stress, anxiety, depression, lengthened grief, esteem issues etc.) may cause
consistent fatigue, lethargy and anhedonia, which leads to lower libido levels and premature.
More so, having an enduring post-traumatic stress related to sexual abuse may also increase
the risk of this condition.
Physical Health- Various illnesses have also been associated with premature
ejaculation problem. These include chronic illnesses, such as diabetes mellitus, metabolic
syndrome, obesity and endocrinal illnesses, such as thyroid disorders (Coskuner & Ozkan,
2022). Infections causing inflammations in the prostate or urethra may also lead to this
condition. Penis hypersensitivity may also cause excessive stimulation, leading to premature
ejaculation (Guo et al., 2017).
Evidence-based treatment options
Behavioral therapy-This therapy aims at promoting an individual’s ability to control of
orgasm, through sustaining control over stimulation and feelings. PE-focused behavioral
therapy can be conducted in various methods/approaches which include:
Start-and-stop method-The aim of this method is to promote the man’s ability to
control ejaculation. It involves the collaboration of sexual partners, where the women
stimulates her partner to a level close to orgasm, then stops for about 30 seconds until
the man is able to delay the orgasm and gains control to the response. This is repeated
a number of times (typically 3 or 4 times) before allowing orgasm. Partners practice
the method during their sexual engagements until the man achieves full or desired
levels of control.
Pelvic floor exercises: This entails practicing Kegel exercises to tighten the pelvic floor
muscles. This is mainly done through stopping urination midstream or holding gas
Medications: Oral medications, such as antidepressants, tramadol and other drugs used
for improving libido (e.g. tadalafil) may remedy the situation. Anesthetics (cream and sprays)
are also used to delay ejaculation.
Counselling intervention
Talking to a counsellor is an adequate way to relieve psychological and emotional
pathways to the problem of premature ejaculation. The counsellor may effectively help
overcome PE, especially is its primary contributor is relationship issues (e.g. troubled
