Causes, prevention, and male contraception methods for premature ejaculation

One of the most common sexual problems encountered – premature ejaculation

Premature ejaculation is one of the most common sexual problems encountered by adult men.

Many men describe themselves as having premature ejaculation, but experts at home and abroad still do not have a unified definition or time limit. This seemingly simple problem is actually quite complicated.

Generally speaking, premature ejaculation refers to a man's inability to maintain sexual intercourse for more than one minute. However, such a short time is often insufficient to ensure female sexual satisfaction, so some sexologists define premature ejaculation in consideration of female factors.

Sexologists Masters and Johnson, renowned American sexologists, define premature ejaculation as a condition where a man's intercourse time is so short that there is only about a 50% chance of his partner achieving satisfaction. However, this standard largely depends on the woman's sexual responsiveness, which varies greatly from woman to woman.

Another prominent American sexologist, Kaplan, linked premature ejaculation to a disorder of voluntary control over the ejaculatory response. He defined premature ejaculation as a man's inability to ejaculate at a high level of sexual arousal. However, this lack of quantifiable standards makes it difficult to define precisely. Therefore, some experts argue that premature ejaculation is "normal." They cite the animal kingdom as an example: males who can obtain mates and ejaculate quickly have a higher survival rate. Thus, short ejaculation time is not a pathological condition or defect, but rather a desirable "trait."

The modern focus on ejaculation time by men and women stems primarily from the increasing emphasis placed on women's sexual needs. In other words, many men strive to prolong intercourse to ensure their partners experience pleasure or orgasm, and to project a strong masculine image. They feel immense pressure if their intercourse lasts shorter than expected. Experts urge men not to readily label themselves as having premature ejaculation.

Causes of premature ejaculation

Premature ejaculation has many causes, but they can be summarized into two categories:

1. Caused by psychological factors (psychogenic)

More than 80% of premature ejaculation cases are caused by psychological factors. Psychogenic factors account for 85% of premature ejaculation cases. For example, factors such as reunion after a long separation, honeymoon, excessive excitement or tension, excessive fatigue, depression, drinking alcohol, excessive sexual activity, disharmony in the marital relationship, latent hostility, resentment, and anger of the husband towards his wife, or excessive fear, worship, or inferiority complex towards his wife, can all induce premature ejaculation.

Common psychogenic causes include: some men are anxious during intercourse, fearing premature ejaculation and dissatisfaction from their wives; others, due to misunderstandings about sex, unjustifiably doubt their sexual ability, constantly feeling ashamed and inferior during intercourse, a situation often seen in those who believe their penis is small or their physique is weak. Disharmony in the marital relationship, such as suspicion, jealousy, or excessive respect for the wife, can also lead to premature ejaculation. Some men place excessive importance on sex, have overly high expectations, or worry excessively about occasional instances of premature ejaculation, which may increase psychological burden, creating a vicious cycle of tension, premature ejaculation, more tension, and continued premature ejaculation, thus making premature ejaculation a permanent condition.

2. Having organic diseases

For example, congenital malformations of the external genitalia, phimosis, inflammation of the glans or foreskin, urethritis, penile inflammation, multiple sclerosis, spinal cord tumors, cerebrovascular accidents, epididymitis, and chronic prostatitis can all reflexively affect the spinal cord center and cause premature ejaculation. Certain systemic diseases and physical weakness can also lead to sexual dysfunction and premature ejaculation.

Preventing premature ejaculation

Although premature ejaculation is not a major problem, it affects the quality of sexual life and can also lead to other sexual dysfunction diseases, so it is very important to know how to prevent premature ejaculation.

The following methods are for reference only:

1. Practice moderation in sexual activity and abstain from masturbation.

Excessive sexual activity over a long period, immersion in pornography, and frequent masturbation leading to mental fatigue are significant causes of erectile dysfunction and premature ejaculation, and should be avoided. Practice has shown that couples sleeping separately, abstaining from sexual activity for a period of time, and avoiding all types of sexual stimulation to allow the central nervous system and sexual organs to fully rest are indeed effective measures for preventing and treating erectile dysfunction and premature ejaculation.

2. Eliminate psychological factors

It is essential to have a thorough understanding of sexual knowledge and to fully recognize the impact of psychological factors on sexual function. One should have a healthy attitude towards sexual desire, not viewing it as something shameful to be disgusted or fearful of. Couples should increase emotional communication, eliminate disharmonious factors, and cooperate tacitly. The woman should care for and encourage her husband, avoiding expressing dissatisfaction and creating psychological pressure for him. During intercourse, one should concentrate, especially when reaching the peak of sexual pleasure and approaching ejaculation.

3. Dietary therapy

Tomatoes: Rich in vitamin C, which helps bind cells together to produce collagen, thus strengthening blood vessels.

Soybeans: Soybeans contain plant hormones, and men who regularly eat soy products have a lower chance of developing prostate cancer.

Carrots: Rich in potassium, which helps lower blood pressure; dietary fiber helps regulate the intestines.

Oysters: Seafood can enhance sexual function. Male semen contains a large amount of zinc, and insufficient zinc in the body can affect sperm count and quality. A single oyster almost equals the daily zinc requirement (15 mg).

Garlic: Garlic has strong antibacterial properties, thus it can eliminate germs that invade the body. Men who eat more garlic can improve their physical condition and strengthen their bodies.

Foods high in Vitamin C: After age 24, both the quality and quantity of sperm in men decline. There's a kind of "anti-aging elixir" that can revitalize aging sperm: Vitamin C. Vegetables and fruits high in Vitamin C include kiwifruit, oranges, tangerines, broccoli, and asparagus.

Whole wheat bread: B vitamins are crucial for combating stress. Whole wheat bread is a complex carbohydrate that releases energy slowly, has a calming effect, and helps people relax and reduce tension.

Deep-sea fish: High stress levels are also causing men to develop hyperlipidemia and stroke at a lower age. The Omega-3 fatty acids in deep-sea fish can prevent blood clotting, reduce vasoconstriction, and lower triglycerides, which are particularly beneficial for the cardiovascular system.

Tea: Green tea is rich in vitamin C, which is absent in black tea. Vitamin C is an essential nutrient for preventing colds and providing antioxidant benefits.

Red wine: If you must drink alcohol, then drink red wine. This is because the polyphenols, antioxidants from the grape skins, remain in the wine and can reduce the risk of cardiovascular disease.

4. Improve physical fitness

Physical weakness, excessive fatigue, lack of sleep, and prolonged intense mental work are all contributing factors to the disease. It is important to engage in regular physical exercise to improve physical fitness, pay attention to rest, prevent overwork, and adjust the functional imbalance of the central nervous system.

5. Quit smoking and drinking.

Long-term smoking hinders blood flow to the periphery of the body, affecting penile blood circulation and impacting sexual response. Foreign researchers indicate that factors contributing to poor blood circulation and erectile dysfunction include smoking, diabetes, high cholesterol, and high blood pressure, with smoking being the most significant. Alcohol is a gonadotoxin; excessive drinking or alcoholism can poison the gonads, resulting in decreased testosterone levels in men, with 70%–80% experiencing erectile dysfunction or infertility.

6. Massage for prevention

Method 1: Frequently press the 4th lumbar vertebra.

Method 2: Finger massage: Grasp the middle finger of your left hand with your right thumb, index finger, and middle finger, and stretch it from the base of the finger to the tip until the skin turns red; or press the bone between the ring finger and little finger of your left hand with three fingers of your right hand until the skin turns red.

Method 3: Massage the area slightly below the inner and outer depressions behind the ankle, and continue.

7. For those already suffering from premature ejaculation, condoms or other contraceptive devices can be used.

Consciously restricting the base of the penis to desensitize the glans; or diverting attention during intercourse to reduce the urge to ejaculate; or trying to increase the frequency of intercourse to reduce the sensitivity of the glans. Among these, increasing the frequency of intercourse versus abstinence, and diverting attention versus focusing the mind, should be viewed dialectically, varying from person to person and from condition to condition, each with its own use and not contradictory. Generally speaking, men with erectile dysfunction should focus on the latter, while men with premature ejaculation can try the former.

Male contraception methods

Many married men share this experience: their wives become extremely anxious a few days before their period, constantly worrying about whether contraception will work that month. If their period is a few days late, those days feel like an eternity, filled with the fear that their wife might be pregnant. Contraception is arguably one of the biggest issues in married life, yet this burden currently falls almost entirely on the shoulders of the vulnerable wife. If men want to show more care for their wives and relieve them of the anxieties surrounding contraception, they might consider learning about male contraception methods.

Male contraception methods

1. Condoms

Most men are familiar with this small rubber condom. Although some may find it "not satisfying enough," it is, after all, the most widely used contraceptive method. However, condoms can sometimes be unsafe due to improper use, and some brands do not meet quality standards, so extra caution is necessary when choosing one. The advantage of this method is that it has almost no side effects for either partner and can prevent the transmission of sexually transmitted diseases. It is the first choice recommended by doctors.

Disadvantages: The effective contraceptive rate is around 90%. It cannot be used by a small number of men or women who are allergic to rubber.

2. Medications

Medications are divided into two types: oral medications and injectable medications.

Gossypol: Gossypol is a representative oral male contraceptive and the only drug ever used clinically. Because this chemical, extracted from common cottonseed, has a powerful inhibitory effect on sperm production, scientists have been paying close attention to its contraceptive properties for over half a century.

Disadvantages: It has many side effects, such as hypokalemia, which can cause generalized paralysis and temporary loss of working ability. The most serious side effect is that it may cause infertility. Experts do not recommend its use.

Testosterone depressant injection: This injection is recommended by the WHO (World Health Organization) and touted as "one injection a month for contraception." However, it is currently undergoing multi-center phase III clinical trials globally and has not yet been fully developed. After men inject this drug, the contraceptive rate reaches over 90% in Asians, while it is only around 60% in Caucasians.

Disadvantages: This medication is not immediately effective. One injection is needed monthly for three consecutive months to achieve contraceptive results. The contraceptive rate among people of Asian descent is over 90%.

3. Surgery

Currently, there are three types of sterilization procedures available: vasectomy, vas deferens occlusion, and non-obstructive vas deferens IUDs. The latter two procedures are based on traditional vasectomy.

Surgery, which is always associated with trauma and pain, sounds terrifying. However, the entire process of sterilization takes only 20 minutes, requires no stitches, and the recovery time is only two days. There are almost no scars after the operation. Its minimal trauma and rapid recovery exceed many people's imagination.

Vasectomy: Cutting off the vas deferens, which serves as the transport duct for sperm, effectively prevents pregnancy. The two vas deferens originate inside the scrotum and can be felt from the outside and pulled down to the scrotal skin. Therefore, the doctor only needs to make a small incision (about the size of a grain of rice) in the scrotum and cut the vas deferens to achieve contraception.

Many people worry that cutting the vas deferens will result in no semen being ejaculated or a significantly reduced amount. In fact, this worry is unnecessary. On average, a man ejaculates about 2 ml of semen each time, of which seminal vesicle fluid and prostatic fluid account for more than 90% of the semen volume. This portion will still be ejaculated. After ligation, epididymal fluid and sperm, which account for less than 10% of the semen volume, are blocked. Therefore, it will not have a significant impact on the amount of semen. When pregnancy is desired, a vas deferens anastomosis can be performed, with a patency rate exceeding 90%.

Disadvantage: Some men may experience epididymal congestion and discomfort after the surgery.

Vas deferens occlusion: This method differs from ligation in that it does not require cutting the vas deferens. Instead, a special material (mainly composed of carbolic acid) is injected into the vas deferens, which is stimulated to form scars and harden, thereby losing its function.

Disadvantages: Because the amount of injected material is difficult to control, some people experience excessively long obstructions in the vas deferens, resulting in a needle-like discomfort at the surgical site. This method has been abandoned by the vast majority of clinicians.

Non-obstructive vas deferens device (IUD): This method involves placing a filter made of a special material (nylon) inside the vas deferens to intercept sperm, thus achieving contraception. When contraception is no longer needed, the filter can be removed, restoring normal fertility. One advantage of this procedure is that it avoids epididymal congestion, a possible consequence of traditional tubal ligation.