A Deep Dive into Premature Ejaculation: Analyzing Definitional Controversies, Psychological and Organic Causes, and Comprehensive Prevention Strategies [i]

Premature ejaculation is one of the most common sexual problems encountered by adult men[i]. Many men describe themselves as having premature ejaculation, but so far, experts at home and abroad have not reached a unified definition or time limit. This seemingly simple problem is actually quite complex[i]. For example, sexologists Masters and Johnson, renowned American sexologists, believe that when a man's intercourse time is so short that there is only about a 50% chance that the woman will be satisfied, it can be called premature ejaculation[i]. However, this standard mainly depends on the woman's sexual responsiveness, which varies greatly from woman to woman[i]. Another renowned American sexologist, Kaplan, links the concept of premature ejaculation to the disorder of voluntary control of ejaculatory response. If a man cannot lead himself to a high level of sexual arousal and ejaculate, it is considered premature ejaculation[i]. Such a lack of quantitative standards makes it even more difficult to grasp[i]. Therefore, some experts suggest that premature ejaculation is "normal"[i]. They cite examples from the animal kingdom, namely that male animals that can obtain sexual partners and ejaculate quickly have a stronger survival ability. In this light, short ejaculation time is not a pathological condition or defect, but a superior "characteristic"[i]. Modern men and women pay attention to ejaculation time, mainly driven by the increasing importance placed on women's sexual needs. Many men, in order to project a masculine image, strive to prolong their intercourse time, and feel immense pressure if the time is shorter [i]. These experts urge men not to readily label themselves as having premature ejaculation [i]. The causes of premature ejaculation are varied, but can be summarized into two categories: 1. Caused by psychological factors (psychogenic): More than 80% of premature ejaculation cases are caused by psychological factors [i]. Psychogenic cases account for 85% of premature ejaculation cases [i]. For example, long-awaited reunions, honeymoons, excessive excitement or tension, excessive fatigue, depression, drinking alcohol, excessive sexual activity, disharmony in the marital relationship, potential hostility, resentment, and anger towards the wife, or excessive fear, worship, or inferiority complex towards the wife are all factors that can induce premature ejaculation [i]. 2. 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, chronic prostatitis, etc., can all reflexively affect the spinal cord center and cause premature ejaculation[i]. Certain systemic diseases and physical weakness can also cause sexual dysfunction and premature ejaculation[i]. Although premature ejaculation is not a major problem, it affects the quality of sexual life, so it is very important to prevent premature ejaculation[i]. 1. Moderate sexual activity and abstain from masturbation: Long-term excessive sexual activity and frequent masturbation lead to mental fatigue, which is an important cause of impotence and premature ejaculation[i]. Practice has shown that couples sleeping separately, stopping sexual activity for a period of time, avoiding all types of sexual stimulation, and allowing the central nervous system and sexual organs to get sufficient rest are indeed effective measures to prevent and treat premature ejaculation[i]. 2. Eliminate psychological factors: It is necessary to have a full understanding of sexual knowledge and to treat "sexual desire" correctly. It should not be regarded as something shameful and disgusted or feared[i]. Couples should increase emotional communication and eliminate disharmonious factors. The wife should care for and encourage her husband and avoid showing dissatisfaction [i]. Concentration is important during intercourse, especially when reaching the peak of sexual pleasure and about to ejaculate [i]. 3. Dietary conditioning: Tomatoes are rich in vitamin C, which can strengthen blood vessels; soybeans contain plant hormones, and eating them regularly can reduce the risk of prostate cancer [i]. Seafood such as oysters can enhance sexual ability. Zinc deficiency can affect the quantity and quality of sperm, and one oyster is almost equivalent to the daily requirement of zinc [i]. Garlic has strong bactericidal power, which can improve physical condition and strengthen the body; foods high in vitamin C, such as kiwifruit, can revitalize aging sperm; whole wheat bread has a calming effect and can relax people [i]. Omega-3 fatty acids in deep-sea fish are particularly beneficial to the cardiovascular system [i]. Polyphenols in red wine can reduce the risk of cardiovascular disease [i]. 4. Improve physical fitness: Physical weakness, excessive fatigue, lack of sleep, and prolonged intense mental work are all pathogenic factors. Physical exercise should be carried out to adjust the functional imbalance of the central nervous system [i]. 5. Quit smoking and drinking[i]. 6. Massage prevention: Frequently press the 4th lumbar vertebra; or grasp the left middle finger with the right thumb, index finger, and middle finger, stretching from the base to the tip until it turns red; or massage the depressions on the inner and outer sides of the ankle[i]. 7. For those already suffering from premature ejaculation, condoms or other devices can be used: consciously constricting the base of the penis to reduce sensation in the glans; or shifting attention during intercourse to reduce the urge to ejaculate; or trying to increase the frequency of intercourse to reduce the sensitivity of the glans[i]. Generally speaking, those with erectile dysfunction should concentrate, while those with premature ejaculation can try shifting their attention[i]. [i]