The psychology of premature ejaculation
Early ejaculation due solely to psychological factors in the absence of organic problems. The psychogenic form of premature ejaculation can be associated with a neurosis of expectation of failure, sexual overexcitation, irregular sexual activity and other reasons. With this form of sexual dysfunction, the duration of sexual intercourse in a man may be different with different partners; a fear of sexual contacts is formed, self-esteem decreases. With the psychogenic form of premature ejaculation, a man needs the help of an andrologist-sexologist or psychologist.
The psychogenic form of premature ejaculation is a short intercourse with rapid ejaculation, caused by external or internal psychotraumatic factors. The psychogenic form of premature ejaculation is not associated with physiological (organic) causes (increased sensitivity of the glans penis, neurological pathology, urological problems - prostatitis, vesiculitis, short frenum of the penis, etc.). At the heart of its development, to one degree or another, there is a psychogenic component. The psychogenic form of premature ejaculation in the future can lead to psychogenic impotence, therefore it is studied not only within the framework of sexology and psychotherapy, but also urology and andrology.
Classification of psychogenic forms of sexual disorders
Approximately 80% of cases of various sexual dysfunctions in men and women are in one way or another associated with psychological factors. In women, sexual dysfunctions of a psychogenic nature include the absence (alibidemia) or decrease (frigidity) of sexual desire, non-orgasm (anorgasmia), painful intercourse (dyspareunia or genitalgia), reflex convulsive contraction of the genital tract muscles (vaginismus).
Psychogenic sexual disorders in men include decreased libido or lack thereof, psychogenic erectile dysfunction or impotence, impaired ejaculation (premature ejaculation, anejaculation, asthenic ejaculation), weakening or absence of orgasm, fear of sexual incompetence. The psychogenic form of premature ejaculation can be permanent or transient.
Causes of the psychogenic form of premature ejaculation
Most often, premature ejaculation of a psychogenic nature is based on excessively strong sexual arousal. Usually, sexual overexcitement is characteristic of young people who have recently begun sex, but it can also be inherent in quite mature and experienced men. Too strong sexual arousal is accompanied by a rapid increase in tension in the corresponding parts of the brain. When the “threshold level” of arousal is reached, the man can no longer arbitrarily control the ejaculation process, so ejaculation occurs prematurely.
A psychogenic form of premature ejaculation can develop as a result of a neurosis of expectation of failure. Usually this is preceded by a not very successful "sexual debut", which may be associated with the inexperience of the young man, the state of alcohol intoxication, the fear of being rejected or ridiculed, the fear of not satisfying the partner, etc. Anxious expectation of sexual failure often arises in anxious and suspicious persons with a weak sexual constitution.
Quite often, the problem of the psychogenic form of premature ejaculation lies in the plane of interpersonal relationships between sexual partners. In this case, psychological factors of premature ejaculation can be a lack of understanding and trust between a man and a woman, fear of betrayal, lack of deep affection for each other, dissatisfaction with relationships, fear of contracting STIs, etc. In men who are in a state of chronic stress or depression, lack rest and sleep, a psychogenic form of premature ejaculation can also develop.
Sometimes the psychogenic form of premature ejaculation is strictly selective (situational), that is, it manifests itself only during sexual intercourse with a particular woman or in a particular situation.
Symptoms of the psychogenic form of premature ejaculation
A man's inability to provide sexual satisfaction to his partner disrupts family relationships and often leads to a break in relations. Single men, suffering from a psychogenic form of premature ejaculation, do not dare to start a family and try to avoid close communication with women. Men are extremely painfully experiencing their sexual "inferiority" - this leads to a decrease in self-esteem and the quality of sexual life, further aggravates the psychological component of premature ejaculation.
A characteristic feature of the psychogenic form of premature ejaculation is the different duration of sexual intercourse with different partners. The situation is usually improved by thinking on abstract topics or taking small doses of alcohol. Sometimes patients with a psychogenic form of premature ejaculation fix their attention on imaginary somatic diseases, trying to find in them an excuse for their sexual inadequacy. Libido, erection and orgasm in the psychogenic form of premature ejaculation can be normal or secondarily weakened.
Diagnostics and treatment of the psychogenic form of premature ejaculation
Usually, the psychogenic form of premature ejaculation is diagnosed in the absence of organic prerequisites for early ejaculation in a man. Therefore, the examination of a patient suffering from premature ejaculation begins in the office of an andrologist or urologist. As part of diagnostic measures, a comprehensive urological examination is carried out (ultrasound of the prostate gland, penis and scrotum organs, USDG, functional tests, examination of prostate secretion and urethral smear, etc.).
Psychological problems with premature ejaculation can resolve on their own with age and the acquisition of sexual experience. In many cases, after 30-35 years, as sexual excitability decreases, the duration of sexual intercourse in men is lengthened. If the problem persists, the man needs the help of a psychologist (psychotherapist) or sexologist. The leading method of treating the psychogenic form of premature ejaculation is psychotherapy (suggestive therapy, hypnotherapy, autogenic training).
At the same time, explanatory work is carried out with the spouse or regular sexual partner.
To reduce increased anxiety, vibration massage of the perineum, ascending and circular douches, general baths, galvanization and inductothermy of the spinal centers, which reduce the excitability of the ejaculatory center and at the same time have a psychotherapeutic effect, can be shown. In some cases, prescribing antidepressants, tranquilizers and antipsychotics helps to overcome sexual dysfunction.
In most cases, the psychogenic form of premature ejaculation is reversible. Therefore, one should not hesitate and hush up the existence of a problem, avoid professional help from specialists. Of great importance in overcoming sexual dysfunction is the presence of an understanding and sensitive woman next to a man.