Archive for the ‘performance anxiety’ Category

Premature Ejaculation-When Comin’ Instead Eof Goin’!

February 2, 2016

 

Nothing is more embarrassing to a man than a problem of rapid ejaculation.  Men are interested in satisfying their partners and when they ejaculate\cum too soon, it is a source of embarrassment and anxiety for every man and a source of frustration and lack of fulfillment for every partner.

Premature ejaculation (PE) is a problem that plagues 36,000,000 men and is defined as ejaculation within 5 minutes of penetration. It is important to point out that premature ejaculation depends on the satisfaction of the partners.  It is a sexual event for a male actually includes erection orgasm, and ejaculation.

The exact etiology of PE isn’t clear, but it is felt to be a lack of control of the receptors to the nerves from the spinal nerve to the prostate gland and the seminal vesicles, the two organs behind the prostate gland that store the sperm prior to ejaculation.

A list of treatments that have been shown NOT to be beneficial incldues:

1. Long-term psychoanalysis.

2. Getting drunk.

3. Use of one or more condoms.

4. Concentrating on something other than sex while having intercourse. (i.e. Baseball line-ups, or state capitals)

5. Biting one’s cheek.

6. Frequent masturbation.

7. Testosterone injections.

8. Tranquillizers.

9. PD5 inhibitors.

Current treatment options available include selective serotonin reuptake inhibitors (SSRI’s), utilizing the side effect of delayed ejaculation via their impact on the receptors in the brain. In numerous studies, these medications taken on a regular basis have been shown to prolong ejaculation. Drugs in this category include Zoloft, Anafranil and Prozac.

Topical creams have been tried in the past and recently, a company, Promescent, (for more information go to Promescent.com) has come out with a spray that is applied to the penile glans to lessen sensitivity. It is available online without a prescription and the feedback from the men who have tried it has been very positive.

My current recommendation is for men to start with Promescent if that is not successful, then consider the SSRI’s.

Bottom Line:  Premature ejaculation is a very common problem affecting millions of American men.  It certainly impacts the relationship between a man and his partner.  Help is available.  Speak to your doctor.

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Can’t Get It Up-It May Just Be In Your Head If the mind is crazy….the penis can be lazy!

August 28, 2013

When I went to medical school, the party line was that most men with impotence had a psychological cause of their inability to engage in sexual intimacy. Now, the situation is reversed and most men have ED or impotence as a result of physical causes, i.e., decrease in the blood supply to the penis, hormone deficiencies, or nerve problems. However, 10-20% are still due to emotional causes.

Emotional causes are often a secondary reaction to an underlying physical cause. In some cases, the psychological effects of ED may stem from childhood physical abuse or sexual trauma. However, the most common psychological causes of ED include:

Stress can be job-related, money-related, or the result of marital problems.

Once a man experiences ED, he may become overly worried that the problem will happen again. This can lead to “performance anxiety,” or a fear of sexual failure, and consistently lead to ED.

A man may feel guilty that he is not satisfying his partner.

A common cause of ED, depression affects a person physically and psychologically. Depression can cause ED even when a man is completely comfortable in sexual situations. Drugs used to treat depression may also cause ED.

Low self-esteem can be due to prior episodes of ED (thus a feeling of inadequacy) or can be the result of other issues unrelated to sexual performance.

Indifference to sexual intimacy may come as a result of age and a subsequent loss of interest in sex, be the result of medications or stemming from problems in a couple’s relationship.

Let the truth be told: all men at one time or another will experience ED. Only if the problem becomes persistent, i.e., occurs more than half the time — or becomes a source of distress for you or your partner should you be concerned and consider seeking medical advice and treatment. Most men with ED due to either psychological or physical causes can be helped and even cured. I suggest you have a discussion with a doctor if you are “striking out” more than half the time. I can’t promise you a home run every time, but I can tell you that you can be helped.