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Premature ejaculation (PE), often also called rapid ejaculation, isamong the most widespread sexual dysfunction in men below 40years. Broadly, premature ejaculation may be described as theoccurrence of ejaculation before the desires of both sexual partnersare fulfilled. This definition, however, does not exactly specify theduration of the sexual intercourse and reaching an orgasm, both beingvariable and relies on several aspects characteristic to the individualsinvolved in the sexual activity. In fact, every male have experiencedpremature ejaculation at some point or the other in his life, and, hence,an occasional happening is not a matter of worry. However, if premature ejaculation occurs over 50 per cent of ventured sexualintercourse, it may be said that there is an ineffectual relationshipnecessitating medical treatment.Making the issue more comprehensible, let’s suppose that a malereaches orgasm after eight minutes of sexual intercourse. This cannotbe called a case of premature ejaculation provided his partnerfrequently climaxes in five minutes and both are content with theirtimings. On the other hand, another male may prolong his ejaculationto 20 minutes, but this may still be regarded as premature ejaculationprovided his partner requires 35 minutes of stimulation beforereaching her orgasm. Thus, it is apparent from the second instancethat premature ejaculation is a relative issue depending on thepartners engaged in the sexual act.Premature Ejaculation Statistics-According to the National Health and Social Life Survey (NHSLS),around 30 per cent of all males in the United States suffer frompremature ejaculation. In fact, many professionals treating prematureejaculation in the U.S. put the figure at 70 per cent saying that mostmen are not willing to admit the problem owing to embarrassment. Onthe other hand, the American Urological Association says thatpremature ejaculation affects between 27 per cent and 34 per cent of males of all age groups. In fact, premature ejaculation has been foundto happen at any age in a male's life, but is more common in youngermales – aged between 18 and 30 years. It has also been noted to occuras a secondary condition to impotence in men aged between 45 and65 years. Although there are no available data for Asia, Australia orAfrica, the European nations and India report statistics comparable totheir American counterparts.Premature Ejaculation Categorization The condition of premature ejaculation may be divided into threecategories – constant and regular ejaculation with minimal sexualstimula
 
tion before, on or shortly after penetration before the person wants to,distinct suffering or owing to problems in the relations between twopersons and not entirely due to any express consequences. On theother hand, the human sexual reaction too may be categorized intothree segments – libido or sexual desire, excitement or sexual arousal,and orgasm or climax. Moreover, premature ejaculation may beprimary or secondary.Primary premature ejaculation is applicable in the case of men whohave had the disorder ever since they were competent of functioningsexually, i.e. after the puberty period. On the other hand, secondarypremature ejaculation refers to the sexual dysfunction in a man whohad earlier enjoyed a satisfactory stage of ejaculatory control and forcauses unidentified, the individual endured premature ejaculationlater. In fact, premature ejaculation is considered to be a psychologicalcrisis and does not manifest any identified organic disease relating tothe male reproductive tract or any recognized abrasions in the brain orthe nervous system. The organs that are expressly affected bypremature ejaculation comprise the male reproductive tract – penis,prostrate, seminal vesicles, testicles and their limbs, segment of thecentral nervous system, the peripheral nervous system regulating themale reproductive tract as well as the reproductive tract of the femalesex partner that may not be effectually aroused for an orgasm.Premature Ejaculation Grades There are basically four grades of premature ejaculation. The hazard of this male sexual dysfunction is that it develops rapidly going from onegrade to another in a matter of few months.Grade 1 This is the most docile grade of premature ejaculation and is believedto be the beginning of the sexual dysfunction. This grade is mainlyrelated to ‘primary ejaculators’ or those who had control overejaculation in the past. In this grade, premature ejaculation occurssporadically in moment's emotional tension.Grade 2 This grade is common in secondary premature ejaculation or thosewho have never had control over their ejaculation. In this grade,premature ejaculation occurs more or less every time and the durationof the sexual act is between 1 to 5 minutes.Grade 3
 
 Those who don't overcome premature ejaculation on grades 1 or 2develop grade 3 fairly fast. Psychological aspects like performanceanxiety are attached to the dysfunction making it chronic. In this gradepremature ejaculation occurs always and the subject ejaculatesinstantly after penetration.Grade 4Grade 4 is when the sexual dysfunction becomes a disorder. Men whosuffer from grade 4 premature ejaculation are inclined to avoid sexualencounters and could even develop into a psychological impotence‘erectile dysfunction’ where the mind refuses any kind of sexualactivity to avoid more frustration and suffering. In this gradepremature ejaculation occurs every time and the man ejaculatesdirectly before or right on penetration.Premature Ejaculation ReasonsHistorically, premature ejaculation problems has been believed to be apsychological disorder. One theory is that males are conditioned bysocietal pressures to reach climax quickly because of fear of discoverywhen masturbating as teenagers or during early sexual experiences "inthe back seat of the car" or with a prostitute. This pattern of quickrealization of sexual release is difficult to change in marital or long-term relationships. The fact that female arousal and orgasm requiremore time than male arousal is being increasingly recognized, and thismay result in increased recognition and definition of prematureejaculation as a problem.Many have doubted whether premature ejaculation is purelypsychological. A number of investigators have found differences innerve conduction/latency times and hormonal differences in men whoexperience premature ejaculation compared with individuals who donot. The conjecture is that some men have oversensitivity of theirgenitalia, thus preventing down-regulation of their sympatheticconduits and delay of orgasm. Lately a certain group of nerves in thelumbar spinal cord has been identified as the possible originator of ejaculation. This nerve site is thought to be linked to excitatory andinhibitory dopamine pathways in the brain, which play significant rolesin sexual behavior. This information is providing the basis fordevelopment of medications like Dapoxetine or Priligy specificallytargeting delay of ejaculation.Premature Ejaculation Impact
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