Psychogenic form of premature ejaculation
The psychogenic form of premature ejaculation is a short sexual intercourse with rapid ejaculation, caused by external or internal psychotraumatic factors. The psychogenic form of PE is not associated with physiological (organic) causes (increased sensitivity of the glans penis, neurological pathology, urological problems – prostatitis, 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 PE can subsequently lead to psychogenic impotence, therefore it is studied not only in the framework of sexology and psychotherapy, but also in urology.
Classification of psychogenic forms of sexual disorders
About 80% of cases of various sexual dysfunctions in men and women are more or less related to psychological factors. In women, disorders of sexual function of a psychogenic nature include the absence or decrease (frigidity) of sexual desire, non-occurrence of orgasm (anorgasmia), pain of intercourse (dyspareunia or genitalia), reflex convulsive contraction of the genital tract muscles (vaginismus).
Psychogenic sexual disorders in men include a decrease in libido or its absence, psychogenic erectile dysfunction or impotence, impaired ejaculation (asthenic ejaculation), weakening or lack of orgasm, fear of sexual failure. The psychogenic form of PE can be permanent or transient.
Causes of the psychogenic form of premature ejaculation
Most often, the basis of PE of a psychogenic nature lies in excessively strong sexual arousal. Usually, sexual overexcitation is characteristic of young people who have recently begun sexual activity, 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. Upon reaching the “threshold level” of arousal, a man can no longer arbitrarily control the process of ejaculation, therefore, ejaculation occurs prematurely.
A psychogenic form of premature ejaculation can develop due to the neurosis of expectation of failure. Usually this is preceded by a not-too-successful “sexual debut”, which may be due to the inexperience of the young man, the state of intoxication, the fear of rejection or ridicule, the fear of not satisfying the partner, etc. Anxious suspicious persons often have anxious waiting for the failure to recur. with a weak sexual constitution.
Quite often, the problem of the psychogenic form of PE lies in the plane of interpersonal relationships between sexual partners. In this case, the psychological factors of PE can be a lack of mutual understanding and trust between a man and a woman, fear of betrayal, lack of deep attachment to each other, dissatisfaction with relationships, fear of infection, etc. In men who are in a state of chronic stress or depression, lacking rest and sleep, a psychogenic form of PE can also develop.
Sometimes the psychogenic form of premature ejaculation is strictly selective (situational) in nature, that is, it manifests itself only through sexual intercourse with a certain woman or in a certain situation.
Symptoms of the psychogenic form of premature ejaculation
The inability of a man to provide sexual satisfaction to a partner disrupts family relationships and often leads to a break in relations. Single men suffering from a psychogenic form of PE do not dare to start a family and try to avoid close contact with women. Men are extremely painful at experiencing their sexual “inferiority” – this leads to a decrease in self-esteem and the quality of sexual life, further exacerbates the psychological component of PE.
A characteristic feature of the psychogenic form of PE is the different duration of sexual intercourse with different partners. Improving the situation, as a rule, is facilitated by thoughts on abstract topics or by 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 failure. Libido, erection and orgasm with a psychogenic form of PE can be normal or secondarily weakened.
Diagnosis and treatment of the psychogenic form of premature ejaculation
Usually a psychogenic form of ejaculation is diagnosed in the absence of a man’s organic prerequisites for early ejaculation. Therefore, examination of a patient suffering from this problem begins in the office of an urologist. As part of diagnostic measures, a comprehensive urological examination is carried out (ultrasound of the prostate, penis and scrotum, functional tests, examination of the secretion of the prostate and urethral smear, etc.).
Psychological problems with premature ejaculation can be resolved independently 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 lengthens. If the problem persists, the man needs the help of a psychologist or sexologist. The leading method of treatment for the psychogenic form of ejaculation is psychotherapy (suggestive therapy, hypnotherapy, autogenic training). At the same time, explanatory work is carried out with the spouse or permanent sexual partner.
To reduce increased anxiety, vibrational massage of the perineum, ascending and circular showers, shared baths, galvanization and inductothermy of the spinal centers can be shown, which reduce the excitability of the ejaculatory center and at the same time have a psychotherapeutic effect. In some cases, overcoming sexual dysfunction helps the appointment of antidepressants, tranquilizers and antipsychotics.
In most cases, the psychogenic form of premature ejaculation is reversible. Therefore, one should not be shy and hush up the existence of a problem, and avoid the professional help of specialists. Of great importance in overcoming sexual dysfunction is the presence next to the man of an understanding and sensitive woman.