July 29th, 2016
Premature ejaculation is a fairly common sexual dysfunction that is clinically defined as ejaculation of semen within one-two minutes of vaginal penetration (1). According to a new study reported in the Journal of Sexual Medicine, investigators suggested that the prevalence of premature ejaculation in the general population is approximately 30%, making it one of the most common sexual health issues (1).
Various etiological factors are linked to the pathophysiology of premature ejaculation. For example, it is believed that most cases of premature ejaculation are psychological and are caused by feelings of guilt, anxiety stress, relationship issues and discomforting/unusual situations. Biological causes of premature ejaculation include; damage to vital nerves due to a surgery or injury in the inguinal region, hormonal irregularities, thyroid dysfunction and ongoing infection of urethra or urinary system (1).
According to a new study reported in the Therapeutic Advances in Urology journal (2), investigators discovered that pelvic exercises can help a great deal in managing chronic or lifelong premature ejaculation in men. A team of Italian scientists enrolled 40 men with a lifelong history of premature ejaculation (with an intravaginal ejaculatory latency time of under one minute) in a 12-week pelvic exercises. After the completion of study period, 82.5% (or 33/40 patients) were able to regain the ejaculatory control. The mean post-therapy intravaginal ejaculatory latency time (IELT) was found to be 146.2 seconds and a fair percentage of study participants reported improvement in the sexual performance on the 6th month follow-up visit.
Besides premature ejaculation, pelvic exercises also helps in addressing other types of sexual ailments such as erectile dysfunction. According to another study, investigators enrolled 108 men with a chronic history of premature ejaculation and 122 men with a known history of erectile dysfunction in a prospective study. During the study period, each participant attended voluntary pelvic exercises session of at least 30 minutes coupled with electrical stimulation. After only 20 such sessions, the intracavernous pressure improved by 88% and 87% in premature ejaculation and erectile dysfunction group. Both groups reported remarkable improvement in the sexual performance and quality of sex life.
Lavoisier and associates explained the pathophysiology of erectile issues in the comprehensive paper published in the Physical Therapy journal (3). Investigators explained that the powerful and sustained contraction of ischiocavernosus muscle (in the penis) is responsible for the build-up of pressure during penile erection. Since the intracavernous pressure (or pressure inside the penis) is higher than the systolic blood pressure, the blood continues to pool in the penis to maintain sustained erection during intercourse. Disease processes that affects the strength or stability of ischiocavernosus muscle often leads to erectile dysfunction and/or premature ejaculation. However, the strength of pelvic floor and ischiocavernosus muscle can be regained with pelvic exercises.
Sexual dysfunction is a very sensitive topic for most men. In fact, it has also been observed that males avoid discussing these topics with their physicians which can delay the diagnostic process. But, keep in mind that delaying the diagnosis can only make symptoms worse and aggravate the risk of complications; such as relationship conflicts. It is therefore highly recommended to schedule your appointment with an expert at earliest convenience. Besides pelvic exercises, there are a number of other therapeutic and pharmacological options that can address these sexual health issues such as serotonin reuptake inhibitors like dapoxetine which is associated with promising results.
Dr. James Elist is a urologist who specializes in sexual health issues such as male sexual dysfunction, erectile disorders, impotency, and infertility.
1. Carson, C., & Gunn, K. (2006). Premature ejaculation: definition and prevalence. International journal of impotence research, 18, S5-S13.
2. Pastore, A. L., Palleschi, G., Fuschi, A., Maggioni, C., Rago, R., Zucchi, A., … & Carbone, A. (2014). Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: a novel therapeutic approach. Therapeutic advances in urology, 1756287214523329.
3. Lavoisier, P., Roy, P., Dantony, E., Watrelot, A., Ruggeri, J., & Dumoulin, S. (2014). Pelvic-floor muscle rehabilitation in erectile dysfunction and premature ejaculation. Physical therapy, 94(12), 1731-1743.
4. Pastore, A. L., Palleschi, G., Leto, A., Pacini, L., Iori, F., Leonardo, C., & Carbone, A. (2012). A prospective randomized study to compare pelvic floor rehabilitation and dapoxetine for treatment of lifelong premature ejaculation. International journal of andrology, 35(4), 528-533.