The psychogenic form of premature ejaculation is early ejaculation caused solely by psychological factors in the absence of organic problems. Disease may be associated with the neurosis of expectation of failure, sexual overexcitation, irregular sexual life and other reasons. With this form of sexual dysfunction, the duration of sexual intercourse in a man may be different with different partners; fear of sexual contact is formed, self-esteem decreases. With pathology, a man needs the help of an andrologist-sexologist or psychologist.
General information
The psychogenic form of premature ejaculation is a short sexual act with rapid ejaculation caused by external or internal traumatic factors. Disease is not associated with physiological (organic) causes (hypersensitivity of the glans penis, neurological pathology, urological problems – prostatitis, vesiculitis, micropenis, etc.). At the heart of its development, to one degree or another, there is a psychogenic component. This pathology in the future can lead to psychogenic impotence, therefore, it is studied not only in the framework of sexology and psychotherapy, but also urology and andrology.
Classification
Approximately 80% of cases of various sexual dysfunctions in men and women are more or less related to psychological factors. In women, psychogenic disorders of sexual function include the absence (alibidemia) or decrease (frigidity) of sexual desire, non-onset of orgasm (anorgasmia), soreness of sexual intercourse (dyspareunia or genitalgia), reflex convulsive contraction of the muscles of the genital tract (vaginismus).
Psychogenic sexual disorders in men include decreased libido or lack thereof, psychogenic erectile dysfunction or impotence, ejaculation disorder (premature ejaculation, anejaculation, asthenic ejaculation), weakening or lack of orgasm, fear of sexual insolvency. The psychogenic form of premature ejaculation can be permanent or transient.
Causes
Most often, premature ejaculation of a psychogenic nature is based on excessively strong sexual arousal. Usually sexual overexcitation is characteristic of young people who have recently started sexual life, but it can also be inherent in quite mature and experienced men. Too much 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, a man can no longer arbitrarily control the ejaculation process, so 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 very successful “sexual debut”, which may be associated with the inexperience of a young man, a state of intoxication, fear of being rejected or ridiculed, fear of not satisfying a partner, etc. An anxious expectation of sexual failure often occurs in anxious-hypochondriac individuals with a weak sexual constitution.
Quite often, the problem of the psychogenic form of premature ejaculation lies in the plane of interpersonal relations between sexual partners. In this case, the psychological factors of premature ejaculation may be the lack of mutual understanding and trust between a man and a woman, fear of betrayal, lack of deep affection for each other, dissatisfaction with relationships, fear of infection with STIs, etc. Men who are in a state of chronic stress or depression, experiencing a lack of rest and sleep, may also develop a psychogenic form of premature ejaculation.
Sometimes the psychogenic form of premature ejaculation is strictly selective (situational) in nature, i.e. it manifests itself only during sexual intercourse with a certain woman or in a certain situation.
Symptoms
The inability of a man to ensure sexual satisfaction of his partner violates family relationships and often leads to a breakup of relationships. 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. Improving the situation is usually facilitated by thoughts 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 may be normal or weakened a second time.
Diagnosis and treatment
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, ultrasound, functional tests, examination of prostate secretions 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 is lengthened. If the problem persists, the man needs the help of a psychologist (psychotherapist) or a sexologist. Psychotherapy (suggestive therapy, hypnotherapy, autogenic training) becomes the leading method of treating the psychogenic form of premature ejaculation. At the same time, explanatory work is carried out with a spouse or a permanent sexual partner.
To reduce increased anxiety, vibrating massage of the perineum, ascending and circular showers, shared baths, galvanization and inductothermy of the spinal centers can be shown, reducing the excitability of the ejaculatory center and simultaneously having a psychotherapeutic effect. In some cases, the appointment of antidepressants, tranquilizers and neuroleptics helps to overcome sexual dysfunction.
In most cases, the psychogenic form of premature ejaculation is reversible. Therefore, one should not be shy and conceal 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.