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Premature ejaculation (ejaculatio praecox, rapid ejaculation, or early ejaculation) is the most frequent male ejaculatory disturbance. During the last century, premature ejaculation has been considered from both a medical and a psychological view, often resulting in contrasting psychotherapeutic and drug treatment approaches. For a better understanding of the current debate regarding its etiology and treatment, it is important to consider the history of how clinicians thought about and treated premature ejaculation. History Waldinger distinguishes four periods in the approach to and treatment of premature ejaculation. The First Period (1887–1917): Early Ejaculation In 1887, Gross described the first case of early ejaculation in medical literature. A second report of von Krafft-Ebing followed in 1901. Although publications were rare, it is worth noting that during the first 30 years of its existence in the medical literature, early ejaculation was viewed as an abnormal phenomenon but not significantly as a psychological disturbance. The Second Period (1917–1950): Neurosis and Psychosomatic Disorder In 1917, Abraham described early ejaculation as ejaculatio praecox and stated that it was a symptom of a neurosis caused by unconscious conflicts. Treatment should consist of classic psychoanalysis. On the other hand, some physicians stated that premature ejaculation was due to anatomical urological abnormalities, such as a too short foreskin frenulum or changes in the posterior urethra, which had to be treated with incision of the foreskin or electrocautery of the verumontanum. In 1943, Schapiro argued that premature ejaculation was neither a pure psychological nor a pure somatic disorder, but a psychosomatic disturbance caused by a combination of a psychologically overanxious constitution and a weak ejaculatory system. Schapiro described two types of premature ejaculation, type B in which early ejaculation existed from the first intercourses and type A, which led to erectile dysfunction. Many years later, both types became distinguished as the primary (lifelong) and secondary (acquired) forms of premature ejaculation. The Third Period (1950–1990): Learned Behavior The biological component of premature ejaculation and therefore also drug treatment, advocated by Schapiro, was ignored by the majority of sexologists who advocated psychoanalytic treatment. This neglect became even more pronounced after Masters and Johnson claimed the high success rates of behavioral therapy in the form of the squeeze technique, an adaptation of the stop–start technique published by Semans in 1956. Masters and Johnson stated that men with premature ejaculation had learned this rapidity behavior as a result of their rushed initial experiences of sexual intercourse. The Fourth Period (1990 to Present): Neurobiology and Genetics Since the 1990s, there has been an increasing number of publications on the efficacy of SSRIs, clomipramine, and topical anesthetic creams in delaying ejaculation. At the same time, in 1998, Waldinger postulated a new neurobiological view arguing that premature ejaculation is related to disturbance of serotonin (5-HT) receptors in specific areas of the central nervous system with a possible genetic vulnerability.
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About The Author David Crawford is the CEO and owner of a Penis Enlargement Pills company known as Male Enhancement Group which is dedicated to researching and comparing male enhancement products in order to determine which male enhancement product is safer and more effective than other products on the market. Copyright 2010 David Crawford of Penis Enlargement Products This article may be freely distributed if this resource box stays attached.
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