What Is Premature?

For years, sex therapists, researchers, and physicians have debated what should be the medical definition of premature ejaculation. There is still no worldwide agreement on one definition of what premature means in the context of ejaculation. Having one might help one day. But in the meantime, if you’re trying to figure out what premature means to you or to your partner, you can start by coming up with your own definition of premature.

Premature for What?

Most of us don’t talk about sex enough with our partners or healthcare providers. If we think there is a problem, we often want to skip the part where we talk about it, try to describe it, and work on it ourselves. It can seem much easier (and less anxiety provoking) to wait for a pill and hope our doctor will be as uncomfortable as we are and just write a prescription. One of the many problems with this approach is that we never define the problem for ourselves.

In the case of premature ejaculation, the question becomes, "Premature for what? What is it that you’re missing by ejaculating when you do?" Another way to ask this question is, "What is the goal of the sex you’re having?" If the goal is for everyone involved to have an orgasm, this can be accomplished even if one of you ejaculates first (when you think about it, someone almost always comes first). If the goal is to have a female orgasm from intercourse, then you need to know that a) most women don’t orgasm from intercourse, and b) you can do other things to increase the chances of having an orgasm through intercourse. The point is that most people assume they know the goal of every sexual encounter without ever asking themselves what they want from it. For example, is it possible that your ejaculation is “premature” because you have nothing else to look forward to?

What Is Premature for You?

You need to start by deciding how you are comfortable defining premature. Is it based on time (such as it’s premature if you ejaculate before 5 to 10 minutes of intercourse)? Is it based on satisfaction (such as it’s premature if you ejaculate before your partner has an orgasm)? Is it a problem if it happens once in a while versus happening all the time? It’s hard not to feel pressure from partners and the culture around us which says that a man should have complete control over his penis and be able to ejaculate when and where he wants. But it’s worth trying to think about how you feel and what you desire, as opposed to what you think others expect and want from your ejaculation abilities.

Does a Partner Have a Right to Define Premature?

If you’re in a committed relationship with someone you care about, consider and account for how your partner experiences your sexual activities. But if one of you thinks you’re premature and the other doesn’t, it’s a sign that there is a problem with communication and expectations, not ejaculation. So if you’re happy with when you ejaculate but your partner considers it premature, it is worth asking him why. Does he take your ejaculation timing as a sign of something? Is he comparing you to previous sexual experiences (this is a hard one to hear, but the bottom line is that if he can’t have sex with you in the present, without comparing the sex to previous experiences, something probably needs to be worked out on his end)? Having your partner define your ejaculation as premature can be painful, and it can feel like he doesn’t have a right to do it. Whether it’s his place to label the ejaculation as premature or not, once it’s out there, you’ve got to deal with it.

Times Change, So Can a Definition of Premature

If you’re struggling with premature ejaculation, one of the first things a doctor or therapist will ask is how long it’s been going on. He’ll also want to know how often it happens and if there have been other times in your life when you’ve felt you were premature ejaculating. For some men, premature ejaculation is constant. For many others, it comes and goes. I’d like to suggest that how you define premature can also change over time. What is premature in one sexual encounter might actually be way too long in another. This doesn’t make it any better. But the idea of premature ejaculation can seem so scary and monolithic that it’s important to remember that, in fact, it can be highly dependent on context.

Source: About.com

What are the sexual effects of alcohol on men?

Research has shown that the sexual effects of alcohol are different for men and women. This is likely the result of both physical and social differences in the way women’s bodies and men’s bodies react to alcohol and respond sexually.

Not surprisingly, the amount of alcohol consumed, and how often a man drinks, has an impact on whether there will be negative sexual effects of alcohol for men. Most of the research in this area has been with men who are, or were, alcoholics. Sexual effects in these studies include:

• Difficulty getting and maintaining erections
• Difficulty ejaculating/delayed ejaculation
• Reduced sexual desire
• Increased sexual aggression
• Infertility

As with women and alcohol, men may find that small amounts of alcohol increase sex desire and sociability. But positive quickly turns to negative as the amount of alcohol consumed increases. One of the differences researchers often point out is that most men consider an erection necessary for sex, and consuming high amounts of alcohol usually has a negative effect on erectile function.

How common are sexual effects of alcohol for men?

Because most of the research relies on men recalling past sexual experience and performance, and because research studies differ wildly in their methodology, narrowing down prevalence isn’t easy.

Estimates for men having difficulty with ejaculation range from 5-25% in some studies. Some researchers estimate that as many as 54% of alcoholic men have difficulties getting and maintaining erections, and decreased sexual desire has been found in between 31-58% of men across several studies.

The impact on men who are not alcoholics, and men who are drinking low to moderate amounts of alcohol is likely much less than this. And while drinking enough alcohol to become intoxicated may very well result in not being able to get an erection, if the man isn’t a chronic drinker, the erection difficulties should not persist.

Alcohol’s impact on testosterone in men

Researchers debate the impact of alcohol on testosterone in men. Whether they are definitive or not, there are several studies that show a decrease in testosterone both in alcoholic men and in non alcoholic men who drink enough to become intoxicated. Alcoholism can result in hypogonadism. However, with men who drink occasionally, testosterone levels return to normal, and moderate amounts of alcohol are not associated with reduced testosterone.

Can sexual effects of alcohol be reversed?

We don’t know the point at which sexual effects of alcohol such as erectile and orgasm difficulties become irreversible. We also don’t know exactly how long after a man stops drinking that his normal sexual functioning may resume.

One study of over 17,000 alcoholic men found that after several years of no alcohol 50% returned to normal erectile functioning, and the other 50% were either partially or completely unable to get an erection, even when sexual desire returned.

Sexual dysfunction due to alcohol abuse may also be caused by the kinds of diseases made worse by chronic alcohol consumption (for example diabetes and heart disease).

Sources:

1. Crenshaw, T.L. & Goldberg, J.P. Sexual Pharmacology: Drugs that Affect Sexual Function. New York: Norton, 1996.
2. Muthusami, K.R. and Chinnaswamy, P. “Effect of Chronic Alcoholism on Male Fertility Hormones and Semen Quality.” Fertility and Sterility. Volume 84, Issue 4 (2005): 919-924.
3. Seagraves, R.T. & Balon, R. Sexual Pharmacology: Fast Facts. New York : Norton, 2003.