Premature ejaculation is the inability of the patient to control the ejaculatory reflex for a sufficient time for normal satisfying intercourse for him and for his partner. This is the most common sexual disorder and it affects about 40% of the male population during sexual activity and it is said that there is not one man who has not experienced at some time during sexual activity. In some cases as one might imagine premature ejaculation is understandable and normal, for example, when it affects people who rarely have intercourse, or it might occur with one partner and not with another. Obviously the latter situation concerns the dynamics of the relationship.

Premature ejaculation is known as primary when it concerns a person at the beginning of his sexual life; and secondary when it occurs after a period of normality. Primary premature ejaculation can be of a psychological nature or medical, bearing in mind the fact that psychological unease accompanies almost always the medical disorder. Psychological causes are mostly a result of unease, anxiety, lack of self-esteem, lack of experience and doubt, whilst medical causes can derive from erectile disorders, innate deformities, peripheral nerve disorders and so on.

In some cases premature ejaculation is the result of erectile difficulty, that is the inability to maintain a rigid erection sufficient to have satisfying sexual intercourse; this results in an anticipated end to the erection which concludes with an uncontrolled ejaculation. In other cases premature ejaculation is a symptom of a neurological hypersensitivity that can derive from peripheral nerve disorders: or from disorders and irritations of the spinal cord, for example, in the case of disc hernia. Inflammation of the male genitalia, for example, inflammation of the gland (that is the terminal part of the penis), of the urethra, of the prostate and of the seminal vesicles can result in premature ejaculation which can obviously be resolved when these inflammations are cured.

Finally, a situation which deserves particular medical attention. That is, when the ejaculation is lacking the release of the seminal fluid. When this occurs one must quickly consult a specialist since, as well as being the result of certain surgical operations, for example, the removal of the prostate, it can also be a symptom of disease, sometimes serious, in the male genitalia (prostate cancer).

The seminal fluid which is expelled during the orgasm should be distinguished from the transparent fluid which is released during the first moments of sexual excitement. This fluid, which is not fertile, is produced by the Cowper urethral glands and is used to lubricate the urethra. It is also necessary to consult the specialist when one notices significant changes in the seminal fluid, for example when one notices the presence of blood or otherwise of a reddish colour (emospermiìa).

Sometimes ejacluation can be accompanied by pain and this occurs in several pathological situations such as inflammation. Therapy for primary premature ejaculation is based on sexual rehabilitation using several techniques that teach the person to recognize and control the various phases of sexual excitement, assisted by several specific pharmaceuticals. Secondary premature ejaculation can be resolved in many instances by simply resolving the basic problem using also the techniques mentioned above.