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Defining Premature Ejaculation with the help of patient symptom
Case scenario 1
Hello doctor my name is Raju, aged 38, married from last 5 years. I have been suffering from quick ejaculation from the time of my marriage since i started my sex life; it’s like not even few minutes i get for sexual intercourse and sometimes i ejaculate before sexual intercourse during the time of foreplay itself. My erections are good and i am satisfied with my erections. I do not suffer from any other major illness. Am really worried about my ejaculation time as i am not able to satisfy my wife and we are leading an unsatisfied sex life. Most of the time my wife never feels the orgasm as i ejaculate within few minutes of intercourse. Sometimes she gets orgasm by foreplay and oral sex but majority of times she feels unsatisfied. This problem is creating a lot of stress in me and it’s creating some kind of disharmony among both of us. Am really tensed and worried, please help doctor. Is PE curable?
Interpretation by Sex and Infertility Specialist: Dr. Hameed Ibrahim
This is one of the most common presenting symptoms in a patient who is suffering from Primary Premature Ejaculation. Since the time the patient has started his sex life he is suffering from rapid climax or severe form of Premature Ejaculation. He is not able to extend his sexual intercourse (Vaginal Penetration) for more than 2 minutes even causing lack of orgasm in his wife. This condition over a period of few years leads to gradual loosing of interest in sex specially in patients wife, because due to repeated non orgasmic sexual intercourse, patients wife gradually looses interest in sex and does not give importance to sex and the frequency of sexual intercourse goes down gradually which in turn aggravates the problem of PE in her husband leading to complete loss of satisfied sex life.
Thus PE has to be understood after analyzing the satisfaction level among both the partners, if they feel they are unsatisfied and it’s leading to non orgasmic sexual intercourse in majority of times in either of the partner then there is some degree of PE.
There is no exact definition of PE and there is no exact time duration for sexual intercourse. It is stated that a man suffers from premature ejaculation if he ejaculates before his sex partner achieves orgasm in more than fifty percent of their sexual encounters. Various researches suggest that 85% of women NEVER achieve an orgasm during intercourse, and 72% of women said that they have lied to their lover about having an orgasm, which they never actually had.
Through Dr. Hameed Ibrahim’s Cognitive Behaviour therapy (CBT) and counselling and through Multi Specialty Ayurveda treatment based on Rasayana, Rasa shastra, and Vajeekarana treatment, PE can be permanently and effectively controlled, thus giving you a satisfied sex life. Proper Cognitive counseling is equally required for both the partners to control Primary PE.
Case scenario 2
Hello doctor my name is Imran, aged 45, married from last 12 years. Off lately i have started to notice that during sexual intercourse, i ejaculate very fast and this problem was not there previously of initial 6 years of my marriage. Now i ejaculate very fast within few minutes and am not able to have a satisfied sex life. I have noticed that my erections are also not that strong like before. I do not suffer from any other major illness. Please help me doctor so that i can have a satisfied sex life as i was having in the initial 6 years of my marriage.
Interpretation by Sex and Infertility Specialist: Dr. Hameed Ibrahim
This condition is called as Secondary Premature Ejaculation, where in the patient was happy and satisfied with his sex life in the initial 6 years of his married life. Later he developed secondary Premature Ejaculation and associated erection problem as well. Therefore Erection problem can also cause PE which is 100 % curable. Once the erection is rectified, there is optimum level of blood circulation to the penis making the nerves healthy and helps in pr4oper stimulation conduction to the brain in most appropriate way. Thus this condition can easily be treated as compared to Primary PE.
Primary PE requires Behavioral changes and sexual intercourse method changes along with correct and targeted Herbo-Mineral medicine. Proper Cognitive counseling is equally required for both the partners to control Primary and as well as secondary PE.
Case scenario 3
My name is Abhilash, aged 27, unmarried, persuading my post graduate studies. Doctor i ejaculate very fast whenever i do Masturbation and i find leakage of colourless sticky fluid from my penis whenever am sexually aroused and whenever i talk with my Girl friend related to sex. While doing Masturbation i do not last even more than 2 minutes. On few occasion i had sexual intercourse with my girl friend but i could not even penetrate because i ejaculated during foreplay itself. I feel am suffering from severe form of Premature Ejaculation. Please help me doctor as am very much worried thinking about my future married sex life.
Interpretation by Sex and Infertility Specialist: Dr. Hameed Ibrahim
This is one of the most common presentations of assumed problem of Premature Ejaculation conveyed by Majority of unmarried males with no active sex life. Here what they fail to realize is that PE should never be assumed or judged based upon Masturbation or few attempts of sexual intercourse. Our body requires time to adjust itself with sex life and sexual maturity is very much required to assess whether a person has PE or not. In majority of unmarried individuals there is always some degree of anxiety, curiosity, and fear related to sexual intercourse and that’s one more reason for quick PE. Thus in short sexual maturity and experience in sexual life is very much required before judging whether a person has PE or not. Therefore such patients should come out of there constant worries thinking that they are suffering from PE and they should lead a normal life and wait till sexual maturity or regular sex life starts in their sex life. Here Sexual Maturity means regular sex life.
Leakage of sticky colorless fluid is nothing but prostatic fluid or fluid from bulbourethral glands or in common terms called as Pre Cum or pre-ejaculate or lubricating fluid which is 100 % normal response created by our body whenever a person is sexually excited. When sexually aroused, the glands produce a mucous like fluid called pre-ejaculate. The pre-ejaculate fluid is a viscous, clear, and salty liquid that neutralizes any residual acidity in the urethra. The now neutralized urethra is a more hospitable environment for the sperm to travel in. This fluid also lubricates the vagina and maintains an optimum Ph for the sperm to travel and stay alive. High acidic ph of vagina can kill the sperm. Therefore leakage of this fluid is normal and has importance. In some people these glands are over reactive, whenever there is minimal sexual excitement, it causes discharge of too much of this fluid which sometimes creates anxiety and worry in few individual thinking that they have some disorder. Again it’s a normal phenomenon. The over reactive glands can some time predict that the person might have Premature Ejaculation in his sex life, therefore we have seen many individuals with over reactive glands suffering from Premature Ejaculation. Thus with the right combination of Herbo-mineral medicine, this excess discharge of fluid and Premature Ejaculation can be controlled.
Majority of unmarried individuals judge themselves that they are suffering from PE from masturbation alone. Masturbation and Sexual Intercourse with a female is like the side of two coins which are entirely different, therefore young and unmarried individuals should not simply worry and get anxious thinking that they are suffering from PE. Masturbation is an act of self sexual satisfaction which majority of individual do it regularly and they tend to finish the act within few minutes. Nobody tries to prolong the act nor do they do it slowly, whenever they are in the mood they self stimulate their genitals and within few minutes they ejaculate but Sexual Intercourse is different and our body and mind needs to get accustomed with sexual act which needs some time.
Therefore in short, PE should never be judged by Masturbation or irregular sex life.
Concepts related to Premature Ejaculation and its understanding and Dr. Hameed Ibrahim’s approach for the same.
It’s almost impossible to get an accurate definition of premature ejaculation: what some couples consider a satisfactory length of intercourse would be very inadequate for others.
At the 2006 Congress of the European Society for Sexual Medicine, an American research paper reported:
The average lasting time of men with PE was 1.8 minutes
‘Normal’ men lasted an average of 7.3 minutes.
But there were males who claimed to have premature ejaculation, yet who could last up to 25 minutes. This clearly shows people have wildly differing ideas about what is normal.
At the same Congress, it was reported that 2.5 per cent of men couldn’t last 90 seconds inside the vagina. Those males undoubtedly have PE.
From our own clinical experience, there are plenty of couples who would regard intercourse that lasts under 20 minutes as less than satisfactory, and would feel that any ejaculation in less than 10 minutes or so is decidedly premature.’As a working definition, if either you or your partner feels that orgasm is happening too soon, then there is probably some degree of PE.
For a’successful’sex life, proper’affection’should be present among both the partners and both the partners should love each other, understand each other, value each other, respect each other and have the desire for sex equally, then only proper psychological and physical’arousal’takes place for a successful sexual intercourse.
Many times it’s seen that, there is some degree of relationship issues, or lack of proper sexual understanding between partners’, lack of correct sexual knowledge, too much anxiety and wrong methods of sexual intercourse, curiosity and worry among the partners can create some degree of PE.
Hyper sensitive Glans penis and previous habit of Masturbation can cause PE in many males.
Masturbation is one such habit which is one of the main reasons for PE, because a person’s mind and body gets accustomed to ejaculation within few minutes during Masturbation, which prevails even after starting the sex life. Therefore habit of Regular Masturbation for years actually causes PE in many men.
Today science has agreed that Premature Ejaculation is no Longer considered a Mental Disorder
Today it is believed (but not proved) that the neurotransmitter Serotonin (5HT) has a central role in modulating ejaculation. Several animal studies have demonstrated its inhibitory effect on ejaculation modulated through the PGI system in the brain. (Serotonin is a neurotransmitter, regulating signals between neurons.) Therefore, it is perceived that low level of serotonin in the synaptic cleft in the specific areas in the brain could cause premature ejaculation.
Dr. Hameed Ibrahim’s Scientific understanding regarding the cause of PE
It is said that stimulation response going to brain via the neurotransmitters or in other words, communication between brain cells via neurotransmitters in the brain are abnormal in cases of PE which needs to be corrected safely without any side effects and injury to brain cells, with the right combination of Ayurveda- Herbo- Mineral Medicines.
Majority cases of Premature Ejaculation can be controlled to a great extend if proper stimulation of the penis or Oral sex is done in every attempt of sex, which makes the brain understand and respond normally to the stimulation through the process of adaptation. And if the stimulation is not done then brain does not understand this impulse which leads to over sensitivity of penile nerves which in turn leads to Premature Ejaculation. One more reason for PE is that, men who suffer from premature ejaculation have a faster neurological response in the pelvic muscles. This we call it as over sensitive Nerves or Nervous weakness, which can effectively be treated with the right combination of Herbo- Mineral Medicine.
Here is where Dr. Hameed Ibrahim’s Cognitive Behaviour therapy (CBT) and counselling and through Multi Specialty Ayurveda treatment based on Rasayana, Rasa shastra, and Vajeekarana treatment, PE can be controlled and treated effectively.
Treatment of Premature Ejaculation in Allopathic system of medicine
Allopathic System of Medicine follows SSRI treatment for Premature Ejaculation. First let us find out what is this SSRI treatment.
SSRI means Selective serotonin reuptake inhibitors which mean it increases the serotonin level in the brain. Let us see what serotonin is all about. Serotonin is a neurotransmitter, it relays signals between nerve cells (neurons), controlling their intensity. It regulates signals between neurons. Normally once a neurotransmitter has transmitted its neural impulse it is generally reabsorbed. SSRIs inhibit the re-absorption of serotonin and thus serotonin levels in the body increase. It is believed that changing the balance of serotonin in the body helps brain cells send and receive messages, and in turn this boosts overall mood. As a neurotransmitter, serotonin influences both directly and indirectly the majority of brain cells. The following is a list of things that serotonin could affect:
- Mood and social behaviour
- Appetite and digestion
- Sleep
- Memory
- Sexual desire and function.
- Serotonin is a chemical made by the human body that works as a neurotransmitter. It is believed by some researchers that, it’s a chemical that is responsible for maintaining mood balance, and that a deficiency of serotonin leads to depression.
- Serotonin is manufactured in the brain and the intestines. The majority of the body’s serotonin, between 80-90%, can be found in the gastrointestinal tract.
- Serotonin that is used inside the brain must be produced within it.
- It is thought that serotonin can affect mood and social behaviour, appetite and digestion, sleep, memory and sexual desire and function.
- Selective serotonin reuptake inhibitors (SSRIs) can affect the levels of serotonin in the body.
- There is no test till date which can measure the level of serotonin in the living brain, measurement of serotonin in the blood is only possible today.
The link between serotonin and depression
It is unknown precisely what causes depression. It is thought to be likely that an imbalance of neurotransmitters or hormones in the body can lead to this disorder. An association has been made between depression and serotonin, although scientists are unsure whether decreased levels of serotonin contribute to depression or depression causes a decrease in serotonin levels. SSRIs are approved by the Food and Drug Administration (FDA) to treat depression and are the most commonly prescribed antidepressants. Common examples of SSRIs are citalopram, fluoxetine, paroxetine and sertraline.
Dr. Hameed Ibrahim’s View on SSRI TREATMENT FOR PREMATURE EJACULATION
Today science has agreed that Premature Ejaculation is no Longer considered a Mental Disorder, if so then why Allopathy suggests SSRI medicine which is used to treat Depression and other mental disorder for Premature Ejaculation?
SSRI treatment rebranded from antidepressant treatment to treatment for Premature Ejaculation, is it a gimmick?
SSRI is the approved FDA treatment, for treating depression and certain mood disorders and not Premature Ejaculation. Its 100 % not clear as how exactly it acts on depression. Therefore the FDA approved SSRI treatment for depression is still under research and precisely not known as how it acts then how can it be used for treating Premature Ejaculation. When SSRI treatment is the main line of treatment in Allopathy, as of today to treat depression but which is still under research and mechanism not fully understood then how can this treatment be applied to treat Premature Ejaculation?
Many experimental researches were done and it was observed that serotonin (5-HT), throughout the brain descending pathways, exerts an inhibitory role on ejaculation. Many researchers observed contradicting claim for this and thus it’s again not 100 % clear as how SSRI treatment can delay ejaculation. Thus the treatment of choice for Premature Ejaculation should certainly not be SSRI. For instance, let’s consider that the SSRI medicines like citalopram, fluoxetine, paroxetine and sertraline and newly invented dapoxetine increases the serotonin level in the body by not allowing the serotonin to get re absorbed, and thus the increased level of serotonin delays ejaculation. Lets believe this claim for time been. SSRI medicine like Dapoxetine increases the level of serotonin and thus increased level delays ejaculation, here a question or contradiction arises: When dapoxetine and other similar SSRI medicine is given orally it increases the serotonin level in the blood and not in the brain, because of the blood brain barrier, therefore how can it be claimed that serotonin is increased in brain?
There is no test till date which can check the level of serotonin in living brain in humans, thus its a assumption that when serotonin level increases in blood then it might also increase in brain. Thus with this assumption and other reflex parameters and study of Central Nervous System SSRI medicine is indicated to treat premature ejaculation which is still not proved scientifically. Although it is widely believed that a serotonin deficiency plays a role in depression, there is no way to measure its levels in the living brain. Therefore, there have not been any studies proving that brain levels of this or any neurotransmitter are in short supply when depression or any mental illness develops. Blood levels of serotonin are measurable — and have been shown to be lower in people who suffer from depression ‘ but researchers don’t know if blood levels reflect the brain’s level of serotonin. Also, researchers don’t know whether the dip in serotonin causes the depression, or the depression causes serotonin levels to drop.
Thus when the original use of SSRI as antidepressants is still not fully understood how can Dapoxetine and similar SSRI medicine be used in the treatment of Premature Ejaculation?
Side effects of SSRI medicines
As a neurotransmitter, serotonin helps to relay messages from one area of the brain to another. Because of the widespread distribution of its cells, it is believed to influence a variety of psychological and other body functions. Of the approximately 40 million brain cells, most are influenced either directly or indirectly by serotonin. This includes brain cells related to mood, sexual desire and function, appetite, sleep, memory and learning, temperature regulation, and social behaviour. SSRI changes the chemistry inside your brain. This causes subtle changes in the way you feel, act, and behave. It also causes addiction and withdrawal symptoms’
In terms of our body function, serotonin can also affect the functioning of’our cardiovascular system, muscles,’and various elements in the endocrine system.
Thus medicine which alters the level of serotonin or disturbs the natural equilibrium of serotonin level, can play havoc in the entire system of our body and can be potentially very dangerous. Thus SSRI’s can create fatal side effects. It causes severe form of Erectile Dysfunction, delayed ejaculation, loss of libido, difficulty attaining orgasm and mood disorders therefore if SSRI medicines are used for treating Premature Ejaculation, it causes complete loss of erection, libido, orgasm problems, delayed ejaculation etc.
Thus in short SSRI medicines are originally used as antidepressants and is been prescribed off label to treat Premature Ejaculation and if this medicine is used for long term then it leads to complete failure in sex life.
The same concept applies for the newly invented Dapoxetine, which is again a SSRI class of medicine.
How OUR TREATMENT WORKS, Multi Specialty approach through Ayurveda system of medicine based on the following treatment modalities
Through Dr. Hameed Ibrahim’s Cognitive Behaviour therapy (CBT) and counselling and through Multi Specialty Ayurveda treatment based on Rasayana, Rasa shastra, and Vajeekarana treatment, PE can be controlled and treated effectively
Indian Medical Vedic Alchemy is a Sophisticated and Specialized branch of Ayurveda that deals with purified Minerals and Metals for specific therapeutic usage. Herbal compounds are effective, but in cases of chronic diseases, Ayurveda conveys solution to this problem which is called as Rasa Shastra, an alchemical fusion between rigorously purified minerals, Metals, active Herbs and organic compounds.
These medicines are found to be 10 to 20 times more potent that plain Herbal medicines and can replace surgeries in certain diseases. The science of Rasa Shastra contradicts the common notion’ Ayurveda Medicine acts slowly’ as medicine acts very fast and is most potent. Therefore Ayurveda Herbo Mineral Medicines are in par with modern allopathic system.
Rasayana chikitsa means the essence of all tissues and organs of the entire system of our body is nourished to its most purest and potent form. Rasayana also means the purification of all tissues from Rasa to Shukra, which means purification starting from the blood covering the entire tissues and organs of our body to the formation of healthiest most potent Male and female sex hormones, sex organs functioning, and products of sex organs like Sperm cell and Ovum.
Rasayana Chikitsa improves the metabolic process, which results in the best possible Biotransformation, and produce the best quality bodily tissues and organs including Sex Organs, and eradicates Senility and other diseases of Old age. It also has marked effect on reproductive organs and help in making most potent and healthy sperm and Ovum. It invigorates the body as a whole by sustaining the required balance between anabolism and catabolism. It also aims at giving strength to senses, mind and intellect. Hence Rasayana or rejuvenation is such a form of treatment in which all the tissues are nourished and enhanced. The nourishment of vital tissues helps in stopping old age. Thus it is useful for enhancement of qualities of life, span of life, increased intellect and enhanced physical strength.
Means Reproductive Medicine in Ayurveda.’Vaajikaran rasayan is the special category of rasayana chikitsa, which improve the reproductive system and enhance sexual functions. It acts on higher centre of the brain, i.e., the hypothalamus limbic system and neuro-endocrino-immune system. Vajikarana Chikitsa is an important treatment modality as per Ayurveda and proposed benefits are manifold including increased sexual capacity, healthy future progeny as well as in treatment of many common Male- Female Sexual Disorders and Infertility. A boon to infertile couples and an effective, result oriented, scientifically documented alternative to today’s modern Infertility treatments like IVF, ICSI etc. Various studies have showed that administration of vajikarana rasayana chikitsa corrects the level of various important hormones like FSH, LH, testosterone, prolactin, Progesterone, estrogens, which plays a very important role in normal functioning and production of healthy Sperm and Ovum which in turn is a boon to Infertile couples.
Research Article
Premature Ejaculation
Please read about the scientific and well documented research of the efficacy of Herbal Preparation called as (Occimum santum Linn.), Akarakarabha (Anacycluspyrethrum Linn.), in Ayurveda which has effectively cured Premature Ejaculation. This research work was approved and published in INTERNATIONAL JOURNAL OF RESEARCH IN AYURVEDA.
The motive to give example of one such kind of research is to say that Ayurveda has the tremendous scope and scientific backing to prove that chronic and long term diseases can be effectively cured in Ayurveda. In this research work, one of the Herbal preparations called as (Occimum santum Linn.), Akarakarabha (Anacycluspyrethrum Linn.), is used, therefore if Ayurveda is applied scientifically related to Rasa Shastra, Rasayana and Vajeekarana treatment which includes many rare and efficacious Herbs and Minerals, results can be astonishing and permanent. Therefore our motive to present this research work is just to convey the meaning that AYURVEDA HAS THE POTENTIAL and it’s scientifically proved and documented thus we follow authentic AYUR-VEDA. Therefore with our Multi Specialty Approach of Ayurveda Treatment in accordance to RASA SHASTRA, RASAYANA AND VAJEEKARANA, permanent cure for Premature Ejaculation is possible.
At Khokar Specialty Clinic,
Our expert physicians provide the right combination, dosage, potency, purity, processing, procuring of various Herbs and Minerals for treatment depending upon each individual, age, life style, immunity, diet and the severity. For diagnosing and treating PE we have the facility of ONLINE CONSULTATION, PHONE CONSULTATION, OR CONSULTATION THROUGH VIDEO CHAT for treatment to patients from worldwide and we can dispense our medication to them through Courier.
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