Pathophysiology of PE
Premature ejaculation as a psychological problem does not involve any known disease of the male reproductive tract or any so far discovered problems of the brain or nervous system. Could the problem lie somewhere in the male reproductive system (i.e., penis, prostate, seminal vesicles, testicles)? The answer is that we do not really know. But when PE happens before satisfying intercourse is completed, both the man and his partner will be dissatisfied both emotionally and physically.
Premature ejaculation has often been spoken of as a psychological problem. As you may have seen, some experts have suggested that young men are conditioned by societal pressures to ejaculate in rapid order because of fear of discovery when masturbating or during early sexual experiences. But although this may become a habit, it’s hard to imagine it is actually an ingrained physiological response which cannot be changed later in life. Therefore, some researchers have suggested there may be a physical cause, such as differences in nerve conduction rates or hormonal differences between men: even hyper-excitability or oversensitivity of the penile nerves has been suggested. This would stop down-regulation of their sympathetic nervous system pathways and inhibit delay of orgasm.
In some cases premature ejaculation represents other issues: e.g. a cardiac patient may fear a myocardial infarction during sex, and so develop premature ejaculation.
But it is logical from an evolutionary point of view that males who ejaculated rapidly would have more success when mating and fertilizing a female than those who needed prolonged mating time. Therefore, the genes of a male who came quickly would stand more chance of passing his genes on to the next generation – and also, a male who took a long time to mate might well be killed because of his vulnerability during intercourse.
Frequency of premature ejaculation
Premature ejaculation occurs in between 30 and 70% of men. The percentage is similar in all age categories: of course, erectile dysfunction becomes more common in older age groups. Since many men do not discuss rapid or premature ejaculation with their doctor, probably because of embarrassment or a sense of hopelessness around a cure, or even because they are satisfied with the quality of their ejaculations (no matter how quickly they occur), the proportion of men who have premature ejaculation in their lives is almost certain to exceed conventionally accepted figures of 30%.
Race and premature ejaculation
No firm data exists on the subject.
Age and premature ejaculation
Premature ejaculation is most common in younger men (in an age group between 18 and 30 years) but is far from uncommon in men aged 45-65 years, where it is often associated with erectile dysfunction.