According to the studies, 83% of men at some point experience nocturnal emission. When a young man experiences nocturnal emission, he will be shocked. If the person is unaware of the normal sexual process, he will be bewildered at what is happening to him.
Sometimes, it is hard to find out what exactly caused the involuntary orgasm. Sometimes, the person wakes up once the orgasm has occurred but in other instances, the person sleeps through it.
Premature ejaculation (PE) is a common complaint. The available evidence supports the notion that control and modulation of sexual excitement is learned behavior. If someone has learned it incorrectly or inadequately, they can relearn it. PE is only rarely caused by a physical or structural problem; in these cases it is usually associated with other physical symptoms, usually pain. In rare cases, PE may be associated with a neurological condition; infection of the prostate gland; or urethritis (inflammation of the duct that carries urine and semen to the outside of the body). With the rising prevalence of substance abuse, an increasing number of cases of PE are being diagnosed in patients withdrawing from drugs, especially opioids. PE may be of lifelong duration or develop in later life, especially if a difficult interpersonal relationship is one of its causes. Although PE is commonly associated with psychological symptoms, especially performance anxiety and guilt, these symptoms are its consequences rather than its causes. Once PE is firmly established, however, the accompanying psychological factors, especially in combination with sexual overstimulation, may form a self-perpetuating cycle that makes the disorder worse.
Premature ejaculation is common in adolescents where it may be made worse by feelings of sinfulness concerning sexual activity, fear of discovery, fear of making the partner pregnant, or fear of contracting a sexually transmitted disease (STD). All of these may be made worse by performance anxiety. Adults may have similar concerns as well as interpersonal factors related to the sexual partner.
In PE, ejaculation occurs earlier than the patient and/or the couple would like, thus preventing full satisfaction from intercourse, especially on the part of the sexual partner, who frequently fails to attain orgasm. PE is almost invariably accompanied by marked emotional upset and interpersonal difficulties that may add frustration to an already tense situation, which makes the loss of sexual fulfillment even worse. It is also important to differentiate male orgasm from ejaculation. Some men are able to distinguish between the two events and enjoy the pleasurable sensations associated with orgasm apart from the emission of semen, which usually ends the moment of orgasm. In these cases, the partner is capable of achieving orgasm and sexual satisfaction.
The physical examination of a patient who is having problems with PE usually results in normal findings. Abnormal findings are unusual. The best source of information for diagnosing the nature of the problem is the patient's sexual history. On taking the patient's history, the clinician should concentrate on the sexual history, making sure that both partners have adequate and accurate sexual information. Ideally, the sexual partner should participate in the history and is often able to contribute valuable information that the patient himself may be unaware of or unwilling to relate. The female partner should also be examined by a gynecologist in order to ascertain her sexual capabilities and to eliminate the possibility that the size or structure of her genitals is part of the reason for the male's premature ejaculation.
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