Premature ejaculation has been with humans throughout history, but over time the theories of its causes and treatments have changed considerably. Premature ejaculation is a disorder with physical, psychological, social, and genetic components, which have added to the complexity of the conversation over time. Here are some landmarks in the history of human thought on this important subject.
- In ancient India, the Kama Sutra describes early ejaculation, and notes that it can displease the woman. It documents the relationship conflict that can result from premature ejaculation, and openly discusses women’s sexual desire.
- Ancient Egyptians depicted the lotus flower as increasing arousal and reducing anxiety, and thus as a sexual aid. Early ejaculation is also mentioned in documents dating from Greek antiquity.
- In China, Taoist philosophers taught delayed ejaculation as a means to maintain strength and discipline.
- In 1917’s Married Love, Dr. Marie Stopes mentions premature ejaculation as a source of women’s sexual frustration, but doesn’t offer advice or treatments.
- In the first decades of the 1900’s, premature ejaculation was treated as a neurosis, with psychotherapy. Karl Abraham theorised that it stemmed from unresolved Oedipal conflicts, and was an act of subconscious aggression toward the female partner.
- As late as 1940, physicians seeking physical causes for premature ejaculation thought it was caused by a defective verumontanum, and was sometimes treated with cauterization.
- In 1948, when Kinsey and his team published their research, they found that 75% of men ejaculate within 2 minutes of the onset of intercourse, which helped contribute to the body of knowledge.
- Masters & Johnson, in 1970, speculated that premature ejaculation could be caused by early sexual experience, where a person masturbates to orgasm quickly, out of shame or fear of being caught. This creates social conditioning toward rapid sexual response. Masters & Johnson advocated the “squeeze” technique, which involved delaying orgasm by squeezing the penis.
- The 1990’s first saw SSRIs introduced as an effective, but off-label, treatment for premature ejaculation.
Of course, there is still tremendous difficulty in reaching scientific and medical consensus regarding the condition, both in terms of a specific definition and in terms of how widespread a problem it may be. The complexity of the current discourse is heightened by the fact that we have now classified 4 distinct types of premature ejaculation:
- Lifelong: Ejaculation occurs too early in nearly every sexual encounter, from early in life onward. Most sufferers climax within seconds, and all of them within 2 minutes of the onset of intercourse.
- Acquired Early ejaculation occurs at some point when it has not in the past. Onset is at a later age, and is often concurrent with other physical or psychological changes.
- Variable: Early ejaculation is inconsistent. Time before ejaculation may be short or within the normal range.
- Subjective: Ejaculation may be within a statistically normal time frame, but the self-perception of the sufferer is of inconsistent and early ejaculation.
While, as we have seen, time has seen many changes in theories regarding premature ejaculation, our current understanding is that there are many causes, which may occur singly or be compounded. Currently, doctors, therapists, scientists, and researchers have only created more theoretical causes, rather than narrowing them down.
- Physical causes: Physical illnesses and injuries may cause premature ejaculation, or there may be specific neurological contributing factors. Studies have shown that many men who suffer from premature ejaculation have stronger than average neurological responses.
- Mental causes: Mental health issues such as general anxiety or some personality disorders may contribute to premature ejaculation.
- Psychosocial: premature ejaculation may also be caused by transitory social factors like illness or stress. These factors may resolve on their own, but a person may also learn lasting sexual behaviours during this period that leave a legacy of premature ejaculation.
- Genetic: Many evolutionists believe that premature ejaculation is an adaptation that allowed early men to copulate in the midst of physical danger. Also, recent studies have shown that men suffering from lifelong premature ejaculation are likely to have a close male relative with the same condition, although this research is still in early phases.
As we can see, early ejaculation has been with humans throughout recorded history, and is still a source of complex speculation. However, the modern era has also brought us many effective treatments, informed by almost a century of modern scientific research.
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