Premature ejaculation: Difference between revisions
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'''{{FULLPAGENAME}}''' "occurs when male sexual climax (orgasm) occurs before a man wishes it or too quickly during intercourse to satisfy his partner."<ref>{{REFweb | '''{{FULLPAGENAME}}''' "occurs when male sexual climax (orgasm) occurs before a man wishes it or too quickly during intercourse to satisfy his partner."<ref>{{REFweb | ||
|url=https://medical-dictionary.thefreedictionary.com/premature+ejaculation | |url=https://medical-dictionary.thefreedictionary.com/premature+ejaculation | ||
|title=Premature ejaculation | |title=Premature ejaculation | ||
|last | |last | ||
|first= | |first= | ||
|init= | |init= | ||
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|date=2008 | |date=2008 | ||
|accessdate=2022-10-21 | |accessdate=2022-10-21 | ||
}}</ref> Premature ejaculation (PE) has many causes, however | }}</ref> Premature [[ejaculation]] (PE) has many causes and proposed treatments,<ref>{{REFjournal | ||
|last=Barnes | |||
|first=Tricia | |||
|init=T | |||
|author-link= | |||
|last2=Eardley | |||
|first2=Ian | |||
|init2=I | |||
|author2-link= | |||
|etal=yes | |||
|title=Premature ejaculation: the scope of the problem | |||
|trans-title= | |||
|language= | |||
|journal=J Sex Marital Ther | |||
|location= | |||
|date=2007-03 | |||
|volume=33 | |||
|issue=2 | |||
|article= | |||
|page= | |||
|pages=151-70 | |||
|url=https://www.jsm.jsexmed.org/article/S1743-6095(15)31266-2/fulltext | |||
|archived= | |||
|quote= | |||
|pubmedID=17365515 | |||
|pubmedCID= | |||
|DOI=10.1080/00926230601098472 | |||
|accessdate=2022-10-21 | |||
}}</ref> The [https://www.nhs.uk British National Health Service] offers some advice on premature ejaculation, including some drugs, that may help.<ref name="nhs2023">{{REFweb | |||
|url=https://www.nhs.uk/common-health-questions/sexual-health/can-premature-ejaculation-be-controlled/ | |||
|title=Can premature ejaculation be controlled? | |||
|last=Anonymous | |||
|first= | |||
|init= | |||
|publisher=National Health Service | |||
|date=2023-10-09 | |||
|accessdate=2023-10-31 | |||
}}</ref> | |||
This article, however, will focus on male [[circumcision]] and the loss of the [[foreskin]] as a cause of premature ejaculation (PE). | |||
==Anatomical considerations== | ==Anatomical considerations== | ||
The [[glans penis]] is most heavily innervated at the corona. | The [[glans penis]] is most heavily innervated at the [[corona]]. | ||
The foreskin is noted for its freedom of movement and its [[gliding action]] which allows it to move to and fro during sexual intercourse.<ref name="lakshmanan1980>{{REFjournal | The [[foreskin]] is noted for its freedom of movement and its [[gliding action]] which allows it to move to and fro during sexual intercourse.<ref name="lakshmanan1980>{{REFjournal | ||
|last=Lakshmanan | |last=Lakshmanan | ||
|init=S | |init=S | ||
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|init2=S | |init2=S | ||
|title=Human prepuce: some aspects of structure and function | |title=Human prepuce: some aspects of structure and function | ||
|journal=Indian | |journal=Indian J Surg | ||
|volume=44 | |volume=44 | ||
|issue= | |issue= | ||
|pages= | |pages=134–7 | ||
|url=http://www.cirp.org/library/anatomy/lakshmanan/ | |url=http://www.cirp.org/library/anatomy/lakshmanan/ | ||
|quote=The outer layer of the prepuce in common with the [[shaft skin|skin of the shaft]] of the penis glides freely in a to and fro fashion and has to be delicate and thin, as was observed in this study. [...] The inner lining of the projecting tubular part has the structure of the outer layer and adds to the thin gliding [[skin]] when retracted. | |quote=The outer layer of the prepuce in common with the [[shaft skin|skin of the shaft]] of the penis glides freely in a to and fro fashion and has to be delicate and thin, as was observed in this study. [...] The inner lining of the projecting tubular part has the structure of the outer layer and adds to the thin gliding [[skin]] when retracted. | ||
|date=1980 | |date=1980 | ||
|accessdate=2022-10-21 | |accessdate=2022-10-21 | ||
}}</ref> | }}</ref> | ||
The foreskin typically covers the corona during the | The [[foreskin]] typically covers the [[corona]] of an [[intact]] male during the out stroke and protects it from excessive stimulation. | ||
==Circumcision and premature ejaculation== | |||
Gerard Zwang (1997) reported: | |||
<blockquote> | |||
Contrary to a tenacious mythology, the thickened glans of the [[circumcised]] penis is not always immune to pleasurable surfeit when brought in contact with vaginal mucous membrane. … Furthermore, there are many other [[circumcised]] males who have directly incriminated their mutilation for their lack of staying power.<ref name="zwang1997">{{REFbook | |||
|last=Zwang | |||
|first=Gerard | |||
|init= | |||
|author-link= | |||
|last2= | |||
|year=1997 | |||
|title=Functional and Erotic Consequences of Sexual Mutilations | |||
|url=https://link.springer.com/chapter/10.1007/978-1-4757-2679-4_5 | |||
|work=Sexual Mutilations — A Human Tragedy | |||
|editor=George C. Denniston and Marilyn Fayre Milos | |||
|edition | |||
|volume= | |||
|chapter= | |||
|scope= | |||
|page= | |||
|pages=67-76 | |||
|location=New York | |||
|publisher=Plenum Press | |||
|ISBN=978-1-4419-3275-4 | |||
|quote= | |||
|accessdate=2022-10-21 | |||
|note= | |||
}}</ref> | |||
</blockquote> | |||
Zwang had discovered that [[circumcision]] moves the dominant sexual stimulation from the nerves in the [[foreskin]] to the nerves in the corona of the [[glans penis]] with consequent loss of control of ejaculation. | |||
Although Yang et al. (2018) claimed that [[circumcision]] has no effect on premature ejaculation,<ref>{{REFjournal | |||
|last=Yang | |||
|first= | |||
|init=Y | |||
|author-link= | |||
|last2=Wang | |||
|first2= | |||
|init2=X | |||
|author2-link= | |||
|last3=Bai | |||
|first3= | |||
|init3=Y | |||
|author3-link= | |||
|last4=Han | |||
|first4= | |||
|init4=P | |||
|author4-link= | |||
|etal=no | |||
|title=Circumcision does not have effect on premature ejaculation: A systematic review and meta-analysis | |||
|trans-title= | |||
|language= | |||
|journal= Andrologia | |||
|location= | |||
|date=2018-03 | |||
|volume=50 | |||
|issue=2 | |||
|article= | |||
|page= | |||
|pages= | |||
|url=https://onlinelibrary.wiley.com/doi/10.1111/and.12851 | |||
|archived= | |||
|quote= | |||
|pubmedID=28653427 | |||
|pubmedCID= | |||
|DOI=10.1111/and.12851 | |||
|accessdate=2022-10-22 | |||
}}</ref> others have also observed and reported more premature ejaculation in [[circumcised]] men as compared with [[intact]] men. Women reported that their [[circumcised]] partners were more likely to have premature [[ejaculation]].<ref name="ohara1999">{{REFjournal | |||
|last=O'Hara | |||
|first= | |||
|init=K | |||
|author-link= | |||
|last2=O'Hara | |||
|first2= | |||
|init2=J | |||
|author2-link= | |||
|etal=no | |||
|title=The effect of male circumcision on the sexual enjoyment of the female partner | |||
|trans-title= | |||
|language= | |||
|journal=BJU Int | |||
|location= | |||
|date=1999-01 | |||
|season= | |||
|volume=83 Suppl 1 | |||
|issue= | |||
|article= | |||
|page= | |||
|pages=79-84 | |||
|url=http://www.cirp.org/library/anatomy/ohara/ | |||
|archived= | |||
|quote= | |||
|pubmedID=10349418 | |||
|pubmedCID= | |||
|DOI=10.1046/j.1464-410x.1999.0830s1079.x | |||
|accessdate=2022-10-21 | |||
}}</ref> Vissing (1999) reported more premature ejaculation in areas where most men have had a [[Brit Milah| ritual circumcision]].<ref>{{REFjournal | |||
|last=Vissing | |||
|first= | |||
|init=M | |||
|author-link= | |||
|etal=so | |||
|title=Premature ejaculation and circumcision: biogenic or a cultural factor | |||
|trans-title= | |||
|language= | |||
|journal=Scand J Sexol | |||
|location= | |||
|date=1999 | |||
|season= | |||
|volume=3 | |||
|issue=3 | |||
|article= | |||
|page=103 | |||
|pages= | |||
|url=http://www.cirp.org/library/sex_function/vissing1/ | |||
|archived= | |||
|quote= | |||
|pubmedID= | |||
|pubmedCID= | |||
|DOI= | |||
|accessdate=2022-10-21 | |||
}}</ref> Masood et al. (2005) surveyed men who had experienced an [[adolescent and adult circumcision| adult circumcision]]. 13 percent reported that [[adult circumcision| circumcision]] had improved premature [[ejaculation]], but 33 percent found it worse.<ref name="masood2005">{{REFjournal | |||
|last=Masood | |||
|first= | |||
|init=S | |||
|author-link= | |||
|last2=Patel | |||
|first2= | |||
|init2=HRH | |||
|author2-link= | |||
|last3=Himpson | |||
|first3= | |||
|init3=RC | |||
|author3-link= | |||
|last4= | |||
|first4= | |||
|init4= | |||
|author4-link= | |||
|last5= | |||
|first5= | |||
|init5= | |||
|author5-link= | |||
|last6= | |||
|first6= | |||
|init6= | |||
|author6-link= | |||
|etal=yes | |||
|title=Penile sensitivity and sexual satisfaction after circumcision: Are we informing men correctly? | |||
|trans-title= | |||
|language= | |||
|journal=Urol Int | |||
|location= | |||
|date=2005 | |||
|season= | |||
|volume=75 | |||
|issue=1 | |||
|article= | |||
|page= | |||
|pages=62-6 | |||
|url=http://www.cirp.org/library/sex_function/masood1/ | |||
|archived= | |||
|quote= | |||
|pubmedID=16037710 | |||
|pubmedCID= | |||
|DOI=10.1159/000085930 | |||
|accessdate=2022-10-21 | |||
}}</ref> | |||
Papers by notorious circumcision promoters [[Brian J. Morris]], [[John N. Krieger]], and [[Guy Cox]] were excluded from consideration due to overwhelming [[bias]]. | |||
{{SEEALSO}} | |||
* [[Neurotomy]] | |||
* [[Sexual effects of circumcision]] | |||
{{REF}} | {{REF}} | ||
[[Category:Circumcision complication]] | [[Category:Circumcision complication]] | ||
[[Category:Circumcision risk]] | [[Category:Circumcision risk]] | ||
[[Category:Male sexuality]] | |||
[[Category:Penile disorder]] | [[Category:Penile disorder]] | ||