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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
Line 9: Line 8:
  |date=2008
  |date=2008
  |accessdate=2022-10-21
  |accessdate=2022-10-21
}}</ref> Premature ejaculation (PE) has many causes and proposed treatments,<ref>{{REFjournal
}}</ref> Premature [[ejaculation]] (PE) has many causes and proposed treatments,<ref>{{REFjournal
  |last=Barnes
  |last=Barnes
  |first=Tricia
  |first=Tricia
Line 37: Line 36:
  |DOI=10.1080/00926230601098472  
  |DOI=10.1080/00926230601098472  
  |accessdate=2022-10-21
  |accessdate=2022-10-21
}}</ref> however this article will focus on male [[circumcision]] and the loss of the [[foreskin]] as a cause of premature ejaculation.
}}</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
Line 48: Line 58:
  |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 of Surgery
  |journal=Indian J Surg
  |volume=44
  |volume=44
  |issue=
  |issue=
  |pages=134–137
  |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.
|pubmedID=
|pubmedCID=
|DOI=
  |date=1980
  |date=1980
  |accessdate=2022-10-21
  |accessdate=2022-10-21
}}</ref>  
}}</ref>  


The foreskin typically covers the corona during the outstroke and protects it from excessive stimulation.
The [[foreskin]] typically covers the [[corona]] of an [[intact]] male during the out stroke and protects it from excessive stimulation.


==Circumcision and premature ejaculation==
==Circumcision and premature ejaculation==
Gerard Zwang (1997) reported:
Gerard Zwang (1997) reported:
<blockquote>
<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>{{REFbook
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
  |last=Zwang
  |first=Gerard
  |first=Gerard
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  |year=1997
  |year=1997
  |title=Functional and Erotic Consequences of Sexual Mutilations
  |title=Functional and Erotic Consequences of Sexual Mutilations
  |url=
  |url=https://link.springer.com/chapter/10.1007/978-1-4757-2679-4_5
  |work=Sexual Mutilations — A Human Tragedy
  |work=Sexual Mutilations — A Human Tragedy
  |editor=George C. Denniston and Marilyn Milos Fayre Milos
  |editor=George C. Denniston and Marilyn Fayre Milos
  |edition=
  |edition
  |volume=
  |volume=
  |chapter=
  |chapter=
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  |note=
  |note=
}}</ref>
}}</ref>
<blockquote>
</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]]
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