A condition in which a man ejaculates before his penis erects, at the moment of penetration or immediately afterwards. There have been many more lengthy and complex definitions but this is a workable one for all practical purposes.

What causes it?

There are probably about twenty reasons for premature ejaculation but the most common is that the otherwise normal man has not learned to recognize the sensations that immediately precede ejaculation. In most animals copulation is a very brief business but humans have developed skills in prolonging the whole process of arousal and delaying ejaculation so as to give both participants more sensations.

Just why some men can’t recognize the ‘almost there’ sensations and go beyond the point of no return before they want to is a complex subject and involves both physical and psychological factors.

• Physical disorders of the man’s genitals are rare causes-most men have no medical or anatomical reason for their premature ejaculation.

• Much more common, though, are the psychological causes, which include: a fear of women; a fear of being controlled by women; the view that women are really sexless and so don’t want a man to ejaculate in them; the view that sex is an unwelcome assault on the woman; and a general anxiety about or fear of sex. Such views are surprisingly common yet the man who holds them may not even realize that he does so-they are locked away in his unconscious mind. Previous bad experiences make many premature ejaculators worry that the same thing will happen again and they become so anxious that they ejaculate too soon once again.

• Poor masturbation training. Because of guilt a man may have masturbated only hastily and guiltily right from the beginning, with the result that as an adult he is programmed into speedy ejaculations.

• Furtive early intercourse, perhaps hastily in the back of a car or in the girl’s home, can produce men who become locked into fast arousal and ejaculation cycles.

• Feeling unsafe and anxious for any reason can cause premature ejaculation.

• Not having had sex or masturbated for some time makes some men ready to ejaculate at a moment’s notice.

• Some men with hostile feelings about their partner want (unconsciously) to punish her, so they withhold from her their ejaculation and the pleasure it gives her. Some men express their dissatisfaction or rage with their partner in this way rather than doing so outwardly. For a few men who cannot otherwise exert any power or control over their partner premature ejaculation is the only way they know.

• Fear of a particular sexual occasion-especially when it comes to extramarital sex-is a common cause of premature ejaculation, and many young men are so anxious at their first intercourse that they ejaculate too soon.

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Sexual dysfunction in the female usually is exhibited by an individual either who has never had an orgasm or who has had orgasms only occasionally by some form of non-coital activity. Such problems are primarily psychological and usually the result of early environmental or situational factors. They also may be responsible for the development of vaginismus and dyspareunia, although such symptoms commonly are associated with some type of pelvic pathology. Since many of these problems are psychological, a psychological understanding and approach is basic to dealing with the difficulty.

It is vitally important for the couple to develop both a good verbal and nonverbal communication, since lack of communication is often a major reason for sexual dysfunction. The sensate-focus program is one way of helping to develop good communication.

It is important to emphasize that sexual function is as natural as most other body functions and should not be the source of feelings of guilt or shame, although this is a common reaction in some patients, based on their early life experience. The therapist who has a good knowledge of sexual physiology and psychology is in a position to give adequate instruction in the various phases of sexual function, which is very important as far as the patients are concerned.

In the final analysis, it is vitally important for both partners to understand the psychological factors which so often cause most instances of sexual dysfunction. The need for mutual cooperation must be stressed, with evidence of love and compassion on the part of both husband and wife.

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If Breuer could shut his eyes to the evidence of sexuality, for interesting transference reasons of his own (Pollock, 1968), fortunately for the development of psychoanalysis Freud did not. In the cases he presented in the Studies on Hysteria (1893-1895), Freud was explicit in relating issues of sexuality and sexual conflict to the etiology of hysteria. Freud’s thinking led him in the direction of a reactive or defensive theory of neurosis which had at its basis sexual conflicts. More specifically, his clinical experience led him to hypothesize that the roots of hysteria, and presumably other neuroses, lay in an infantile sexual trauma which had been defensively repressed and which was re-expressed in the neurotic symptomatology. As Freud explored the reminiscences of his patients, following Breuer’s cathartic principle, he discovered more apparent evidence of such infantile sexual trauma in the recollections of his patients.

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Sex stereotypes are the basis for access discrimination, both because they characterize women as less equipped to handle effectively nontraditional occupational demands and because they specify that such jobs are inappropriate for women. Some examples of the consequences follow.

Selection. Sex discrimination has been repeatedly demonstrated in employee selection processes. Although a few studies found no differences in how men and women applying for masculine jobs were treated (e.g., Terborg and Ilgen), the majority do indicate a tendency toward sex discrimination. When rating predetermined resumes for suitability to a managerial position, males were found to be judged preferable to comparable females by both male college students and professional interviewers (Dipboye, Fromkin, and Wiback). In another investigation, the lowest acceptance rates and poorest evaluations for managerial positions were of female applicants (Rosen and Jerdee). Shaw demonstrated that sex bias prevailed among college recruiters whether the applicant’s resume indicated an MBA degree or a degree in mathematics. This) tendency to discriminate against women in hiring decisions has been found to be as true of| female subjects as of male subjects (Dipboye, Arvey, and Terpstra).

In many of the studies documenting discrimination in hiring decisions, perceived characteristics of the applicants also have been recorded. A look at these data makes clear the fact that sex stereotypes were used in formulating conception of applicants. Dipboye and others, for instance, found female applicants to be less experienced, decisive, informed, competitive, motivated, logical, and assertive than male applicants. Female applicants also were rated as friendlier, warmer, and more emotional than males. Although such data do not provide conclusive evidence that this type of discrimination is mediated by sex stereotypes, it strongly supports this idea.

Role norms are violated by the inconsistency between the gender of a female job applicant and the nature of the job in question. One might thus expect that the more feminine a potential female employee is perceived to be or the more nontraditional the job is, the more inappropriate her work interests would appear, and the more discrimination she would suffer. There is, in fact, some indication that sex bias in selection is more likely when traditionally masculine jobs rather than neutral or traditionally feminine jobs are in question (Cash, Gillen, and Burns). Results of several studies have additionally indicated that more attractive women (also, according to Bern, considered to be more feminine women) are at a disadvantage when they seek nontraditional positions. In one study, professional personnel consultants judged attractive women to be less qualified than unattractive ones with identical qualifications for low status masculine jobs (Cash and others). In another investigation, college students recommended that attractive women be hired less often for managerial positions but more often for clerical positions than their unattractive counterparts (Heilman and Saruwatari, in press). When the degree of inappropriateness of fit between the woman and a job is exaggerated, either by the definitively masculine nature of the job or the femininity of the woman, the likelihood of sex bias appears to increase.

Starting salary. Levitan, Quinn, and Staines reported that 95% of the American working women sampled at that time earned an average of $3,458 less than men with the same educational backgrounds and qualifications. This may be because men and women have very different jobs. There are instances, however, when a woman is offered a lower starting salary than a man for the identical position. This type of differential treatment on the basis of sex is yet another aspect of access discrimination.

Using an in-basket exercise, Terborg and Ilgen asked subjects to indicate a starting salary for each of four job applicants. The female applicant was given a significantly lower starting salary than a male counterpart. The authors suggest that this type of access discrimination can influence the applicant, even if she has received a job offer, to decide against taking the job. Thus it can be a subtle but nonetheless effective way of discouraging entry.

As Terborg has pointed out, some (e.g., Treiman and Terrell) have argued that lower salaries for women are justifiable for economic reasons. Generally the argument is that hiring women is not cost efficient; they yield fewer long-range payoffs but cost no less to train than men. This assertion is not borne out by facts. Although this is true under some circumstances, in the aggregate women have not been found to take more sick leave and/or terminate employment sooner than men (Hoffman and Nye). Given recent social trends, this is apt to be even less true in the future than it is now.

Impediments to women’s access into nontraditional careers often are substantial. They derive from the clearly delineated sex stereotypes that not only prejudice our views of women’s capabilities but also influence our beliefs about what women should be and most desire to be.

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The shepherd is forced, by definition, out of the ken of the community which depends upon physical presence for social control. The farmer, on the other hand, continues to live in the bosom of that community. The sexual morality of the bachelor farmer is not subject to the same implicit doubt as that of the bachelor herder who may be his brother. Because the farmer is in constant view of his neighbors, keeping the same schedule that they keep, his movements are known. More important, because he lives continually among others, even though celibate, he is not thought to suffer from lack of sexual satisfaction. Here emerges the notion that strong sexual needs grow out of a life of isolation and are not the necessary product of bachelorhood. The single person who lives among others is thought not to experience sexual desire to the same degree as the person who lives in isolation. Thus the shepherd’s sexuality is more exaggerated also than that of the priest and constitutes the greater threat —hence the peculiar apprehension with which herders and other migrants are regarded when they pass through town.

Freeman correctly identifies the important symbolic dimension of this interaction. Briefly, she finds an important inside/outside relationship between the farmer and the shepherd. This makes good sense, because farmers are generally of and from the community, but shepherds are more frequently marginal. Shepherding excludes people from the village who may not have been excluded formerly. The farmer is thought to be social in his orientation to others, but interactions with the shepherd are feared as primarily sexual. Here we have a polarization of a sexual and hazardous presence on the outside, contrasted with a social and controllable one on the inside. One does not need to inquire into the sexual behavior of farmers or shepherds to appreciate the symbolic message. Sexual drive (at least for men) grows out of isolated living conditions; sociality and sociability are substitutes for sexuality, which is important to these people in marking the difference between inside and outside.

Although sociality and sexuality are defined as different by the hamlet dwellers, they address the same issues. Certainly sexuality will be pertinent to many issues of definition and development for villagers, such as male/female, young/old, kinsmen/non-kinsmen, and good/ bad. The investigation of how sexuality participates in these larger cultural constructions is the anthropological contribution to the study of sexuality and society.

Because of this orientation to cultural constructions, one might wonder about the place of behavioral analysis in cultural sex research. Although the anthropologist is interested in behavior, he or she is not interested in the behavior per se but rather, in a cultural system of symbols and meanings. Gagnon and Simon state:

The physical sexual activity of two males when one of them is defined as berdache among the Western Plains Indians is identical with the sexual activity of two men in ancient Greece or in a modern Western society; but the meanings attached to the behavior and its functions for the society are so disattached to the behavior and its functions for the society are so disparate in these cases that seeing them as aspects of the same phenomena except in the most superficial way is to vitiate all we know about social analysis.

In fact, not all anthropologists agree with Gagnon and Simon, and some would prefer to treat homosexuality, for example, as a unit of or category of behavior that can be analyzed as a phenomenon across cultures.

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It is difficult, if not impossible, to isolate those aspects of human sexuality which only physiology (or age-related physiological change) influences. The relationship between biology and sexual behavior in humans is not fully understood. Many correlational studies point to the importance of endocrine structures as they support reproductive functioning, but since sexuality in humans involves more than reproductive capacity, isolating physiological mechanisms cannot tell the whole story. Much less is known about specific psychological mechanisms (for example, early experience and learning, cognitive style) as they affect sexuality and certainly the complex interaction of these variables is not known.

This essay will outline the principle differences between sexually mature humans and their elderly counterparts in terms of physiological factors, sexual capacity, activity, and attitudes.

*96/187/5*

There is much controversy over what allergy actually is. Historically, the definition is very broad, encompassing a wide range of illnesses brought about by people reacting to substances in their environment. By the 1960s, scientific research into the workings of the immune system had identified the mechanisms underlying most of the classic allergic diseases – asthma, eczema, hay fever, perennial rhinitis, urticaria, anaphylactic shock (>SYMPTOMS for full details). However, this research left unexplained many disorders that had hitherto come under the umbrella of allergy. Patients with these disorders have symptoms that are not typical of the classic allergic diseases – for example, they may have migraine, arthritis, muscle pains, irritable bowel syndrome, mood swings or other mental symptoms – and their symptoms are often highly variable and difficult to pin down to one specific cause. There is little solid scientific research into the underlying causes of such environmental illness or allergy.

*4\117\8*

When the prosthesis is sized and inserted properly, it provides enough ridigity to the shaft of the penis and enough support to the base to allow intercourse. The implant provides stability to the head of the penis, although it does not make the head hard. It also increases the diameter of the penis, although not as much as a natural erection. And once the implant is in, the erection will not subside; it won’t come and go like a regular erection. The prosthesis should be easily concealed under close-fitting underwear, but a man with a semirigid implant should realize that he will appear to have a partial erection when he is naked. This may be of concern to men who belong to athletic clubs or have other activities where nudity is common.

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We all know that a fat-heavy diet is not beneficial. As a general rule, a balanced, low fat diet with at least 5 servings of fruits and vegetables daily will do you a world of good. Focusing more meals around carbohydrates (pasta, rice, and beans), with meat as a side dish, is a sound way to eat.

But there is more to consider. You may not be aware of the way that certain foods can lessen the chance of developing ED. All of the foods I am recommending are readily available and you may be eating them already, but perhaps not in the quantities you need. They are: soy, fish, olive oil, flaxseed, and tea. You don’t have to ingest massive quantities of them; all you have to do is add them to your diet.

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Research supports this. The Massachusetts Male Aging Study (MMAS) conducted in 1994 found that men taking vasodilator medication for their heart conditions were four times as likely to have moderate or complete ED compared to other men. Those who took cardiac drugs as well as those who needed drugs to control their diabetes were three times as likely to suffer from significant ED. And in addition, those who required medication for hypertension suffered significantly from erection problems. Cholesterol-lowering drugs are also the culprits where sexual function is concerned. While this was not apparent in the men sampled in the MMAS, I see it too often in my own practice to discount it.

Overall, there are five main classes of drugs responsible for negative sexual side effects. They are:

• Cardiovascular drugs for heart disease, hypertension, and elevated cholesterol.

• Psychiatric medications, including antidepressants, antianxiety drugs, and tranquilizers.

• Antihistamines, including drugs for allergies and motion sickness, and cold remedies.

• Gastrointestinal medications formulated to relieve heartburn, stomach aches and pain, spastic colon and bowels, and flatulence.

• Miscellaneous drugs which encompass substances used to treat everything from muscle spasm and Parkinson’s disease to glaucoma and prostate tumors.

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