Premature Ejaculation (PE) is defined as ejaculation before the completion of satisfactory sexual activity for both partners. In severe cases, it is characterized by ejaculation either before penetration or soon after that. The causes can be biological (relatively uncommon) or psychological (performance anxiety). PE is generally regarded as one of the most common male sexual dysfunctions. It is affecting on average 40% of men worldwide. PE is a psychosomatic disturbance due to a psychologically overanxious personality and it is classified in to primary (lifelong) or secondary (acquired).
Various other factors such as age, novelty of the sexual partner or situation and recent frequency of sexual activity etc should be considered while diagnosing PE. Vajikarana (sexual medicine/sexology/aphrodisiac therapy) is one of the eight branches of Ayurveda which deals with the preservation and amplification of the sexual potency of a man, conception of healthy progeny as well as management of infertility & sexual dysfunctions.
Vajikarana improves sexual capacity and also physical, psychological and social health of an individual. The diagnosis and management of infertility and various sexual dysfunctions are dealt in detail in Ayurvedic classics. The male sexual dysfunctions have been elaborately described as ‘Klaibya’ in Ayurvedic classics. ‘Shukragata vata’ is a pathological entity described in Ayurveda which is similar to PE.
Concept of PE in Ayurvedic Classics
The rich heritage of Indian culture considered ‘kama’ (desire/sex) as one among the purusharthas, the objectives of life. The concept of ‘kama’ reveals that the recreational aspects like enjoyment and it is also equally important for procreation. As an art as well as science the ancient Indian erotic literature deals various aspects of ‘kama’ along with its social, cultural and medicinal importance.
Ayurveda enumerates eight factors responsible for ejaculation. They are harsha (excitement, sexual fantasy), tarsha (strong desire for sex), saratwat (fluidity of semen), paicchilya (sliminess of semen), gaurava (heaviness of semen) and anutva (atomicity of semen), pravanabhava (tendency to flow out), drutatvat marutasya (due to vata). Dysfunction of either one or all of these eight factors leads to ejaculatory impairment out of which ‘drutatvat marutasya’ is most important. The physiology of ejaculation is under control of vata dosha. Vitiation of vata (especially apana vata) leads to PE
Ayurvedic Management of PE
Ayurveda has given importance to shukra (semen / reproductive system) as the supreme body tissue because of its generative property. Vajikarana is the branch of Ayurveda, which deals with various types of physical, psychological, sexual problems like impotence, libido, poor erection, and early ejaculation in the males as well as sterility and frigidity in females. The vajikarana drugs are helpful in providing strength and vigor to the person along with improvement of reproductive potentiality. Scanty research has been done on role of Ayurvedic drugs/procedures in the management of PE. Praharsha anna (exhilarating food items), balya (tonics), shukrakara drugs (aphrodisiacs) and vajikarana vasti’s (various enemas with medicated oils & decoctions) are useful in the management of shukragata vata.
Individual herbs like, Erandamoola (Ricinus communis Linn.), Brahmi (Bacopa monnieri Linn), Mandukaparni (Centella asciatica Linn), Amlaki (Emblica officinalis Garten), Jatiphala (Myristica fragrans Houtt); compound formulations like, Akarakarabhadi yoga, Rasayana vati, Manasamitra vataka, Katphaladi kwatha; mineral compounds like, Swarna bhasma (gold), Rasa sindhura (mercury based formulations) etc; proved effective in the management of PE. Few studies have evaluated the efficacy of panchakarma procedures (Ayurvedic five major body cleansing procedures) like vasti (various medicated oil or decoction enemas) and shirodhara (continuous oil drip on forehead) were also proved effective in PE.
Akarakarabhadi yoga has improved the time taken for ejaculation and satisfaction to female partner. Narasimha choorna, Bhallataka phala majjadi avaleha, Musalyadi choorna have provided better results in improving the duration of sexual act and frequency of coitus. Atmagupta (Mucuna prurita Hook) and Ashwagandha (Withania somnifera Linn) has improved the duration of sexual act. Brahmi (Bacopa monnieri), Mandukaparni (Centella asciatica) are having anti-anxiety, adaptogenic and stress relieving properties. Putranjeevaka (Drypetes roxburghii) is beneficial in increasing the ejaculation time. Kapikacchu (Mucuna prurience) is an aphrodisiac and also effective in improving the performance in men.
Ayurvedic line of treatment for early ejaculation/sukragatavata should consists of vrishya (aphrodisiacs), balya (tonics), vatahara (drugs/procedures which pacifies vata dosha), medhya (psychotropic drugs) and sukrastambhaka (drugs helpful to delay ejaculation) properties. Vasti is the best available treatment / an ideal choice for vata vikara’s or shukragata vata, as it controls vata at its own site. Role of Yoga in PE ‘Hatha yoga’ gives utmost importance related to conservation of semen and controlling ejaculation. Identification with the body ceases and consciousness becomes free from physical identification, if a yogi (the one who practices yoga) controls the bindu (semen) and prevents its release from the body even during maithuna (sexual intercourse), according to ‘Hatha yoga pradipika’. The knower of yoga conquers death by preserving the bindu (semen). Release of the bindu is equal to death and conservation of semen is life.
There are some practices explained in hatha yoga texts to preserve the semen (to stop / to control/to withhold ejaculation). The bindu which is about to fall in to the woman’s vagina should be made to move upwards with continuous practice. The ejaculated semen along with the secretions of women’s vagina should be drawn up through urethra by muscular contractions. The flow of bindu can be reversed by continuous practices of various mudra’s like, vipareeta karani mudra, khechari mudra, vajroli mudra etc.
Role of Mind in Ejaculation According to Yoga
A man’s semen can be controlled by the mind and control of semen is life giving. Therefore, the semen and mind should be controlled and conserved. Yogis (people who practices yoga) have always claimed that autonomic body functions can be consciously controlled with time and effort. Functions of the reproductive organs can also be influenced and controlled by yoga practices over a sustained period of time. By practicing vajroli, one can learn to control the physical mechanism, but along with the mental control also can be developed.
For Ayurvedic management of PE, various herbal or herbo-mineral formulations, external applications over lower abdomen or all over the body, wearing different amulets made by herbs, psychotropic herbal drugs for reducing performance anxiety, various techniques elaborated in ancient Indian erotic literature to fasten the orgasm in female partner and use of shukra stambhaka drugs/formulations to improve control over ejaculation are mentioned.
Various yoga practices are also described to get control over ejaculation and among them ‘vajroli mudra’ is an important one. Further clinical trials are required to substantiate these claims.
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Information from: Med Crave Website