Loose Nerves, Weak Blood And Cold Climates - Cultural Meanings And Explanations Of Premature Ejaculation Among S. Asian Men In East London

Medical discourses around premature ejaculation (PE) focus on neuro-biological phenomenon and present reductive, mechanical explanation and treatments that provide little space for cultural contexts and social meaning. As part of a randomised controlled trial in East London comparing treatment modalities for clinical management of PE, we interviewed 40 men to identify their experiences, explanations, meanings and consequences of having premature ejaculation. The majority of men attending for advice about PE were from a predominantly Bangladeshi Muslim background, and were a mixture of 1st and 2nd generation immigrants. Interviews yielded rich data with explanations for premature ejaculation, including \'weak blood\', \'loose nerves\', \'a cold climate\' and \'stress\', as the possible explanations for the condition. In some instances these causative factors, it is claimed, come from family doctors in their home country. The majority of these explanations were from 1st generation Bangladeshi men, i.e. men who had been in the UK for less than 10 years. Most of these men were fearful of the discrediting social consequences of being diagnosed with PE and were anxious that their ‘condition’ was managed away from the local community. Furthermore, there was a strong desire for pharmacological intervention, rather than conventional behavioural therapies. We present an analysis of these narratives to provide a ‘textured’ understanding of PE in these men, and group the analysis into 5 themes or frames of discourse, and explore the cultural meanings of each theme using Foucauldian discourse analysis. It is hoped that these narratives and explanations will add to the debate surrounding clinical management of PE, and we contend that cultural meanings should be taken into consideration in treatment programmes. Our data indicates that sole therapy, whether psychological or pharmacological, can fail to capture the nuances that individuals attach to the condition and therefore affect the clinical outcomes and patient satisfaction.

Conflict of Interest: None disclosed
Financial Support/Funding: Barts And The London Rab Charitable Foundation
Sydney Australia, April 2007