Is It Too Late To Say It's Too Soon? - Talking About Premature Ejaculation
Premature ejaculation is one of male sexual dysfunction. Epidemiological surveys show that premature ejaculation is the most common sexual dysfunction in men. According to the American Center for Health and Social Life, 21 percent of American men between the ages of 18 and 59 have the disorder, suggesting that many men have it. Other reports range from 5 to 30. It has been suggested that such a large discrepancy may also be caused by different definitions of premature ejaculation in various studies.
Definition Of Premature Ejaculation
For premature ejaculation, it is difficult to give an appropriate definition, and to date a widely accepted definition of premature ejaculation has not been established.
The premature ejaculation guidelines issued by the American Urological Association in 2005 defined premature ejaculation as premature ejaculation when the sexual dysfunction of the sexual partner has resolved, whether before or shortly after the penis enters the vagina, ejaculation has occurred before the desire to ejaculate, resulting in Loss of feeling in the sexual partner or partners.
Classification Of Premature Ejaculation
Primary Premature Ejaculation:
That is, premature ejaculation persists from the first sexual experience, and the delay time of the bulbocavernosus reflex (BCR) is relatively short. These patients often have characteristics including fear of failure, self-control of sexual impulses, role switching (from sex participant to observer), and decreased frequency of sexual activity. The breakdown of the partnership would further exacerbate premature ejaculation, but no organic lesions were found in all patients.
Secondary Premature Ejaculation:
Sexual function was normal for a period before premature ejaculation, and the bulbocavernosus reflex was delayed for a long time. Such patients are usually older, often have concurrent erectile dysfunction or difficulty reaching orgasm, and seek treatment earlier.
Causes Of Premature Ejaculation
So far, the real cause of premature ejaculation remains a mystery, including numerous studies and discussions from physical, psychological, behavioral, and even sociocultural backgrounds.
There are some views that premature ejaculation is a purely psychological problem, as men's early sexual experience (including masturbation) is often done in the fear of being found in a state of stress and develops a rapid response pattern of sexual behavior, which also It is difficult to change sexual behavior in later marriages.
Of course, some people also object to the purely psychological argument. Some scholars have found that patients with premature ejaculation are indeed different from normal people in nerve conduction and sex hormone levels. They believe that patients with premature ejaculation have physiological excitability and allergic reactions.
Some scholars even believe that premature ejaculation is a behavioral pattern that represents the evolution of a species. From an evolutionary standpoint, males who ejaculate within a relatively short period of time are more likely to fertilize females. Compared to males that require prolonged ejaculation and mating, males are more likely to be invaded or killed by other males or even other species during the mating process, so premature ejaculation may be the result of evolution by natural selection.
Diagnosis Of Premature Ejaculation
The diagnosis of premature ejaculation is primarily based on the patient's medical history statement. A detailed medical history is the basis for the diagnosis and treatment of premature ejaculation . The diagnosis of premature ejaculation is based on a complete medical history. Any patient with rapid ejaculation should be asked to provide a detailed medical history. From the medical history, premature ejaculation can be simply divided into primary premature ejaculation and secondary premature ejaculation. Primary premature ejaculation refers to the patient's premature ejaculation problem from the beginning of the sexual experience, while secondary premature ejaculation refers to the patient's previous successful sexual experience. In general, secondary premature ejaculation is easier to find and treat, and has a better prognosis.
What should doctors pay attention to when asking a patient's medical history? The content of the inquiry should include the frequency and duration of premature ejaculation, the intensity of sexual stimulation when premature ejaculation occurs, specific external environments and even specific sexual partners are prone to premature ejaculation, and the impact of premature ejaculation on sexual behavior. These are the focus of medical history inquiries. In addition, the general health of the patient is also something that needs to be asked. Find out if there are any other conditions that predispose or cause premature ejaculation. For example, patients with coronary heart disease may suffer premature ejaculation due to fear of myocardial infarction caused by excessive sexual stimulation. This premature ejaculation problem will heal naturally after myocardial infarction treatment. When asking about the medical history, we should also know some information about the patient's usual sexual life, including foreplay, masturbation and sexual intercourse, the relationship and interaction between sexual partners, and the patient's interpersonal relationship and work situation. We should ask and evaluate them separately. For patients with idiopathic premature ejaculation, the patient's family and growth history, childhood growth background, and the psychological trauma suffered by the patient often affect adult sexual life. For patients with secondary premature ejaculation, special attention should be paid to distinguishing whether the disease is premature ejaculation or erectile dysfunction. Of course, many patients suffer from both premature ejaculation and erectile dysfunction.
In diagnosing premature ejaculation, physical examination and laboratory tests are less important than taking a medical history. When people with premature ejaculation undergo physical examination and laboratory tests, the results are usually normal. Nonetheless, a simple external genital examination is still necessary. If the patient has erectile dysfunction in addition to premature ejaculation, necessary auxiliary examinations should be carried out according to organic erectile dysfunction, such as sex hormone examination, neuro-EMG examination and penile vascular examination to find out the exact cause of erectile dysfunction and carry out Targeted treatment. Many patients suffer from premature ejaculation and erectile dysfunction. Once erectile dysfunction is effectively treated, the patient's confidence and ability to maintain an erection will increase, and the problem of premature ejaculation will be resolved accordingly.
Treatment Of Premature Ejaculation
There are many treatments for premature ejaculation, but one thing is for sure: premature ejaculation is curable! For the majority of premature ejaculation patients, this is undoubtedly a happy thing. All treatment options and the advantages and disadvantages of each treatment should be discussed with the patient prior to treatment. In addition, patient and partner satisfaction should be used to assess the success of treatment. What's more, since premature ejaculation is not a life-threatening condition, the safety of treatment should be the top priority.
1. Behavioral Therapy:
Behavioral therapy includes increasing ejaculation frequency, adopting male and female sexual positions, stopping and starting ejaculation, squeezing techniques, pelvic floor muscle contractions, and more. , the short-term success rate was 95%, but the long-term follow-up results showed that after 3 years of treatment, 80% of patients were still the same as before. Therefore, behavioral therapy still has long-term effects in a small number of patients with premature ejaculation.
Sex requires continuous learning in the process of repeated practice, and can also continue to increase experience and improve skills under the guidance of experts to master excitement and impulse control. These skills are classified as sex therapy. Masters and Johnson suggest that when men feel that they are about to ejaculate, the male and female positions should be suspended and the woman should immediately lift her body away from the man. She can even press on the lower part of the glans for three to four seconds to reduce the excitement and continue after a 15 to 30 second rest. Other methods can also be used, including shifting focus and changing posture. In addition, improvements in the relationship between husband and wife or sexual partners, harmonious relationships, frank communication, mutual understanding of the sensitive areas of both parties, and as much sexual foreplay and love as possible after sex can increase sexual satisfaction and resolve premature ejaculation naturally. The tension and impact of both sex lives.
2. Drug Treatment:
Traditionally, male doctors believed that premature ejaculation was almost caused by mental factors, so the concept of behavioral therapy was strongly recommended. Whether this view is correct is up for debate. In fact, in addition to mental factors, physical factors often lead to premature ejaculation. In patients with premature ejaculation, physical and psychological factors should be assessed in sufficient detail before appropriate treatment is given.
The research of basic medicine, especially the progress of neuropharmacology, can provide several effective drugs for the treatment of premature ejaculation caused by physiological factors or other diseases, hoping to restore the normal sexual life of premature ejaculation patients. With the discovery of selective serotonin reuptake inhibitor (SSRI) drugs that prolong ejaculation time, the problem of premature ejaculation in men has been brought to a new era . It is no longer two parts with distinct psychological and physical impairments, but a more complete and individualized assessment and treatment strategy for premature ejaculation patients in a complementary manner. This is a milestone in the treatment of male sexual function.
- Did You Know How To Prevent Premature Ejaculation?
At present, the commonly used drugs for the treatment of premature ejaculation are divided into two categories: oral drugs and topical drugs.
1. Oral drugs are mainly selective serotonin reuptake inhibitors (SSRIs). These drugs were originally used to treat depression. However, after long-term clinical application, it has been found that several drugs have obvious delayed ejaculation phenomenon after taking them. Male specialists showed great interest in the side effects of this drug, and it was soon used to treat premature ejaculation. Commonly used are Zoloft , Prozac, Celestine and so on. Dapoxetine is also a selective serotonin reuptake inhibitor. This drug has been approved by the American Urological Association as the drug of choice for the treatment of premature ejaculation. It could become the first antidepressant drug approved by the U.S. Food and Drug Administration to treat premature ejaculation.
2. Topical drugs are mainly local anesthetics. 20-30 minutes before sexual intercourse to use local anesthetics (commonly used gel) on sensitive parts such as the glans penis, coronal sulcus, frenulum, etc., can prolong the latency of ejaculation, and there are no obvious side effects. After local anesthesia, it can be used without a condom . If you don't use a condom, drug residue on your penis can be washed off before sex. It should be noted that prolonged anaesthesia (30 to 45 minutes) can cause the erection to disappear, as quite a few people experience numbness when anaesthesia is too long. For example, the spread of residual local anesthesia on the penis can also cause numbness of a woman's vaginal walls and reduce sexual pleasure if the penis is not thoroughly cleaned of drug residues (in the absence of a condom) prior to intercourse. This treatment is contraindicated if the patient or sexual partner is allergic to local drugs.
3. Surgical Treatment:
If the above treatments are ineffective, surgery may also be considered. Common surgical methods include selective dorsal penile neurotomy and penile prosthesis implantation. Because surgical treatment is invasive, physicians and patients should exercise caution before choosing surgical treatment.
In Conclusion
Whether it's premature ejaculation or other sexual dysfunctions, it's a challenge for both patients and male doctors. Patients must remove the psychological burden and discuss their underlying disease with their doctor. Doctors should listen carefully to patients' complaints and conduct necessary examinations to understand whether the real cause of premature ejaculation is organic or psychological, and whether it is caused by the patient's own factors or social and cultural background. If it is caused by organic disease, the primary disease should be actively treated, and premature ejaculation can be solved. If it is functional, the factors that cause sexual tension should be eliminated. Under the premise of giving correct knowledge education and guidance, patients should maintain a happy mood. Jennifer, both parties should cooperate and understand each other in order to achieve a harmonious interaction between both parties in sex and normal life. After that, premature ejaculation, which is said to occur late at night, will disappear naturally, and the disappointment or shadow of sex life will disappear naturally.
The above is a brief introduction to talking at a later time and then at a fast pace - premature ejaculation. If you need to learn more about premature ejaculation, say it late and then quickly - follow us and bring you more about it in the future. I wish you a happy life .