Premature ejaculation
Premature ejaculation is the most common male sexual dysfunction in clinical practice, and is a condition in which men and women ejaculate during sexual intercourse when the erect penis just touches the labia or is not inserted into the vagina, as shown by “a touch and go” and “see the flowers ejaculate”, but in 2-5 minutes, both husband and wife are satisfied and cannot be diagnosed as Premature ejaculation. Premature ejaculation cannot be diagnosed for newlyweds, long time abstinence, poor environment, short time, etc.
Second, the etiology pathology
1, mental factors: anxiety can affect the ability to perform sexually. Such as the couple’s affection is not harmonious, or the husband’s excessive fear and worship of his wife, the existence of inferiority complex; some accidental reasons, 1-2 times premature ejaculation, the burden of thought, the fear and anxiety; anxiety situation of premarital intercourse; the female partner is bored with intercourse, hoping to end as soon as possible. So that men in the sexual response cycle quickly from the excitement period into the climax period, the lack of platform period, and almost no experience of the pleasure of sexual life.
2, organic factors: circumcision foreskin tethered too short patients, because the glans tethered sensitive intolerance of friction. Genitourinary tract infection. Endocrine system lesions. Neurological lesions.
Third, treatment
The treatment of premature ejaculation is a systematic project, which includes psychotherapy, behavioral therapy, and pharmacotherapy treatment aiming to try to improve the stimulation valve of ejaculation, prolong the plateau period of sexual excitement, and delay the arrival of erotic climax.
1, psychological treatment: premature ejaculation is a psychological disease, rapid ejaculation is a universal problem, related to the lack of sexual knowledge and sexual skills. Both husband and wife work closely together to eliminate anxiety (doubt, tension, apprehension, fear) build confidence and relieve the patient’s ideological concerns and tension. Good sexual behavior needs to be in a peaceful, warm emotional atmosphere, so that couples can indulge in the beautiful experience brought about by sex.
2, behavior therapy: through sex knowledge education and sexy concentration training homework, so that patients and wife contact completely relaxed, the patient pay attention to experience the feeling before orgasm, before it is not to be unable to control, reduce or stop penile pumping, so that the sexy receding after re-activity.
(1) Increase the number of ejaculations.
(2) Intermittent masturbation method: up to 15 minutes before ejaculation.
(3) change of position: female superior position with deep breathing.
(4) external genitalia cold compress method
(5) condom method
(6) interrupted urination method: pubococcygeal muscle training method, when urinating, first expel part of it, pause, then expel, then hold it, and finish the urine in several times. Consciously contract the anus to elevate the testicles during normal times. or cover the erect penis with a bath towel to do lifting exercises.
(7) Scrotal pulling method: strong sexual excitement, pulling the scrotum and testicles downward with the hand.
(8) Stop-and-start therapy: when the woman is about to ejaculate with hand stimulation, the man signals to stop immediately, and then restimulate after the ejaculatory premonition has completely disappeared, repeatedly.
(9) penis head squeezing method: have the female partner implement, fully stimulate the penis, when the male partner is about to ejaculate, the female partner will put her thumb on the penis tether area, show the middle finger put above the coronal groove, steady squeeze and pressure for 4 seconds, then suddenly relax, the pressure is from front to back, also available penis root squeezing method.
3.Medication: It plays a very important role in premature ejaculation.
(1) Western medicine: antidepressants: phenobarbital, iproniazid, loxinping; glans and penis coated with anesthetics, emulsions, ointments, 10-30 minutes before sexual intercourse with.
(2) Chinese medicine: according to the physical symptoms tongue and pulse identification application of tonifying the kidneys and fixing essence, nourishing Yin and submerging Yang dredge the liver and Qi activate blood circulation and resolve blood stasis sedation and tranquilization activate blood circulation and resolve blood stasis etc. but all add gold cherry, gorgonian, mulberry cuttlebone nit etc. subject to astringency and solid astringency. The treatment effect is better. The condition of the available Chinese medicine external washing scrotum penis.
4, surgical treatment: prepuce too long, prepuce, should be surgical treatment.
Health education knowledge (erectile dysfunction)
I. ED
Where the penis erection hardness is not enough to insert the vagina or erection maintenance time is not enough to complete sexual intercourse satisfactorily, and its frequency of occurrence more than 50% of the sexual behavior, can be diagnosed as erectile dysfunction (ED) is divided into light, medium and heavy 3 degrees. It is divided into 3 categories: psychological, organic and mixed erectile dysfunction.
Second, the etiology of the pathogenesis
Adult men due to fatigue, anxiety, panic, injury, or damp heat and other factors, resulting in the loss of nourishment from the zong tendons, atrophy and weakness, so that the room is not erect or not firm. Etiology:Kidney Qi deficiency, vital fire, liver Qi stagnation, heart and spleen damage, Qi stagnation and blood stasis, liver and gallbladder damp heat, phlegm and dampness obstruction, fright and fear injury to kidney, spleen and kidney deficiency, kidney deficiency and blood stasis.
Western medicine pathophysiology.
1, psychological erectile dysfunction
(1) Incompatibility in daily relationships.
(2) Inappropriate or inadequate sexual stimulation.
(3) adverse sexual experiences.
(4) stress anxiety depression.
2, organic erectile dysfunction
(1) endocrine.
(2) neurological.
(3) arterial.
(4) venous.
(5) post-surgical.
(6) pharmacological.
II. Treatment
1, sexual psychotherapy: sexual psychotherapy should be carried out with the participation of both husband and wife, more communication between husband and wife, more learning about sex, psychological counseling, establish confidence to overcome the disease, abandon the burden of thought, eliminate anxiety.
Sexual concentration training should be carried out under quiet and comfortable conditions, both parties should create a mutual understanding and warm atmosphere, do not talk about topics unrelated to the treatment, divided into 3 stages.
(1) non-genital organs sexy concentration training: both sides naked, mutual touch, caress, kiss, but do not touch the genital organs, try to relax, eliminate tension and fear, encourage both sides to communicate more, especially non-verbal communication, let each other understand their body sex sensitive areas, and strive to stimulate sexy through mutual caress, gradually over to stimulate sexual desire. The training is generally 20-30 minutes, and finally the couple cuddled together to end. So repeated training, 2-3 times a week, a total of 2 weeks.
(2) Sexual concentration training of the genital organs: touch and caress the sexual organs, but do not rush vaginal penetration, and then caress and massage the sexual organs again after the erection subsides, for a total of 2 weeks to further eliminate the patient’s fear, arouse sexual response and build confidence.
(3) Penis insertion training: finally adopt female superior position, after penis insertion into vagina, both husband and wife do not do any jerking, keep penis erect, try to feel the pleasure of vaginal insertion, when the penis is weak, you can move around a little, so repeatedly train until satisfactory erection, and finally over to the vaginal jerking stage until ejaculation to reach orgasm.
2, drug treatment: the effect of drug treatment is difficult to be sure, there are certain side effects.
(1) hormonal drugs: testosterone enanthate, long-acting oil testosterone ester, chorionic gonadotropin, need patients less than 5%.
(2) Non-hormonal drugs: drugs acting in the center, drugs acting in the periphery (sildenafil).
(3) topical drugs: nitroglycerin, triple cream, prostaglandin E1 gel, but poor results adverse reactions exist.
3, Chinese medicine diagnosis and treatment: from the etiology of the disease, the deficient should be tonic, the real should be diarrhea, with fire should be clear, without fire should be warm according to the patient’s symptoms tongue and pulse identification for treatment. However, the clinical treatment of impotence is a serious abuse of warm tonic products, and some of them are not effective, but cause the depletion of kidney yin and the internal growth of dampness and heat. In addition to the warming of the kidney medicine should be used on the basis of warm but not dry or less dry flesh and blood sentient products, Baji Tian, Cistanches, Semen Cuscutae, deer horn gum and add yellow essence, reed land, in addition to the liver and kidney meridian of the cow knee, to improve the effectiveness. The centipede and the fine spice are used appropriately to improve the efficacy. And combined with Chinese medicine external treatment methods: acupuncture, moxibustion, compressing, auricular acupuncture, bathing and other effective
4.Negative pressure suction device
5, trans-urethral drug delivery: MUSE and Bifal creams, etc.
After comprehensive treatment, sexual dysfunction is able to be cured, the key to cooperate with the doctor’s treatment, establish confidence in the couple with.