In recent years, with the accelerated pace of modern life, from work, family, economic and other aspects of the pressure increases, the probability of male sexual dysfunction increased, and with the improvement of people’s living standards, in pursuit of a higher quality of life, so the number of patients coming to the clinic is gradually increasing. But because the patient is not clear about the cause of the disease, many patients in the treatment took a lot of detours. Now this problem for the majority of male compatriots for a brief introduction.
First, the adverse factors that cause sexual dysfunction
The normal male sexual function includes sexual desire (sexual excitement), penile erection, sexual intercourse, orgasm and ejaculation 5 major links. In the whole process of sexual life, any part of the function of the obstacle, and affect the smooth completion of sexual life, it is called sexual dysfunction.
What factors in daily life are likely to cause sexual dysfunction?
1, psychosocial factors sexual abuse, anxiety, couples sexual disharmony, non-sexual friendship.
2, mental disorders affective mental disorder, schizophrenia, anorexia nervosa, anxiety disorder syndrome.
3, physical diseases chronic medical diseases (chronic medical diseases can cause hypersexuality, mainly chronic pain, fatigue, sleep reduction, body image problems and low self-esteem in the role called), lung disease and anemia, local inflammation (genital inflammation such as prostatitis, urethritis, vesiculitis, etc.) neuropathy such as multiple sclerosis and trauma such as pelvic fractures also stimulate the sympathetic nerve circle, leading to premature ejaculation
4, neurotransmitters DA (dopamine), NE (norepinephrine), 5-HT (pentazocine), acetylcholine.
5.Drug effects
(1) Psychotropic drugs benzodiazepines, antidepressants (such as amitriptyline, antipsychotics, mood stabilizers (such as carbamazepine).
(2) Cardiovascular drugs: Lipiodol, antihypertensive, androgen biosynthesis can be inhibited, causing hypoactive libido, breast development and erectile dysfunction in men.
(3) hormonal drugs: cortisone and other glucocorticoids can cause hypoactive sexual desire, hairiness and hair loss in men and women, and can also cause menstrual disorders, amenorrhea and overflow of breast milk.
(4) Anti-allergic drugs: finasteride, paracetamol, ankylin, diphenhydramine, etc. can cause a decrease in libido in both men and women, and a significant decrease in vaginal lubrication in women.
(5) Gastrointestinal drugs: Cimetidine, ranitidine, and nizatidine are a class of gastrointestinal drugs that are widely used, mainly for the treatment of peptic ulcers. However, more and more case reports indicate that they can cause sexual dysfunction.
(6) psychostimulants and narcotics: the most common is alcohol, cocaine, etc.. It is generally believed that alcohol can enhance sexual desire, but it will affect the erectile function of the penis and reduce the hardness of the penis erection.
(7) anti-tumor drugs: as we all know, anti-tumor drugs can kill cancer cells while also causing damage to normal tissues including the gastrointestinal tract, liver and kidneys. All anti-tumor drugs may damage testicular and ovarian functions, leading to glandular atrophy, resulting in reduced libido, amenorrhea, non-ovulation, reduced sperm or no sperm.
(8) prostate drugs: common drugs used in the treatment of prostate cancer, such as anti-androgen drugs, can affect libido, penile erection, ejaculation, etc. by affecting the secretion of androgens.
Second, the clinical manifestations of sexual dysfunction
Sexual desire disorder: low sexual desire, no sexual desire, sexual aversion, hypersexual desire, sexual desire inversion.
Erectile dysfunction: erectile dysfunction, abnormal erection.
Ejaculatory disorders: premature ejaculation, delayed ejaculation, non-ejaculation, retrograde ejaculation.
Sensory disorders: sexual intercourse cramps, abnormal sensation, painful erection, painful ejaculation, hypogonadism or absence of orgasm
Third, the correct understanding of ED and premature ejaculation
In ancient times, people talk about tigers, nowadays, they talk about “cancer”, and for men, another disease is more daunting for them to talk about, that is, ED (erectile dysfunction), which is commonly known as impotence.
ED can lead to.
(1) emotional aspects: irritability, depression
(2) affect self-esteem interpersonal relationships: confinement, avoidance
(3) interpersonal disharmony sexual aspects: ED gradually aggravated, affecting the sexual response cycle, and even cause premature ejaculation, low sex drive.
Many men believe that suffering from ED is no longer a real man, so they reject it like the plague and find ways to avoid it. Out of this mentality, people’s knowledge of ED mostly comes from hearsay, and science is far from it.
1, penile erectile dysfunction is the complete loss of penile erectile capacity or although partial erection but its hardness is not enough to insert the vagina for normal sexual activity, or although you can enter the vagina, but the erection time is too short to complete normal sexual activity for more than 6 months. Clinical erectile dysfunction is often divided into three categories: psychological, organic and mixed, and organic penile erectile dysfunction is divided into four categories: neurological, vascular, endocrine and pharmacological.
According to the degree of erectile dysfunction, it can be divided into mild, moderate and severe. In the past 10 times of sexual intercourse, if 1-2 times have bad erection or can’t get an erection, it can be designated as mild; if 3-5 times may be moderate; if 7-8 times or all can’t, it may be severe. Risk factors for erectile dysfunction include; chronic diseases such as diabetes, cardiovascular disease, spinal pelvic trauma and lower abdominal surgery, drug use, heavy smoking, alcohol abuse, and substance abuse.
Fifty percent of erectile dysfunction is caused by organic causes. Treatment includes penile cavernosal drug injection therapy. Oral medication. Vacuum negative pressure device therapy (but must be used under medical supervision to prevent abnormal erections). Penile erectile device penile prosthesis implantation surgery (more expensive), etc.
2.Premature ejaculation
The incidence of premature ejaculation is currently considered to be 5% to 30%. The American Health and Social Life Survey shows that the prevalence of premature ejaculation in men aged 18-59 in the United States is 21%. The definition of premature ejaculation recommended by the American Urological Association is that ejaculation occurs earlier than expected by the individual in the absence of sexual dysfunction of the partner. In ancient times, Chen Shiduo’s “Dialectical Record” describes it as “the extreme slipperiness of a man’s essence, and once he reaches the door of a woman, he even ejaculates”.
At present, there are two types of premature ejaculation: primary and secondary. Primary premature ejaculation occurs from the beginning of sexual life and accounts for the majority of premature ejaculation patients, while secondary premature ejaculation occurs after a period of normal sexual life and is mostly related to erectile dysfunction or other secondary diseases.
Premature ejaculation is usually the main complaint of patients at the time of consultation. Patients should provide their sexual history to the doctor, including the frequency and duration of premature ejaculation episodes, whether they occur every time or occasionally, the degree of sexual stimulation when premature ejaculation occurs, a detailed description of sexual life foreplay, masturbation, intercourse, visual stimulation, the impact of premature ejaculation on sexual life, the relationship with the partner, aggravating or relieving factors of premature ejaculation, and the use of medication.
When a patient has both erectile dysfunction and premature ejaculation, the erectile dysfunction should be treated first. Many patients with erectile dysfunction have secondary premature ejaculation, which may be caused by the effect of tension and anxiety caused by erectile dysfunction on the patient.
Commonly used tests for patients with premature ejaculation include psycho-psychological analysis and neuro-electrophysiological testing. The most common psychological disorders associated with premature ejaculation are anxiety and depression. It is important to understand the physiology of ejaculation, improve confidence in rebuilding the ejaculatory reflex, and master the rules of sexual life to avoid premature ejaculation. Both medication and other therapies for premature ejaculation play an important role in its treatment. Sexual behavior therapy can be taken first, such as choosing the time of sexual intercourse, sexy concentration training method, improving the tolerance of sexual stimulation, squeezing method and so on.
No relief can take medication. Chinese medicine treatment is the main drug treatment means because of less side effects and better efficacy. In terms of medication, for those who are deficient, they should use more cherry and saxifrage to benefit the kidneys and fix the essence, and keel and oyster to submerge the yang and astringent essence, which can often receive certain effect. The treatment of western medicine has certain efficacy on premature ejaculation, but because it mainly works by suppressing the nervous system, it is easier to cause the sexual function to decline and has more side effects.
However, it is a better choice for some people whose psychological treatment is ineffective, or who refuse to accept psychological treatment, or whose sexual partners are unwilling to cooperate with the treatment, and for whom the efficacy of Chinese medicine is not obvious. Clinically, sertraline, clomipramine, paroxetine are more commonly used.