”Doctor, when I have sex with my wife, I ejaculate without a few strokes, for which she often complains about me. Such a narrative can often be heard in the outpatient clinics of male departments.
Compared with erectile dysfunction, premature ejaculation was a rarely seen condition in the past. With the opening up of society and the popularization of sexual knowledge, the number of patients seeking treatment for premature ejaculation has increased in recent years. According to Masters and Johnson, premature ejaculation is the most common sexual dysfunction in the general population, and it is estimated that 20%-70% of men have significant rapid ejaculation problems, but less than 20% of them are diagnosed for premature ejaculation.
1. Premature ejaculation with many different opinions
Generally speaking, premature ejaculation is a relatively clear and not easily misunderstood sexual dysfunction, but it is quite difficult to give a complete and exact definition of premature ejaculation. There are different perceptions of what premature ejaculation is, but of course the diagnosis of severe premature ejaculation is the same, that is, ejaculation before entering the vagina. There are many different diagnostic criteria for premature ejaculation, and the common ones are divided into the following.
1.1 Time as a criterion The time from penile insertion into the vagina to ejaculation is generally considered to be shorter than 2min, which is considered premature ejaculation.
However, strictly speaking, it should be shorter than 30s to be considered premature ejaculation.
1.2 Premature ejaculation is defined by the number of strokes of the penis into the vagina less than 10 times.
1.3 It is considered premature ejaculation if the partner’s reaction is the criterion and the woman cannot reach orgasm in more than 50% of sexual intercourse.
1.4 The ability to control the ejaculatory reflex is the criterion, and Kablan believes that ejaculation can be controlled through learning and training. If you can’t control ejaculation for a long time, it is premature ejaculation.
2. Etiology of premature ejaculation
Some human reflexes can be controlled by the will, such as the erection of a man’s penis, which cannot be controlled by the will, but the act of ejaculation and orgasm can be controlled by the will; a normal person can control the timing of ejaculation and ejaculate only when he wants to. However, this is not the case for premature ejaculators, who lack control over ejaculation and ejaculatory actions occur quickly once they become aroused. Therefore, it can be assumed that the premature ejaculator is not acutely aware of the sensation of his orgasmic precursors and does not know how to control the act of ejaculation.
Premature ejaculation is overwhelmingly functional and organic causes are rare. The authors have tested the sex hormones LH (luteinizing hormone), FSH (prolactin), and T (testosterone) for premature ejaculation and rarely found any abnormalities. There are many causes of premature ejaculation, and the common ones are as follows.
2.1 Fast masturbation habits Many premature ejaculators masturbate when they are young for fear of others finding out, or have a short time alone with their sexual partners, so they need to ejaculate as soon as possible, and over time the habit of fast ejaculation is formed. There is also the fact that when you are young, you should not have a short rise, each time you ejaculate can be accompanied by an orgasm, or masturbate repeatedly within a short period of time to achieve the pleasure of an instant orgasm.
2.2 Inexperienced Most men in the newlywed stage have quicker ejaculation or premature ejaculation. This is due to the lack of newlywed
The lack of experience and excessive excitement and impulsiveness, it is difficult to hold yourself, do not know how to control the ejaculation reflex. The actual fact is that you will not be able to get a good deal on your own.
2.3 Long-term abstinence Many men who have the ability to control ejaculation will occasionally do so after long-term abstinence or when they are highly aroused.
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2.4 Distracted in the absence of a sense of security in the place of intercourse, due to nervousness, suspicion, often speedy war, thus appearing premature ejaculation. Some people have watched some pornographic tapes and feel that the male protagonists “never get tired of fighting”, while they are not “at the touch of a button” or “on the verge of falling”, but also 3-5min The “fire”, feel that they are not a qualified man.
2.5 Sexual partner’s attitude some women watched some pornographic tapes, think men should be so, and their husbands can not last the battle; they do not understand the male sexual ability did not, light to be cold tide hot irony, so that the male anxiety; heavy is angry eyes and eyes, ignore, make the male side of the gray, more heavy the male psychological burden. The next time you make love is more like a defeated soldier going into battle, fearful, so that premature ejaculation intensifies, the result becomes a real sexual impotence.
2.6 organic pathology is the first factor that must be considered and ruled out, such as high blood pressure, diabetes and with the drugs taken (especially aphrodisiacs), etc. A survey by Wang Yunlong and others in China found that the incidence of premature ejaculation is much higher in people suffering from diabetes than impotence.
In addition, there are three or five people joking together when they are bored, “climbing” each other, some people do not get tired of fighting for a long time, as short as half an hour, as long as an hour or more, secretly thinking that they ejaculate in 3-5 min, not only heroic shortage, so that their normal sexual function is affected and premature ejaculation occurs.
3.What degree is needed to treat
There is no certain formula for sexual behavior, and satisfaction depends on the rapport and communication between the two parties. Since sexual intercourse is not a rally, the only criterion is to make both parties achieve the best satisfaction, no matter how long it takes. Since the perception of premature ejaculation is multifaceted, which situation requires a doctor’s visit? The author believes that a visit to a sex therapist is warranted when the following situations occur
3.1 Whenever you see a naked body, or even sexually colored images in books or movies, you can’t help but ejaculate, which is the Chinese medical term for “seeing sex and flowing sperm” or “slippery sperm”.
3.2 As soon as the two people are in contact with each other, before the sexual organs are in contact, there is ejaculation, both the so-called “a touch on the hair”.
3.3 As soon as the genitals of the two people come into contact, ejaculation occurs, which is called “flower ejaculation” in Chinese medicine.
3.4 In the past, sexual intercourse could last for a long time, but recently, the duration of intercourse is significantly less than before, and the woman is not sexually satisfied for a long time.
3.5 Enter the vagina a few times and ejaculate, that is, the so-called “first intercourse is ejaculation”.
It goes without saying that the first four categories should go to a sex therapy specialist as soon as possible; the latter category, of course, depends on the attitude of both parties. In other words, sexual intercourse generally does not have a time standard, because the process of sexual behavior includes flirting, erection, penetration, ejaculation and other stages, the most important thing is the satisfaction of the sexual partner or not. If the woman feels satisfied and she feels nothing wrong, there is no need to seek medical attention.
Clinically, it can be determined in this way. For mild premature ejaculation, a vague concept can be used, depending on the awareness of both partners and the basis of previous sexual behavior and the requirements of sexual treatment, and if the patient requires treatment, the sex therapist should not be confined to the concept of normal intercourse time of 2-6 minutes, but should consider giving the corresponding sexual treatment. It should be pointed out that there is a misunderstanding of “premature ejaculation” and seeking medical treatment, that is, during sexual life, excessive emphasis is placed on the sexual satisfaction of the female partner, and the male partner is considered to be premature ejaculation if he ejaculates before the female partner reaches orgasm, which is unfair to the male partner, because the time for women to reach satisfaction varies from person to person, even if the same part of women originally suffer from orgasm disorder. The time it takes for a woman to reach satisfaction varies from person to person, even if the same part of the woman is suffering from orgasmic disorder, it is futile to have a longer time.
4, how to treat premature ejaculation
Good sex needs to be in a peaceful, warm emotional atmosphere so that the couple can enjoy the wonderful experience of sex. If the couple’s relationship is tense, the woman is unwilling to cooperate with the treatment, often half the effort. On the contrary, both parties are deeply in love, and the woman is happy to cooperate in the treatment. Then they can establish an intimate to be able to share the emotions, rather than the pursuit of sex nativity alone, can often make the treatment with half the effort. Thus, the importance of the female partner’s participation in sex therapy cannot be ignored. With this in mind, it is common for sex therapists to have both spouses participate in treatment together.
Premature ejaculation can be controlled, in addition to some knowledge about sex, the method of ejaculation time extension, there are a variety of specific practices, such as the male partner should remain calm during sexual intercourse, the action of sexual intercourse is also appropriate to slow; or change the position of sexual intercourse, using the female position; wear a penis condom to reduce the sensitivity of the head of the penis; during sexual intercourse so that attention is diverted; and appropriate interruption of sexual intercourse, etc., for the treatment of mild premature ejaculation are The treatment of mild premature ejaculation is helpful. The youngsters can also take repeated sexual intercourse and other methods, which have the effect of delaying ejaculation.
The essence of premature ejaculation is that the stimulation threshold required by the ejaculation center is too low, and the aim of treatment is to increase the threshold required to achieve ejaculation. The following are some of the common treatments used in clinical practice.
4.1 Chinese medicine treatment
Ancestral medicine believes that the collection and discharge of sperm is closely related to the heart, liver, spleen and kidney. Yin deficiency and fire, the failure of the sperm pass; indulgence in sexual desire and exhaustion of sperm, kidney deficiency; depression and anger injure the liver, liver loss of drainage; deficiency of the heart and spleen, loss of gas; desire in the heart, kidney fire delusion, the heart and kidney do not intercourse; dampness and sperm pass, phase fire delusion, opening and closing without authority can lead to premature ejaculation. The author used the methods of nourishing Yin and submerging Yang, benefiting the kidney and fixing essence, relieving depression in the liver, tonifying the heart and spleen, intercourse with the heart and kidney, and clearing the phase fire, respectively, and treated with Sancai Fengmingdan combined with Da Ren Yin Wan plus flavor, Gui Zhi plus Dragon Bone and Oyster Tang plus flavor, self-formulated Shu Jing Decoction plus reduction, Guei Spleen Tang, Huang Lian A Gum and Chicken Zi Huang Tang combined with Jiaotai Wan, and Gentian and Liver Drainage Tang plus reduction. In addition to the incandescent phase fire, other types of symptoms can also be treated with the author’s self-developed formula of solid essence wine. The formula consists of 20 grams each of Cornus officinalis, cherry seeds, five times seeds, hedgehog bark, raspberry, pecan clips and jujube, soaked in 1000 grams of white wine, sealed in a dark place, for 1 week in summer and 2 weeks in other seasons, 25 grams per night with meals. The amount of drinking can be increased to 40-50 grams when you want to have intercourse that night, and most patients can get good results. In addition, local medication can also be used to treat. The author used 20 grams of decoction of five times, five wisps, umeboshi, fumigate the glans and penis, 1-2 times a day; or 20 grams of cloves, horsetail, eucalyptus, five times each, dipped in 250 grams of 95% alcohol, let stand for half a month, every 10 minutes before sexual intercourse, the liquid will be applied to the glans area, the market currently sold “Shen Lu” Most of them are made from this kind of processing.
You can also use Chinese medicine guide techniques, such as the book “Dongxuanzi” introduced “where you want to ejaculate sperm, … men must Hou female fast and sperm a moment with the ejaculation, men must be shallow pull, swimming in the piano string between wheat teeth, Yang Feng deep shallow as a child containing milk, that is, close the eyes within the thought, pull down the jaw, bow the ridge leading the head, open the nose, she shoulders, close the mouth and inhale, sperm will come up. Section limit how much, nothing by the person, ten out of only two or three leaks carry on.” That is, when couples have sex, the feeling of early ejaculation, the penis will be lifted outward, shallowly placed in the lower third of the vagina, the glans shallowly placed in the vaginal opening, while the mind quiet, eyes closed meditation, jaw down, bending the back, stretching the head and neck, nostrils dilated, shoulders inward, closed mouth and inhaled, but the semen inward and not outward, but also by the will of man and control the amount of semen ejaculation. This method is the same as the idea and method used in modern sex therapy to divert attention and increase the interval to reduce sexual excitement, thus delaying the ejaculation time.
4.2 Interrupted urination method
By the method called pubococcygeal muscle training, the specific method is to discharge a part of the urine, pause, then discharge, then hold it, and finish the urine in several times. Usually, you can consciously make the spermatic cord contract to lift the testicles, or cover the erect penis with a bath towel for lifting exercises. In other cases, the opportunity to exercise the pubococcygeus muscle is only available when orgasm occurs. After a few weeks of exercise of the pelvic muscles, it is often possible to consciously prevent ejaculation, and when about to ejaculate, compression of the pubococcygeal muscles, can be when intercourse time arbitrarily prolonged, and can be repeatedly orgasmic.
4.3 scrotal pulling method
In the male orgasm, sexual excitement is very strong, the scrotum contraction, testicular lifting phenomenon, before the hand first pulling down the scrotum and testicles, that can reduce sexual excitement, in order to delay ejaculation, to prevent premature ejaculation effect.
4.4 Dynamic-static training method
The specific method is to stimulate the erection of the penis to the extent that it is about to ejaculate, that is, to stop stimulating until the excitement of the climax is reduced and then stimulate the penis again, and so on repeatedly until the man can tolerate a lot of stimulation and not ejaculate. Through this method of training, the increased number of stimulation and the time required to delay ejaculation will soon be reduced, and the patient will soon be able to tolerate continuous stimulation without intervals, in order to improve the threshold and establish a link between minimal stimulation and response. The patient is made to receive increasingly stronger and longer stimulation, but its intensity and duration are kept below the threshold value that causes the ejaculatory response, so that the therapeutic effect can be achieved.
4.5 Squeezing technique
The purpose of this method is to strengthen the husband’s self-control of ejaculation and to improve the wife’s sexual pleasure, and it is more effective to have the female partner perform this method. The specific practice is to fully stimulate the penis, when the man’s penis erection to the imminent ejaculation, the woman will own thumb on the tethered part of the penis, index finger and middle finger on the other side of the penis just below the coronal edge, steady pinch pressure for 4 seconds, and then suddenly relax. The direction of the applied pressure is from front to back, never from one side to the other. The woman should use the ventral side of her fingers and avoid pinching or scratching the penis with her fingernails. The amount of force used to squeeze and pinch is proportional to the hardness of the erection. This method can relieve the urgency of ejaculation, and insisting on using one of this method every few minutes can improve the inhibitory function and re-establish the appropriate time of ejaculation.
By squeezing, the hardness of the penis can be temporarily reduced by 10-25%. After a few days, if the male partner’s self-confidence has increased, the person can move on to intercourse during training, to be squeezed 3-6 times using the woman on top of the sexual position. The squeezing is done before the penis is inserted into the vagina, and after entering the vagina it is first stationary, without active friction, and both partners focus their attention on physical sensuality. After the penis has been in the vagina for 4-5 minutes, the penis can be squeezed at the base of the penis instead, so that intercourse can be interrupted without squeezing. After 2 weeks of these treatments, most patients will have a significant improvement in their ability to control ejaculation and will generally need to continue using the squeeze technique for 3-6 months to achieve a consolidated and lasting effect. According to Masters and Johnson, premature ejaculation is the best treated sexual dysfunction and they have a 98% cure rate with this method, which is well worth a try at home for patients with this trouble.
In addition, while applying the above methods, one should avoid bad stimulation, regularize life, pay attention to the combination of work and rest, ensure sufficient sleep, and do appropriate cultural and sports activities to enhance physical fitness, all of which are conducive to the recovery of premature ejaculation.