There are various definitions of premature ejaculation, which may be different in each country. The one that can be recognized by most experts is: ejaculation before or within one minute after penile penetration into the vagina, reduced ejaculatory control, and adverse psychological and emotional effects on both partners.
The medical community also has different knowledge and understanding of the clinical classification of premature ejaculation, and the consensus is to classify premature ejaculation into primary and secondary.
The characteristics of primary premature ejaculation are.
① Rapid ejaculation occurs at the 1st intercourse ;
(2) Rapid ejaculation occurs almost every time of sexual intercourse and with different sexual partners;
(3) Ejaculation latency is less than 1 minute in most cases (90%).
The characteristics of secondary premature ejaculation are.
(i) The ejaculatory latency is normal before the appearance of premature ejaculation;
②The patient has rapid ejaculation at a certain stage;
③ Premature ejaculation may be caused by other diseases: it may appear suddenly or gradually;
④It can be relieved or cured with the treatment of the primary disease.
The factors leading to premature ejaculation are undoubtedly complex and diverse, and the causes of primary premature ejaculation are different from those of secondary premature ejaculation.
Primary premature ejaculation: it is currently believed to be a decrease in 5-HT2C receptor sensitivity and/or an increase in 5-HT2C receptor sensitivity. Recent studies suggest that neurobiological and genetic variants may contribute to primary premature ejaculation.
Secondary premature ejaculation: possible causes include
(1) Genitourinary disorders such as erectile dysfunction or prostatitis;
(ii) Abnormal thyroid function;
③Psychological or emotional problems.
Premature ejaculation and psychological or emotional problems: early sexual experience, sexual life environment, sexual skills, frequency of sexual life, anxiety and depression, low libido and other adverse effects on sexual psychology can lead to premature ejaculation. Anxiety and depression: Because anxiety and premature ejaculation are regulated by the same sympathetic nerves.
The conditioned reflex of striving to ejaculate quickly (premature ejaculation) once formed, even after marriage sex is difficult to change the habit of early ejaculation.
The number of sexual intercourse is too little, once sexual intercourse causes excessively strong sexual excitement (sympathetic excitement) and easy to ejaculate early (premature ejaculation).
③ Interpersonal, family and conjugal relationships are not harmonious, resulting in anxiety, tension and fear can cause premature ejaculation.
④Lack of self-esteem, frustration, feelings of guilt, shame, self-pity and other depressive moods can cause premature ejaculation.
⑤ Lack of sexual knowledge, sexual intercourse skills and experience, etc. When the female partner has sexual dysfunction, such as sexual apathy, low libido, sexual aversion, sexual excitement disorder, painful intercourse, vaginal spasm, it can also lead to premature ejaculation in the male partner.
Premature ejaculation and erectile dysfunction: Deliberately increasing the frequency of penile pumping and increasing the amplitude of pumping in order to maintain an erection, as well as anxiety caused by the fear that the erection will disappear before ejaculation, can often lead to rapid ejaculation.
Premature ejaculation and thyroid function: When suffering from hyperthyroidism, accompanied by premature ejaculation, premature ejaculation can be cured in most patients after treatment for hyperthyroidism.
Premature ejaculation and prostatitis: Prostatitis is a common disease in young adults, about 50% of men have had symptoms of prostatitis at different times in their lives, and most patients do not need treatment. In addition to lower urinary tract symptoms such as dyspareunia, dysuria, frequency, urgency and difficulty in urination, and pain in the perineum, penis and suprapubic area, some patients also have symptoms of sexual dysfunction, including decreased libido, impotence and premature ejaculation.
The Chinese Society of Urology, based on a large amount of international and domestic medical literature evidence and expert experience, formulated the “Chinese Prostatitis Diagnosis and Treatment Guidelines”, which clearly states that “some patients with prostatitis may have symptoms of sexual dysfunction such as decreased libido, erectile dysfunction (impotence) and premature ejaculation, but there is no evidence that prostatitis directly causes sexual dysfunction. “.
In the clinic, most patients are seen with sexual dysfunction (erectile dysfunction, premature ejaculation, etc.) and do not have prostatitis at all or their prostatitis symptoms are not obvious, so treatment should be targeted to those who have erectile dysfunction and premature ejaculation as their main manifestation should receive direct targeted treatment without having to treat prostatitis.