More than 2,000 years ago, Confucius said in the Book of Rites, “Food, drink, and sex are the great desires of mankind.” This shows that food and sex are the two most basic things for human survival. A harmonious sex life is important for promoting physical and mental health, and for maintaining harmonious family and social relationships. Premature ejaculation is the most common sexual dysfunction. 75% of men have experienced premature ejaculation in their lifetime, and a large sample of studies have shown that the incidence of premature ejaculation is 14% to 41%. Regarding the definition of premature ejaculation, it is now generally accepted that the American Psychiatric Association issued the Diagnostic and Statistical Manual of Mental Disorders (4th edition): persistent or repeated ejaculation before, during, or shortly after penetration under minimal sexual stimulation, earlier than one desires. The definition here does not specify the time, because early and late are relative, and the reference here is the desire of both partners. To understand the treatment of premature ejaculation well, you must first be clear about the causes of premature ejaculation so that you can treat the cause. The reason for premature ejaculation is not only organic factors, but also psychological factors. The first two factors are related to high penile sensitivity, 5-hydroxytryptamine receptor dysfunction, high sexual arousal, high ejaculation reflex arc excitement, certain endocrine diseases and genetic susceptibility. The first two factors are by far the most likely factors for premature ejaculation: the penis is highly sensitive, resulting in a relatively low ejaculation threshold, so that excitability gradually rises during sex and soon reaches or exceeds the threshold, leading to premature ejaculation; 2C receptors in 5-hydroxytryptamine receptors play an inhibitory role in the ejaculation process and 1A receptors play a facilitating role, so if 2C receptors are low in sensitivity and 1A receptors are high in sensitivity it will lead to Premature ejaculation can occur. Psychological factors include inadequate ejaculation control skills, early bad sexual experiences, anxiety and psychodynamic aspects. There is no evidence that masturbation can cause premature ejaculation. Some masturbation patients develop the habit of ejaculating too quickly may have something to do with premature ejaculation, but there is no evidence that it is related to premature ejaculation; even some masturbation patients in pursuit of sexual pleasure, the intensity of stimulation during masturbation far exceeds that of the sexual process and even leads to non-ejaculation. Premature ejaculation treatment in a previous life. Before the emergence of effective drugs for premature ejaculation, people were also trying to explore treatments for premature ejaculation, for example, some people thought that turning their minds to other aspects during sex such as diet, travel, and partying could prolong sex, but the efficacy was often poor and even caused problems with erectile function, leading to erectile dysfunction and, over time, low libido; some people tried drinking alcohol or using kidney-strengthening and sperm-fixing effects of Food, such as oyster, pecan meat, gravy, chestnut, turtle, clam, pigeon egg, pork loin, etc., but the effect is also not satisfactory; some people try condoms, but they also face poor results, and even erectile dysfunction and decreased libido. Premature ejaculation treatment in this life. Modern premature ejaculation treatment drugs are preferred, in addition to psychological/behavioral treatment, and surgery is not routinely recommended. Medication is the first choice for premature ejaculation treatment, and currently there are mainly selective 5-hydroxytryptamine reuptake inhibitors, tricyclic antidepressants and local anesthetic drugs. 5-hydroxytryptamine reuptake inhibitors can improve increase the local 5-hydroxytryptamine concentration in the brain and activate 5-hydroxytryptamine receptors and work, mainly including dapoxetine, sertraline, paroxetine, fluoxetine, citalopram, fluvoxamine maleate, etc., of which Dapoxetine is the first and only drug approved by the U.S. Food and Drug Administration for the treatment of premature ejaculation, which has been studied in more than 6,000 clinical trials in multiple centers worldwide, and its efficacy has been confirmed. The effect of 5-hydroxytryptamine reuptake inhibitors usually starts in 5-10 days, but the full effect often takes 2-3 weeks, and long-term continuous use is recommended to ensure efficacy; taking s on demand 3-6h before sexual intercourse is not as effective as daily use, although it is well tolerated. Tricyclic antidepressants, mainly clomipramine, are less effective than 5-hydroxytryptamine reuptake inhibitors. Local anesthetic drugs were first used in the treatment of premature ejaculation in 1943, which can reduce penile sensitivity and do not affect the ejaculatory sensation. Currently, commonly used local anesthetic drugs include gels, creams or sprays of mixed preparations of lidocaine and/or proparacaine, and compound preparations of SS creams made from extracts of various herbs, but excessive doses of local anesthetic drugs may lead to If the medication is not wiped off before sex, the vaginal absorption of the medication during sex can cause vaginal numbness and a lack of sexual pleasure in the partner. Psychological/behavioral therapy. Psychological/behavioral therapy is more suitable for patients whose psychological factors are the main factors of premature ejaculation; if combined with medication, it can help improve the efficacy of medication, and some studies have shown that psychological/behavioral therapy combined with medication is currently the preferred treatment option for premature ejaculation. Psychological/behavioral therapy includes general psychotherapy, behavioral therapy and cognitive therapy. General psychotherapy is used to treat premature ejaculation by creating a warm sexual environment through psycho-education, etc., in order to alleviate anxiety, which is an important maintenance factor for premature ejaculation. Behavioral therapy began in the 1950s, and the main methods are Semans’ pause training, Masters and Johnson’s “pause – squeeze” technique and Kaplan’s “stop – move” technique. These methods basically start with self-stimulation, switch to partner manipulation, followed by non-pumping intercourse, and finally the “stop-motion-stop” technique. Behavioral therapy requires the active cooperation of the female partner. The “squeeze and pinch” technique involves the female partner using her thumb on the tether of the penis, and her index and middle fingers on the upper and lower coronal rim, squeezing and pressing the head of the penis for 3 to 4 seconds, and when ejaculation is imminent, the female partner holds the penis body until the ejaculation sensation disappears. The “stop-motion” technique is for the female spouse to stimulate the patient’s penis until the patient feels that ejaculation is imminent, then immediately stop stimulation and re-stimulate the male partner after the feeling of ejaculation has completely disappeared, and then repeat this three times before completing ejaculation. In recent years, some people have tried to treat premature ejaculation through physical stimulation using a sexual function therapy device, the principle of which is similar to behavioral therapy. Behavioral therapy is generally effective in about 2 weeks, and then consolidated for 3-6 months, but behavioral therapy leaks require close long-term cooperation from the female spouse, and many patients have difficulty in adhering to it, which affects the long-term efficacy. Cognitive therapy focuses on targeted perception and experience, improving sexual communication between sexual partners, improving sexual skills and self-confidence, and reducing anxiety related to sexual activity, with the main methods being psychodynamic and muscle relaxation. Surgical methods. Including selective dorsal penile neurectomy and hyaluronic acid gel penile glans enlargement, but these surgical treatments have no large-scale clinical trial evidence and long-term follow-up information, and there are also lead to penile hyposensation, temporary or permanent loss of erectile function, etc. Therefore, experts believe that surgical methods are not should be used with caution and not routinely recommended. History and reality are inseparable, history is the reality of the past, reality is the continuation of history; history needs the support of reality, and likewise reality cannot be separated from history. We study history in order to better understand reality. By the same token, the same is true for the past life and present life of premature ejaculation treatment. People can only develop to modern premature ejaculation treatment after the exploration of premature ejaculation treatment methods in the past life. Medications are preferred in modern premature ejaculation, in addition to psychological/behavioral treatment, and surgery is not routinely recommended.