Premature ejaculation patients have too many concerns about the medications used to treat premature ejaculation, both in the clinic and on the Internet. There are often patients who say, “Doctor, are you prescribing the wrong medication? “Is the side effect of this medication too big”; “Doctor, is this medication dependent?
Premature ejaculation is one of the most common sexual dysfunctions in men, and research data from the United States shows that about 20-70% of men have rapid ejaculation. Premature ejaculation may be found in 9-42% of adult men in China with varying degrees of rapid ejaculation. This figure is a bit conservative, probably related to the fact that we are more subtle in our country.
The definition of premature ejaculation has not yet been defined in a unified and precise language, but it generally includes the following meanings: ejaculation always occurs before, during, or soon after entering the vagina (usually less than 1 minute); and there is no control over delayed ejaculation; and negative personal emotions such as distress, worry, frustration, and avoidance of sexual behavior are generated. Premature ejaculation can be considered when the situations described above are present.
How can premature ejaculation be treated?
Generally speaking, premature ejaculation requires a combination of treatments, including behavioral therapy, topical local anesthetic drugs, oral 5-HT reuptake inhibitors (antidepressants), and surgery. Among them, oral antidepressants are the first choice of medication for premature ejaculation. Behavioral therapy is a very important method to improve the quality of sexual life; surgery such as dorsal nerve block is not recommended (at present, the indications, contraindications and adverse reactions of this surgery have not reached consensus.)
1.How to view antidepressants correctly?
Antidepressants, whose scientific names are collectively known as 5hydroxytryptamine reuptake inhibitors, act on the neurotransmitter 5hydroxytryptamine in the brain and play a role. The main indications for antidepressants are depression, obsessive-compulsive disorder, anxiety, etc. As described in the drug insert, it does have gastrointestinal discomfort, nausea, diarrhea, headache, anxiety, nervousness, insomnia, drowsiness and tiredness and weakness, dizziness or light-headedness, and even the risk of syncope, which is even more harmful if the drug is stopped privately. These are the main reasons why many patients are reluctant, or afraid to take this class of drugs. For patients with premature ejaculation, I emphasize when prescribing not to read the instructions, not to privately discontinue the medication; not to read the instructions, not to privately discontinue the medication; not to read the instructions, not to privately discontinue the medication; (the important thing to say three times)
Antidepressants were first used to treat premature ejaculation because doctors found that a significant percentage of patients taking antidepressant treatment would have difficulty ejaculating or even not ejaculating, which is actually a side effect of the drug. It was later used to try to treat premature ejaculation, and now this has this into the drug of choice for treating premature ejaculation. It is also the side effects of antidepressants that are used clinically to treat premature ejaculation by allowing for longer ejaculation times.
Compared to the treatment of depression, the dosage and duration of taking the medication for premature ejaculation is different, so the incidence of side effects is much less clinically than for the treatment of depression. The most common clinical side effects are mild dizziness and stomach discomfort, which mostly resolve on their own within a week and will not affect the patient’s life, but individual patients with significant dizziness are advised not to engage in high-altitude work, driving and other behaviors.
This kind of drugs we commonly used clinically are sertraline, paroxetine, fluoxetine, etc., need to be taken daily. The newly marketed Dapoxetine, trade name Bilevel, is currently the only drug approved by the State Food and Drug Administration for the treatment of premature ejaculation. Due to the unique metabolic characteristics of the drug, to avoid the shortcomings of traditional antidepressants need to be taken every day, to be taken 1 to 3 hours before intercourse, thus greatly reducing the adverse effects of the drug, the drug from the current use, as long as you find the right time to take, the effect is still quite good.
How long is the duration of these drugs?
At least 3~6 months, gradually reducing the dosage until discontinuation.
Are the side effects of these drugs significant?
There is a great deal of individual variability in whether or not they are significant, with some people showing little to no side effects and others having a hard time taking the medication. “The one that is uncomfortable after eating is often more effective. The majority of patients can tolerate the side effects of the drugs from the current clinical point of view, and it is worthwhile to bite the bullet for the sake of “sexual happiness”.
Do these drugs have dependence?
I am sorry to tell you that the reason why it takes 3-6 months of treatment is because of dependence. We need to use other methods to help withdraw their medications. This is why many patients say, “I was fine when I was taking the medication, but when I stopped, I couldn’t?” Be calm, be honest, premature ejaculation is such a disease. The reason why almost every premature ejaculation patient, in the process of treatment, I will painstakingly advise you to take Chinese medicine, acupuncture, but also detailed pointers between the couple that thing, the purpose is to.
1, combined treatment to increase the efficacy.
2, to help withdraw western medicine; even though many methods are used, there are still many patients who are dependent on drugs, especially those with primary premature ejaculation.
What about dependence on drugs?
① adjust your mind, God favors you, because premature ejaculation patients are mostly thin and tall body type (long-legged Oba Oh), God gave you a handsome appearance, slightly take away some internal, so the normal mind, frankly some.
② increase the treatment course, which is the last resort. I personally feel that Dapoxetine can still be taken for a long time.
③ adjust expectations, increase some premeditated sexual behavior (prepare some topical drugs or delay condoms, etc.), increase the cooperation between the couple, this is very important.
2, oral medication in addition to antidepressants (tricyclic antidepressants than 5 hydroxytryptamine reuptake inhibitors side effects are more obvious some of these drugs), there are almost no other efficacy of Western drugs.
3, the role of Chinese medicine on primary premature ejaculation is poor; secondary premature ejaculation has some therapeutic effect, but not immediately. It tends to improve the systemic symptoms while improving premature ejaculation. (For example, for those who have heart trouble, insomnia, anxiety, and easy to get angry, which are identified by TCM as heart and liver fire, we use the method of clearing the heart and dipping the liver; and for those who have less qi, lazy speech, weakness, white drip, and weak urination, etc., and have spleen and kidney qi deficiency, we use the method of tonifying qi and fixing the regimen.) For just a short period of time, can not control this situation, the effect of Chinese medicine alone is not good. But in clinical practice, Chinese medicine is helpful in helping to withdraw western medicine.
4. Topical medicine. Smear on the glans before sex, through anesthesia to achieve the purpose of extending sex time. This type of drug, health stores sell more, the main ingredient is anesthetic, may also contain other ingredients, the specific unknown. The actual fact is that you can find a lot of people who have been in the market for a few years. It can be used as a supplement to oral medication or as an option for patients with an irregular sex life (in this case, after dapoxetine is available on the market, of course).
Although antidepressants are the safe and effective drug of choice for premature ejaculation, it is only safe if they are applied under the guidance of a specialist. Therefore, patients are strongly discouraged from taking them privately on their own to avoid serious harm from improper administration and wrong dosage.