1. What is premature ejaculation? The definition of premature ejaculation is still controversial. In the past, premature ejaculation was usually judged by ejaculation latency or whether women could achieve orgasm, but this criterion was not satisfactory. 2008, the International Society of Sexual Medicine adopted the first evidence-based definition of premature ejaculation, pointing out that premature ejaculation is a sexual dysfunction with the following characteristics: ① ejaculation often or always occurs within about 1 minute of vaginal penetration; ② the ability to prolong ejaculation after repeated or each vaginal penetration (iii) there are negative consequences such as annoyance, painful frustration, and/or avoidance of sexual intimacy. Taking into account individualized differences, this criterion still does not identify the presence or absence of premature ejaculation. The patient’s ability to control ejaculation and whether the couple can achieve sexual satisfaction should also be taken into consideration. 2. What are the types of premature ejaculation? Premature ejaculation is divided into primary premature ejaculation, secondary premature ejaculation, natural variability premature ejaculation and premature ejaculation-like ejaculatory dysfunction. (1) Primary premature ejaculation: This refers to premature ejaculation that occurs from the beginning of the first sexual intercourse and continues to occur in the subsequent sexual intercourse. This kind of premature ejaculation is common, and the ejaculatory latency period is often <1<
span=””>～2 minutes. (2) Secondary premature ejaculation: It refers to men who had normal ejaculatory function for a period of time in the past and then suddenly or gradually developed premature ejaculation. (3) Natural variability of premature ejaculation: Repeated irregular occurrence of premature ejaculation, which is a normal variation of sexual behavior. (4) Premature ejaculation-like ejaculatory dysfunction: ejaculation at the beginning of sexual intercourse, or even ejaculation before sexual intercourse, and inability to have normal sexual life as its main performance. 3, what factors can cause premature ejaculation? At present, it is believed that most of the causes of premature ejaculation are psychological, such as sexual trauma suffered from improper sexual awareness or sexual behavior, self-guilt and lack of confidence in sexual life. In addition to psychosomatic abnormalities, some people may also have neuropathic organic lesions, such as neurosensory hypersensitivity or increased excitability of sensory nerves, to the extent that ejaculatory dysfunction is regulated and leads to premature ejaculation. In addition, some external genital or urethral diseases such as glansitis of the foreskin and prostatitis may also affect the ejaculation time. 4.What are the treatment measures for premature ejaculation? (1) mental/behavioral treatment: change the position of intercourse, female on top intercourse, side lying intercourse; apply cold compresses to the testicles, use cold water wet towels to slow down the blood flow to the testicles and eliminate tension; choose the time of sexual intercourse, it is appropriate to wake up after sleep, or masturbate and ejaculate first, and then have intercourse after the expiration date; use condoms to reduce the friction between the penis and the vagina and reduce the intensity of stimulation; interrupt the urination method, that is, first part of the urination process Then pause for a while, then discharge and hold it again, and discharge it in several times. (2) Drug treatment: including surface local anesthetics, 5-hydroxytryptamine inhibitors, etc. (3) Surgical treatment: dorsal penile nerve dissection should be chosen carefully because of its irreversible characteristics. 5.What are the behavioral training methods for the treatment of premature ejaculation? (1) Hypnotherapy: The main purpose is to overcome the expected anxiety about failure and enhance sexual arousal through fantasy, once a week for eight weeks. (2) Stop-motion-stop training: The main purpose is to reduce sensitivity, thus delaying ejaculation. This training includes: ① sexual partner stimulate the penis and glans by hand until ejaculation is imminent, then stop stimulation, and then re-stimulate the penis after the ejaculation feeling of excitement is gone; ② masturbation training, the same method as ①, but the effect is not as good as the sexual partner operation; ③ training during intercourse, such as reducing the amplitude and speed of penis pumping, or suspending pumping, so that the excitement is reduced, and then pumping when the penis is about to weaken, and so on and so forth. (3) pinching and squeezing skills: also known as tolerance training, that is, the female party to the penis constantly apply stimulation for about 4 seconds, the direction of pressure is back and forth, with the finger belly, when the male partner feels ejaculation is imminent, the female partner quickly with the right thumb on the tethered part of the penis, index finger and middle finger on the other side of the penis, just below the upper coronal edge, adhere to training 15 to 30 times a day, can significantly strengthen the ability to inhibit ejaculation, prolong latency period. It is generally effective for 2 weeks, and the effect is consolidated for 3-6 months.