1.What is premature ejaculation? Premature ejaculation is mainly manifested as rapid ejaculation, which is a very common sexual dysfunction. If the following conditions are met, then premature ejaculation should be suspected ① Always or almost always ejaculate soon after vaginal penetration, or even before vaginal penetration in severe cases. ② Lack of control over ejaculation during sexual intercourse, and ejaculation is earlier than one expects. (③) Excessive ejaculation affects the sexual satisfaction of both partners, and partners and themselves feel distressed and worried as a result, and both partners will (or do) avoid sexual activities as a result. Wu Zhihuang, Department of Urology, Longyan Second Hospital 2. The classification of premature ejaculation is divided into primary and secondary: 1. Primary premature ejaculation. Primary premature ejaculation is rare and difficult to diagnose. Characterized by: (1) appearing at the first sexual intercourse; (2) to sexual partners, without selectivity; (3) premature ejaculation occurring at every sexual intercourse. 2. secondary premature ejaculation, secondary premature ejaculation is acquired premature ejaculation with a clear physical or psychological etiology. It is characterized by (1) premature ejaculation occurring at a definite time; (2) normal ejaculation time before the occurrence of premature ejaculation; (3) may occur gradually or suddenly: (4) may be secondary to urological diseases, thyroid diseases [9] or psychological diseases, etc. 3. How long is generally ‘normal’ during intercourse? The length of the ejaculatory latency period is an important indicator of whether you are suffering from premature ejaculation, but it is not the only indicator. A study done by Europeans found that some people who had intercourse lasting more than 30 minutes were still not satisfied and considered themselves to be prematurely ejaculated; others were haphazard with only 2-3 minutes, yet still considered theirs to be normal. Therefore normal and abnormal is a relative concept, if both parties have good sexual satisfaction, even if it is only 2-3 minutes, it is not necessarily premature ejaculation. The average coital time of the general population is around 7 minutes. 4. What are the effects of premature ejaculation? Premature ejaculation is a very common sexual dysfunction. Premature ejaculation not only affects sexual satisfaction, but also reduces male sexual confidence and self-esteem, and can affect the female partner, thus affecting the sexual relationship and feelings of both parties. Many men are therefore not confident, thus lacking the courage to interact with the woman and establish a relationship between men and women. The fear of ejaculating too quickly can lead to nervousness during intercourse. Sexual anxiety is common, thus affecting sexual desire inducing impotence. ④ Because of the avoidance of sexual intercourse and reduce the number of sexual life, indirectly may affect fertility. 5.What artificial factors are likely to cause premature ejaculation? The causes of premature ejaculation are both psychological and organic. These factors include ① lack of sexual knowledge, conservative personality or lack of experience in sexual life for the first time, in sexual life is easy to tension and cause premature ejaculation. ②The quality of previous intercourse is not ideal or intercourse is not successful, so it is easy to ejaculate prematurely due to fear of failure of intercourse again. ③Habitual premature ejaculation is formed when you are young and used to reach orgasm with quick masturbation. ③Neglect the feelings of the female partner during sexual intercourse, and only aim at self-satisfaction is bound to ejaculate too quickly. The two sides lack cooperation or do not get along well with each other and are prone to premature ejaculation. ⑤ Worry that sexual intercourse is harmful to health and thus ejaculate too quickly. (6) Abstinence for too long is prone to rapid ejaculation. (7) Female factors such as poor health of the female partner or aversion to sexual intercourse by the female partner, and the male partner being forced to end sexual intercourse quickly. The main causes of premature ejaculation are Ejaculation is a physiological reflex that occurs when sexual stimulation reaches a certain time and intensity. It is believed that the factors that cause premature ejaculation include: ① High penile sensitivity Even a small stimulus can cause a strong feeling of ejaculation. (2) An overactive ejaculatory reflex The feeling of unbearable ejaculation can occur with a slight contact or even with visual stimulation. (③) Genetic susceptibility (family heredity), central 5-hydroxytryptamine receptor sensitivity, etc. Most premature ejaculation has congenital factors. (4) Endocrine metabolic diseases (such as hyperthyroidism) or other systemic diseases can cause or aggravate the abnormalities of ① and ②. 7. What are the main tests for premature ejaculation? The examination of premature ejaculation includes physical examination and laboratory tests: it is necessary to assess whether there are any psycho-psychological factors triggering the ejaculation, and whether there are other triggering factors such as glansitis, prostatitis and vesicourethritis. If necessary, endocrine hormone examination should be done to rule out thyroid and other endocrine abnormalities. 8.What are the main treatment methods for premature ejaculation? ①Psychotherapy It is better if the female partner can cooperate with the treatment. Premature ejaculation is a common problem, eliminate anxiety, build confidence in curing the disease, and it can be cured if both partners cooperate with the treatment. ②Behavioral method guidance The basic treatment method of sexy concentration training aims to teach patients to experience and enjoy sexual pleasure and overcome psychological barriers through tactile stimulation such as hugging, touching and massaging. You can also pull the scrotum and testicles downward before reaching orgasm, or squeeze the glans with the thumb and index finger to reduce sexual excitement and reduce erectile hardness by 10% to 25%. After a long period of training and then have intercourse in the female superior position, still use the form of pumping – stop – pumping again repeated training, gradually improve the ejaculatory stimulation threshold, so as to achieve a more satisfactory artificial control before ejaculation. ③Medication Generally combined Chinese and Western medicine treatment, before sexual life can be combined with oral (such as dapoxetine hydrochloride) and local medication and so on. ④Dorsal penile nerve amputation A few penis with extremely high sensitivity can be used with caution, but the operation is extremely demanding and may affect erectile function if blood vessels and penile corpus cavernosum are damaged during the operation. ⑤ Other methods A small number of severe premature ejaculation can be treated with cavernous drug injection therapy, penile prosthesis implantation, etc. when other methods are ineffective.