The definition of premature ejaculation is still controversial, but it usually refers to a man’s inability to control ejaculation during sexual intercourse, which occurs at or just after penile penetration into the vagina. It is a more common male sexual dysfunction disease.
I. Etiology
The reasons for the occurrence of premature ejaculation are complex and different people have different reasons. Most of them are psychogenic (psychological), influenced by pathological excitation of the brain or enhanced excitation of the spinal cord center, and a few are caused by organic diseases.
(A) Causes of psychogenic premature ejaculation
1). Anxiety and depression
①. The conditioned reflex of striving for quick ejaculation (premature ejaculation) once formed, even after marriage, it is difficult to change the habit of early ejaculation during sex.
②. The number of sexual intercourse is too small, once sexual intercourse causes excessively strong sexual excitement (sympathetic excitement) and easy to ejaculate early (premature ejaculation).
③. Interpersonal relationship, family relationship, husband and wife relationship is not harmonious, resulting in anxiety, tension, fear can cause premature ejaculation.
④. Lack 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.
2). Masturbation vices
Because of the fear of being discovered and shamed when masturbating, they are nervous and try to ejaculate quickly, which gradually develops the habit of premature ejaculation.
3). Excessive fatigue
If you feel tired after physical or mental labor and have sex when you are not energetic, premature ejaculation can easily occur.
(B) Causes of organic premature ejaculation
1). Differences in physical quality
The reflexes of the penile corpus cavernosum muscles of premature ejaculation are faster than those of non-premature ejaculation, probably due to the high G-ketone content in the blood, which increases the excitability of the ejaculatory center and decreases the threshold.
2). Diseases causing organic damage to sympathetic nerves
Such as pelvic fracture, prostate enlargement, arteriosclerosis, diabetes mellitus, etc. directly affect the control center, resulting in premature ejaculation due to decreased control of the ejaculatory center.
3). Diseases of the reproductive organs
The foreskin tether is too short, preventing full erection; inflammation of the seminal mound is in chronic congestion and edema, the slightest sexual stimulation is sexual excitement and soon ejaculation.
Second, classification
According to the previous history of satisfactory sexual life, premature ejaculation can be divided into two categories?
(a) Onset premature ejaculation refers to premature ejaculation from the first sexual intercourse, called primary premature ejaculation.
(2) Secondary premature ejaculation refers to the occurrence of premature ejaculation after having a satisfactory sexual life before, called secondary premature ejaculation.
Third, clinical performance
Already ready for sexual intercourse, the penis has not yet entered the vagina that ejaculation, or has entered the vagina, but sexual intercourse briefly did not reach orgasm that ejaculation.
There is a history of mental factors leading to premature ejaculation, or a history of chronic inflammation of genital organs.
IV. Treatment
1. Drug treatment
Mainly use some antidepressants and sedatives, and use some antibiotics to treat the original disease for organic lesions.
2. Psychological treatment
Mainly analyze the psychological factors that cause premature ejaculation and then carry out psychological guidance to eliminate the causes so as to establish normal ejaculatory reflex.
3. Behavioral treatment
(1). Reduce the sensitivity of the glans by using some anesthetics or similar drugs.
(2). Repeated training of the penis by the wife to delay the ejaculatory urgency and raise the ejaculatory threshold.
A. Intermittent intercourse method: In sexual activity when the male has ejaculation premonition, immediately stop the penis thrust, the penis in the cunt women in sexual excitement vaginal expansion, the penis head did not touch the vaginal wall, can reduce the glans stimulation and reduce sexual excitement until the ejaculation premonition completely disappeared, and then sexual activity. This repeated intermittent sexual intercourse can prevent premature ejaculation.
B. Physiotherapy: lumbosacral ultrashort-wave transthermal therapy warm water bath, mineral bath, etc. can also assist in treatment.
C. Pull down the scrotum and testicles method: during sexual intercourse activities, men can see the scrotum contracting when the ejaculation premonition arrives. The testicles are raised at this time can inform the female partner to use her hand to gently pull the male scrotum and testicles downward, which can reduce male sexual excitement to delay the time of ejaculation to achieve the effect of preventing premature ejaculation.
D. Condom intercourse method: men wearing a condom for intercourse can reduce the friction of the penis, thus reducing the sensitivity of male sexual excitement and prolonging intercourse to avoid premature ejaculation.
F. Pinching method: This method is the best method for non-pharmaceutical treatment of premature ejaculation it can improve the ejaculation stimulation drop value of men, relieve the urgency of ejaculation, enhance sexual excitement improve the reflex state of ejaculation, rebuild or restore the normal ejaculation time. The pinching method can be performed by both men and women but is more effective when performed by the female partner than by the male partner alone.
(3). Change the action of sexual intercourse from slow to urgent and reduce the large movements to delay ejaculation.
4. Surgical treatment: such as dorsal penile neurectomy, but its efficacy and safety have to be further evaluated.
Prevention and care
1. both husband and wife should correctly learn to master the knowledge of sex, understand the physiological differences in sexual response between men and women, eliminate misunderstandings, and properly master the necessary sexual skills in sexual life.
2. Avoid sexual indulgence, excessive emotions, overcome the bad habit of excessive masturbation, be moderate in sexual intercourse and regular in living.
3. Occasionally premature ejaculation, the woman should comfort, understand, care for the man, gentle and considerate to help the man overcome the fear, tension, guilt, do not blame, blame the man.
4. Actively treat various organic diseases that may cause premature ejaculation to avoid the occurrence of premature ejaculation from the root.
5. Deal with the coordination of interpersonal relationships, family relationships, as well as the relationship between husband and wife, to maintain a comfortable mood.