How does behavioral therapy for premature ejaculation work?

  Introduction: October 28 is “World Men’s Health Day”, and WHO has asked countries around the world to increase their efforts to promote men’s health, calling on society as a whole to pay more attention to men’s health, and on every family to care more about men’s health.  On the occasion of “World Men’s Health Day”, the editor of Medical Pulse has compiled a list of high concern premature ejaculation, presenting the recommendations of the guidelines for behavioral therapy, the latest research and training courses, hoping to bring help to the clinical work of doctors and the rehabilitation of patients.  Premature ejaculation (PE) is defined as a disorder caused by a short ejaculatory latency and an inability to delay ejaculation. Management of premature ejaculation can involve behavioral and/or pharmacological treatment. the EAU 2015 Male Sexual Dysfunction Recommendation Form recommends the following treatment for PE: Diagnostic Recommendations for PE Treatment Recommendations for PE: Most psychological causes of premature ejaculation can be treated with behavioral therapy. Recently, Sex Med published a study on the behavioral management of premature ejaculation.  Researchers reviewed nine databases, including MEDLINE. A total of 521 patients were included in 10 randomized controlled trials including behavioral therapy compared with waitlist therapy and other therapies or behavioral therapy compared with medication-only therapy. The main observations included intravaginal ejaculation latency time (IELT), sexual satisfaction, ejaculatory control, anxiety, and adverse effects.  All studies evaluated physical therapy techniques, including squeeze and pause – start, sensual focus exercises, stimulation devices, and pelvic floor rehabilitation. Only one randomized controlled trial included psychotherapy (combined with pause – start and medication). Four trials compared the effects of behavioral therapy with other alternate therapies, with two of the studies (including squeeze, pause and start, and sensual focus exercises) showing a 7-9 minute difference in IELT, while the remaining two studies (sensual focus exercises and stimulation devices) found no difference in IELT. For the other effects (sexual satisfaction, libido, and self-confidence), some of the alternate therapies were beneficial to behavioral therapy, while the rest were not significant.  Three randomized trials tended to combine behavioral and pharmacological treatment rather than pharmacological treatment alone, with minimal differences in IELT (0.5-1 min) and significant improvements in other indicators (sexual satisfaction, ejaculatory control, and anxiety). Direct comparisons of behavioral therapy with medication showed different results, with most either benefiting from medication or not showing significant differences. No studies have reported on this aspect of adverse effects, but safety data are very limited.  This study suggests that behavioral therapy is better than wait-list therapy for PE in improving IELT and other symptoms, and that behavioral therapy combined with pharmacotherapy is more effective than pharmacotherapy alone. Further randomized controlled trials are needed to evaluate the effectiveness of psychotherapy for PE.  Finally, I would like to offer you the “Premature Ejaculation Behavioral Therapy Training Tutorial” shared by a friend of the Medical Pulse Circle in the urology circle. The tutorial comes from the Chinese Medical Science Center and demonstrates the training of behavioral therapy for premature ejaculation through multiple pictures, with fresh drawings, clear explanations, and a cute style that can alleviate a lot of embarrassment.