Premature ejaculation (PE) is a common male sexual dysfunction, the prevalence in adult men is 35% to 50% (in the UK the prevalence is estimated to be (14% ~ 41% ), the Middle East about 12. 4%, Southeast Asia about 30. 5%, East Asia about 29. 1% …… enough to mess it up ). It was not until a few decades ago that people began to see premature ejaculation as a problem requiring treatment, due to the fact that the main purpose of human sexual activity is no longer a reproductive need but has become a mutual pleasure for both partners, especially since the sexual needs and satisfaction of women are fully recognized and affirmed.
It is important to emphasize that although premature ejaculation is a type of male sexual dysfunction, it does not necessarily affect the physical sexual satisfaction of men, which is more evident in culturally backward areas and individuals, who do not take into account the sexual feelings of women, so such individuals do not consider premature ejaculation to be a disease, and it does not even cause dissatisfaction between the two parties. In other words, premature ejaculation may have existed since ancient times, but it has become a problem or even a disease thanks to the progress of social civilization.
On the surface, premature ejaculation is mainly characterized by abnormal ejaculation latency control during sex, characterized by short ejaculation latency time after erection and vaginal penetration, or uncontrollable ejaculation soon after penetration. Under current conditions, the factors that influence ejaculation include both self-factors and external factors. Among the self-factors, it is mainly related to its own physiological anatomy and functional state, such as the functional state of the nervous and endocrine system and the individual’s psychological state; among the external factors, various environmental factors, the sexual attraction of the sexual partner and the cooperation or not have a significant impact.
The formation and maintenance of premature ejaculation and the development of external factors have a significant impact on both self and external factors, according to the Marxist philosophical dialectic, according to the principle of the relationship between internal and external factors: self factors are the basis for premature ejaculation, and external factors are the fuel for the development of premature ejaculation.
Embarrassingly, there are more definitions of PE, and there is still no clearer conclusion. However, it is usually evaluated by the ejaculatory latency of men or the frequency of women reaching orgasm during sexual intercourse. The diagnostic criteria for PE in the Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-TR-IV) issued by the American Psychiatric Association are:
1. persistent or repeated ejaculation before, during, or shortly after penetration with minimal sexual stimulation, earlier than the person desires, various factors affecting the duration of sexual arousal should be considered, such as age, new sexual partners, new environment, and frequency of recent intercourse;
2, obvious pain and interpersonal (between partners) tension;
3. The PE condition is not caused by a substance (e.g., alcohol, opioids, and other drugs). In 2004 the American Urological Association (AUA) considered PE that means that ejaculation occurs before the individual expects it, whether before or after penetration, and causes distress to the other person or both.
The definition of PE is defined as a man losing the ability to control ejaculation during sexual intercourse, ejaculation before or just after vaginal penetration, or a woman reaching sexual climax less than 50% of the time during sexual intercourse, because the latency of ejaculation in men is affected by the length of abstinence, and the frequency of orgasm in women is affected by a variety of factors such as physical state, emotional changes, and the surrounding environment. This definition is not definitive and needs to be further refined.
Is it that easy to put a definition on your head that is yet to be perfected? The actual fact is that you can find out if you really belong to the category of premature ejaculation. If you’re not a fan, you’ll be able to add to your psychological pressure for nothing.
The real danger of premature ejaculation is where?
The particularity of the harm is not to affect the physiological satisfaction of the patient’s own sexual life, but mainly by causing a decrease in the sexual satisfaction of the patient’s spouse, which causes psychological or physiological dissatisfaction of the patient, thus causing an overall decrease in the sexual satisfaction of the sexual life unit. The diagnosis and treatment of premature ejaculation must take this feature into account in order to capture the essence of the problem. Strictly speaking, premature ejaculation is not just an individual disease, but an imbalance within the sexual life unit, a form of sexual disharmony.
The fact that the premature ejaculation status of some premature ejaculation patients can disappear when they change their sexual partners proves this argument from another perspective. Therefore, the diagnosis and treatment of premature ejaculation must be based on the physiological conditions of both partners, taking into account the satisfaction of both partners, rather than simply qualifying premature ejaculation in terms of time or number of thrusts, etc. Also, the treatment should be based on the maximum restoration of the physiological and psychological balance within the sexual unit as the end point of treatment.
The treatment plan for premature ejaculation is to increase the amount of effective stimulation (effective stimulation intensity × effective stimulation time) of the male partner to reach his orgasm threshold, while the female partner’s status should be adjusted appropriately and the cooperation ability of both parties should be improved, so as to improve the harmony of sexual relations between the two parties, which is also in line with the current clinical diagnosis and treatment work.
Increase the amount of effective stimulation of the female partner does not only lie in simply extending the time of intercourse and the number of thrusts, but also depends on the timing, manner and method of sexual stimulation is appropriate or not. As with the male ejaculation latency changes in different environments, the same woman in different states to reach orgasm requires the same amount of stimulation and stimulation methods are not the same, in the appropriate timing and way of stimulation, the time required for women to reach orgasm can be greatly reduced. Therefore, men mastering the right timing and appropriate sexual stimulation skills, together with women’s rich sexual imagination can help women reach orgasm, thus achieving the purpose of treating clinical problems caused by premature ejaculation.
Accordingly, the treatment of premature ejaculation should start from the following three aspects.
1, guide men to learn both sex physiology and psychological knowledge, and through various practices or exercises to improve their sexual stimulation skills;
2, the application of various means to extend the male ejaculation latency, including a variety of means to reduce stimulation, such as condoms, the application of local anesthetic drugs, as well as moving to stop technology, distraction, etc.;
3, the two sides cooperate, women also need to change their physical and mental state during sex, try to improve the excitement through their own regulation, lower their orgasm threshold.
The first two of these three aspects are most closely related to the male, the doctor through theoretical education to make men understand the sexual physiology and sexual psychology of both sides, help men choose the right time to give the woman appropriate sexual stimulation to improve female arousal, while taking a variety of drugs and equipment to assist, and the necessary training and practice, help to break the original male pattern of rapid ejaculation behavior, The third aspect is closely related to the woman, the woman’s own physiological and psychological state adjustment, can change the degree of their own sexual excitement, women through adequate sexual fantasy and their own auxiliary stimulation, etc., can improve the chances of obtaining orgasm in sexual life. Through the above three efforts, if there are no serious organic pathological factors, the harmony of this sexual life unit should be able to be improved.