A handsome young man, over 175cm in height, came to the clinic for treatment. He described that he had had three girlfriends, all of whom left him quickly. The reason was that every time he tried to have intercourse, his penis was erect and his glans was particularly sensitive, so when he touched the vaginal opening, he immediately ejaculated at the first touch. This is a serious blow to both men and women physiologically and psychologically, so the women have left him, making him sad, with all these miseries, and come to the clinic to help. This is the most typical case of premature ejaculation.
Premature ejaculation is one of the common clinical male sexual dysfunctions, it is like a quick battle without success, it is a headache. As both sides are not satisfied and bitter, if not corrected, it will certainly cause marital tragedy over time. For the sake of social stability and the harmony of the couple’s life, we in sex medicine must pay attention and give in-depth research to solve this problem.
Definition of premature ejaculation.
The standard definition of premature ejaculation is not yet unified, and the views at home and abroad are not consistent.
Domestic view; it is called premature ejaculation when the penis fails to enter the vagina and ejaculate, or when the intercourse does not exceed one minute. Professor Wu Jieping, an authority on urology in China, believes that ejaculation within 2-6 minutes of sexual intercourse is normal for a healthy adult in his prime.
Foreign countries believe that more than 50% of the times of sexual intercourse, ejaculation before female orgasm is called premature ejaculation.
Studies at home and abroad show that more than 75% of men ejaculate within 2-6 minutes of sexual intercourse, while women generally need at least 8-15 minutes of sexual stimulation to reach orgasm. If we follow the foreign definition of premature ejaculation, wouldn’t that mean that many men are premature. Unfortunately, this is true. Social surveys made in China show that; “Nearly 80% of women do not know what orgasm is all about, and one of the most important reasons for this is that it is caused by men having sex for too short a time. From an evolutionary point of view, premature ejaculation can be said to be born with, due to our ancestors backward production, the poor environment in which we live, sex is only a means to reproduce offspring, requiring a quick end to sex to avoid the harm that comes at any time, such as fierce animals, the intrusion of companions, causing an important cause of sexual disharmony. Subsequently, in China’s long-standing feudal society, male dominance, men have no responsibility to meet women, of course, premature ejaculation is not a “problem”. Besides, if a woman makes a request for orgasm, she will be subjected to the notorious reputation of being called an adulteress without shame, so premature ejaculation was not considered a disease in feudal society at all.
The times are progressing, with the demise of feudal society, the rise of capitalism and socialism, and the rapid improvement in the status of women. Sex’ is no longer a matter for men, sex is a matter for both men and women, sex must be harmonious, “harmonious sex is a beautiful symphony” (by me), it not only has the orgasm when the man ejaculates but also requires the woman to have the same orgasm as the man It not only has the orgasm when the man ejaculates but also requires the woman to have the same orgasm as the man. As the woman’s orgasm time to long, generally requires 8-15 minutes, if premature ejaculation, there is the concept of “premature ejaculation”. So most men living in modern society; just relying on the drive of reproductive instincts to have sex is not enough, to achieve a harmonious sex life where both men and women have orgasms, we must be familiar with the mechanics of the sexual process, the characteristics and different feelings of the pathophysiology of the male and female reproductive system. The actual fact is that you can find a lot of people who are not aware of the fact that they are not able to get a good deal on their own. Unfortunately, many men are unaware of this, while our country has long been poisoned by feudal consciousness, in this area rarely provide guidance on sexual knowledge, it can be said that couples can successfully and truly achieve a harmonious sex life, and not many of them grow old, many families due to disharmony of sex life, resulting in the tragedy of divorce.
On the contrary, in the real world, men hear the word “premature ejaculation”, which is a heavy blow to men’s virility, and once they hear their lover say “useless”, then his self-esteem, self-confidence will be doubly hit, and his pain is no less than that of women. In my clinic for many years, many men painfully described: which a man does not want to use their virility, to conquer their lover, to achieve a harmonious orgasm, or even more, but for some reason always want things can not be, the heart is not what you want, once the sex, premature ejaculation, resulting in the other party’s pleasure, failure to return, the light is not happy, the heavy is sarcastic and embarrassing words, then the male psychological The difficulty can be imagined. The actual fact is that you can find a lot of people who are not able to get a good deal on this kind of things. Most of the men who come to the clinic are accompanied by their lovers to the doctor and ask questions. The existence of this ambivalence, on the one hand, affects the relationship between the couple, and at the same time, not get the pleasure of sexual harmony.
The pressure of family coupled with the high competition at work, the double pressure, greatly undermines people’s health. Especially on the intellectual layer of the white-collar class has the greatest impact, what “subhealth state”, “cure for the disease”, “kidney deficiency” these terms are very popular in the community. Because of the shyness of the mouth, they see a lot of advertisements in the society and do not know whether they can or cannot be targeted, so they secretly take health care products and various kinds of sex pills indiscriminately, resulting in worse health conditions and causing a vicious circle.
I think that if the problem of premature ejaculation is not solved for a long time, it is unpleasant to the individual physically and mentally, and not conducive to the growth of a healthy career and the happiness of the family. To the country to society to create a factor of instability and disharmony.
Therefore, I would like to say to everyone; remember that “physical premature ejaculation is hopefully curable and is not a terrible disease for men.” Among them are the problem of insufficient sexual knowledge, sexual skills and experience, men and women making love, once the premature ejaculation, do not be afraid to ask questions, more communication with relatives, especially to go to the regular hospital to seek advice from sex specialists, or psychologists, to give the right guidance. The most important thing is to rely on yourself: “active physical and mental self-regulation, and passive medication combined”.
Causes of premature ejaculation.
Before discussing the causes of premature ejaculation, let’s first understand a little about the mechanism of ejaculation. The core of what we say causes ejaculation is roughly this.
The first is the stimulation of the dorsal nerve of the penis, which has branches distributed in the glans and coronal groove penile ties and other parts of the penis, and is the sensory nerve that causes sexual excitement. When the twitch stimulation reaches a certain level (threshold), the impulse signal is transmitted to the cortical sexual excitement center, and after comprehensive analysis, the signal is transmitted to the primary ejaculatory center of the spinal cord in front of the sacrum to execute the command to ejaculate. From the above ejaculation mechanism process, the core is in two parts, one is the stimulation threshold of dorsal penile ejaculation, that is, the sensitivity of the glans, the stronger the sensitivity, that is, the lower the threshold value. The second is the control of the sexual center of the cerebral cortex. Therefore we discuss the etiology and treatment methods are considered with the above mentioned local stimulation amount and central control.
1. Wrong way of masturbation is the cause of premature ejaculation
Generally adolescent men start to develop around 13-14 years old and get married around 25-30 years old, so there is a long “sex gap period”. During this period, for the vast majority of men masturbation is the only option to excrete sexual impulses to release energy. So, domestic and foreign scholars have shown that 90% of men have masturbation experience, it should be said that moderate masturbation is not harmful to the body. However, the wrong way is harmful to health, especially as an important trigger for premature ejaculation. The majority of adolescents lack the right induction from adults and insufficient knowledge of sex, masturbation without the knowledge of adults, itself a sense of guilt, usually always sneaking around, hoping to end early in case they are found, in addition to masturbation due to the poor environment, are hoping to ejaculate quickly, for a moment of pleasure. This is the way to get into the habit of ejaculating quickly day after day, experiencing a process of training yourself to become a premature ejaculator, adjusting the “sensitive switch” of your brain’s sexual center to a highly sensitive state. The actual “ejaculation valve” can be triggered by a little sexual stimulation, causing premature ejaculation.
2, inappropriate premarital intercourse
In the premarital both sides due to fear of being found in an unfavorable environment or nervousness to have sex (such as taking the opportunity of parents out or having sex in a remote corner of the park) will strive to ejaculate quickly and end early, the habit becomes natural. Even in the relaxed environment after marriage, but it is difficult to change the established rapid ejaculation, so before marriage, you are advised not to eat forbidden fruit, so as not to leave the root of premature ejaculation.
3, miss the best opportunity for honeymoon sex regulation
Some patients come to the clinic and say that we have been married for more than two years, from the beginning of premature ejaculation, and so far have become accustomed to it, has been within two minutes of ejaculation, the male partner believes that this is natural, not a disease. The female partner is very dissatisfied because she can’t get an orgasm. Due to sexual disharmony, there is a gap between the minds of both parties. Therefore, they often quarrel. This time, the wife forced her husband to come to the hospital for consultation and asked the doctor to comment. We say that men without real sexual experience, long-term sexual hunger, the wedding night saw the bride, everything is curious, see the bride’s naked body, the brain’s sexual center has been excited to a very high state, in the beginning of embracing kissing or sexual organs just began to contact, these were not the strongest sexual stimulation signals superimposed on the higher “basic sexual excitement “When the overall sexual excitement quickly reaches a climax, thus stimulating the ejaculatory response, these situations almost many men will have premature ejaculation the first time they have sex. If you don’t know the basics of sex, and don’t consult your doctor and parents, and think that sexual intercourse is such a thing, it causes the root cause of premature ejaculation in the long run. Therefore, we should know the basic knowledge before marriage, especially the whole process of sexual life. Have a proper understanding of sexual life, especially during the honeymoon period, there is enough time and sexual interest to regulate your sex life to a harmonious degree, which also determines whether you can grow old in harmony as a couple is an important key moment. When you encounter problems, do not be unashamed to take it seriously, and in the long run will plant the seeds of disharmony. To bear in mind!
4, bad environment and bad mood, the couple’s relationship is not harmonious
The living environment is too poor, such as two generations of people living in the same room, only the cloth curtain as a boundary, or with children in the same bed, during sex is very afraid of sound alarm others, afraid of children suddenly wake up, in a very tense environment for sex, the demand for a quick end to the battle, over time will become premature ejaculation.
Therefore, we advocate equality between men and women, strong men, do not treat their wives in a macho style, what to me; strong women, do not be arrogant and proud, do not look at their husbands in the eyes. I hope that both sides respect and love each other, modest and harmonious, so as to adjust to a harmonious sex life, a hundred years of good cooperation.
5, the factors of disease
Such as the woman has chronic pelvic inflammatory disease, vaginitis, endometriosis. Often can cause different uncomfortable symptoms during sex, hope that the male partner to end the battle as soon as possible. This often causes premature ejaculation on the male side passively and develops the habit of premature ejaculation over time.
For the male side, tight foreskin, prostatitis, vesiculitis, urethritis, etc. can cause inflammatory congestion resulting in pathological premature ejaculation, but to identify whether these causes, it is very simple, such as in these inflammatory conditions before sex normal, and after the emergence of inflammation, that is, premature ejaculation, which is certainly related to the above inflammatory diseases. The actual fact is that you can find a lot of people who are not in a position to get a good deal of money, but you can’t get a lot of money. Once the inflammation appears, it must be treated promptly to remove the root cause of the disease. If the foreskin is too tight when you have an erection and affects intercourse, you must undergo circumcision in time. The two men and women should not be shy about the disease, and get by with it, and it will affect the relationship between the couple for a long time, remember!
The understanding of premature ejaculation in Chinese medicine.
The two organs have phase fires, and their faculties all belong to the heart.” Therefore, the cause of premature ejaculation is closely related to the heart, kidney and liver.
The heart is the master of the gods, and the gods will naturally improve premature ejaculation, so Chinese medicine often advocates clearing the heart fire, nourishing the heart’s yin, replenishing the heart’s qi, and fixing the heart’s spirit, Long Zaijing “Jin Kui Wing, Dreams of Essence” said: “those who move in the heart, the gods shake on the top, then the essence is lost in the bottom.” It indicates that ejaculation and premature ejaculation are closely related to the factors of the mind and spirit.
The kidney is the main seal, Chinese medicine believes that premature ejaculation is mostly due to excessive lust, the destruction of the kidney yin and kidney yang, resulting in the loss of kidney qi, sealing and hiding, no power to fix the regimen, or the phase of fire, masturbation is not moderate, the loss of kidney essence, resulting in Yin deficiency and fire, sealing and hiding is not solid, and the essence is easy to open.
The liver is the master of drainage, the kidney is the master of sealing, the liver and kidney are mutually restrained, the opposite of each other, and together they are responsible for the opening and closing of the sperm pass. The liver collects blood, uses qi as its function, uses yin and uses yang, its nature is ascending and active, and it is the collection of wind. The abnormal function of the liver’s drainage is too much, and if it is too much, the sperm pass is too active, then the qi line is as fast as the wind and rushes against the sperm pass, making premature ejaculation easy.
In conclusion: the understanding of premature ejaculation in Chinese medicine, I think to Zhu Danxi – heart, kidney and liver three Tibet related, it is appropriate to carry out targeted Chinese medicine evidence-based treatment according to different causes.
Treatment of premature ejaculation.
1. Adjustment of the imbalance of the body (basic treatment)
Premature ejaculation patients in the occurrence of premature ejaculation is the first to check what causes their own premature ejaculation, such as excessive masturbation experience, long-term lack of exercise after work, life and work leading to excessive pressure, sexual disharmony caused by tension between husband and wife, or taboo to seek medical help, shy to seek doctors, lack of help from family members, gradually make the body out of balance, immunity gradually decline, if not corrected in a timely manner, the body is in a subhealthy state.
Therefore, I suggest that before treating premature ejaculation, we should gradually restore the balance of yin and yang from the imbalance to the cause, and of course the best way is to take the initiative in physical and mental self-regulation, to “manage your own health”, to actively remove the bad customs of the past, to de-stress yourself, to participate in suitable aerobic exercises, and of course, the necessary Chinese medicine is also important, so that the imbalance of yin and yang can be adjusted from scratch. It is important to adjust the imbalanced yin and yang to achieve a new balance, so that you have a good state of mind and a healthy body to meet the treatment of premature ejaculation. The first step in the treatment is to lay a solid physical foundation, which is the basic factor of whether or not you can adhere to the regular treatment and be successful.
(1) Suspend sexual activities including masturbation and controlled intercourse, the purpose of which is to give the body a relaxed environment and sufficient time to recuperate, the suspension time depends on the person, from two weeks to three months, depending on when the spontaneous sexual impulses appear after stopping sexual intercourse, that is, without any sexual stimulation, an inexplicable demand for sexual impulses appears in the body, so that the next step of sexual treatment can be carried out.
(2) Develop a plan for exercise and exercise, and implement it carefully to improve one’s overall physical fitness.
Exercise therapy regarding premature ejaculation is set to have two purposes, one as part of the basic treatment, and the other is to consolidate the results of premature ejaculation treatment, so exercise therapy is used as a very important tool in the treatment of premature ejaculation, which will be discussed in detail in the section on consolidation therapy, but there is a basic principle to remember, the use of gentle and long-lasting aerobic exercise, the main point of which is to be persistent and circulate forward, to have enlightenment, to live a regular life, to Change the bad habits.
(3) We should carefully identify the imbalance of yin and yang, adjust the imbalance of yin and yang, and improve the immune function of the body, hoping to achieve the purpose of yin and yang secret, and to lay a good foundation for the treatment of premature ejaculation.
2.Behavior training therapy
We know that the core problem of the treatment of premature ejaculation is to try to improve the ejaculatory stimulation valve as well as to strengthen the control of the sexual ejaculation center in the cerebral cortex.
In foreign countries in 1956 James Color Manns first proposed a treatment method, by the wife with hand stroking the head of the penis and dry, until the degree of ejaculation imminent, then stop stimulation, to wait for the excitement orgasm ejaculation feeling disappeared, and then re-stimulate the penis, so repeatedly, can gradually extend the ejaculation time, improve the stimulation valve of ejaculation, gradually cure the problem of premature ejaculation, this method can also be carried out during sexual intercourse. Once there is a pre-ejaculation tide, both men and women immediately stop pumping and wait for the impulse to pass before proceeding with it.
In 1970, Mast and Johnson introduced the “squeezing technique”, also known as tolerance training, the woman sat between the two thighs of the man, facing the neck of the man, the index and middle fingers on the glans coronal sulcus at the tether, thumb on the dorsal side of the coronal sulcus, for the front and back direction of pressure stimulation, squeezing pressure for 4 seconds, and then suddenly relaxed, this method This method can improve the ejaculation valve of men, thus relieving the urgency of ejaculation, if you can adhere to it, continue to practice 15-30 times, can obviously strengthen the ability to inhibit ejaculation, prolong the ejaculation time, the intensity of stimulation is proportional to the strength of the male erection, generally in about 2 weeks to see the effect, continue about 3 months to consolidate the efficacy, according to the authors reported the failure rate is only about 3-5%.
From my experience of many years in male combined Chinese and Western medicine and urology, I have also conducted many years of research and practice on premature ejaculation in men. First of all, premature ejaculation is a very common disease in men, and its actual incidence is much higher than the actual statistics due to the influence of shy male virility. I am very happy that James Color Manns, Mast and Johnson first used behavioral stimulation therapy for premature ejaculation treatment and achieved high efficacy, and made a great contribution to the treatment method of premature ejaculation, which deserves the appreciation of patients and the medical community.
However, there is also room for further improving the efficacy and shortening the course of treatment. Based on his predecessors, he formulated his own method for the treatment of premature ejaculation, which emphasizes improving the local stimulation valve and strengthening the control of the central ejaculatory center under the premise of adjusting the balance and improving the immune function as mentioned above, simultaneously.
In terms of training cortical control, the first step is to do four basic tasks of training.
(1) urinating with the heel high, so that when urinating in a state of abdominal contraction and lifting the anus, training the basic method of sperm control, day after day can be skilled through the idea of sperm control.
(2) Each time you urinate, interrupt twice in the middle to urinate, the method of controlling urination is to control the urethral sphincter by contracting the abdomen and lifting the anus, so the training is conducive to the basic training of controlling ejaculation.
(3) Do 20 times of abdominal retraction and anal lift every day in the morning and before going to bed, and at the same time of each abdominal retraction and anal lift and close the breath for 30 seconds, the idea of semen entering the bladder, that is, retract the abdominal retraction and anal lift when inhaling, and close the breath for 30 seconds, and at the same time the idea of semen entering the bladder, the purpose of which is that when premature ejaculation patients have sexual intercourse, due to the low stimulation valve soon the local impulse enters the cortical sexual ejaculation control center through abdominal retraction and anal lift, closing the breath, the idea of reverse transfer method, in The man must carefully experience the feeling of ejaculation latency in order to shrink his belly and lift his anus in time to cut off the impulse.
3, Hui Chun Gong sitting three exercises, it’s wonderful practice under the Dan, shrink the abdomen and raise the anus as the core of the practice, it can not only improve the body’s immune function, improve sexual ability, while skilled control of ejaculation to provide training, if you can adhere to the training will be able to consolidate the healing effect long lasting. Specific operation steps are as follows.
(1) female penis massage method: the female side do in the male side between the two legs, facing the male side, with the right thumb pressed at the coronal groove on the back of the penis, the index and middle fingers placed in the glans coronal groove ties, massage in the up and down direction, due to the stimulation of the dorsal nerve endings of the penis, immediately excite the erection center and make the penis erect, the female side continue to massage, once the male side appears ejaculation premonitory sense female initiative to stop massage, the The left finger pulling scrotum, and penis dorsal ventral three fingers to be pinched not move, the male immediately do abdominal and anal retraction and closed half a minute, the idea of imaginary sperm back to the bladder, half a minute after the ejaculation equilibrium disappears, rest 1 minute, and then can continue to massage method as above, before and after a total of three times so that three times a week, each time three times a total of two weeks, the purpose is to reduce the sensitivity of the glans local stimulation, strengthen the cerebral cortex Control, but the core of its success, mainly so that the male partner in the massage process, especially to develop a sense of ejaculation aura, once found immediately stop massage, and at the same time control the cerebral cortex control ability, which is the key to success, so after two weeks of operation should be at least double its ejaculation time.
(2) Female superiority sex: three times a week for two weeks. As the male has learned to control the ability to ejaculate, the female upper position male is in a completely relaxed passive position, by the female riding above the male for up and down pumping, but the female pumping to gentle and slow, once the male ejaculation aura, the female immediately stop pumping, at the same time, the male to shrink the abdomen and lift the anus, closed the air intention upward operation, to wait for the balance of the past, the female again for pumping operation, so that can also be carried out three times Lasting two weeks, this stage to experience in real intercourse how to extend the intercourse time experience, so as to lay the foundation of normal intercourse, the core of this stage lies in the male side of passive sexual intercourse to extend the intercourse time method.
(3) old man trolley type male standing female horizontal intercourse: the use of female lying male standing position, the female side of the two legs placed on the shoulders of the male side, the male side in direct vision, sex, so that on the one hand, you can lift the sense of oppression on both sides, on the other hand, in direct vision sex to facilitate rapid insertion, to avoid less detours, while in the process of intercourse, the initiative in the male side, and a gentle method of lifting plug, once the aura of ejaculation immediately stop pumping. Carry out the routine, shrink the abdomen and lift the anus, close the air, the idea of upward method, once the impulse passed, and then intercourse, when the male partner has basically control the ejaculation method, thus curing the premature ejaculation disease.
Points to note.
(1) To get successful treatment, the first thing is the cooperation of the female partner, and close cooperation between men and women is the first element of success.
(2) The male partner must adhere to the method of daily abdominal contraction, anus lifting, air closure, and upward intention, and must be persistent.
(3) This three-stage treatment method, must be step by step, in strict accordance with the operating steps, once the ejaculation, but also a normal phenomenon do not panic, not considered a failure.
As long as you pay attention to the above three points, full of confidence, the success rate is very high, so that your sex life is harmonious and beautiful.
Traditional Chinese medicine treatment.
Chinese medicine has very rich experience in the treatment of premature ejaculation, Zhu Danxi cloud: “the main occlusion of the kidney also, the Division of drainage of the liver also, both have phase fire, and its system on all originated in the heart, and the essence of the off although in the kidney, its system is in the heart, heart fire a move, phase fire followed, is premature ejaculation carried forward.”
In the course of long-term practice, there is indeed a close relationship with the heart, kidneys and liver, in terms of etiology, work and study stress is too high, tension between husband and wife, lack of sexual knowledge, etc., these are related to the heart, originally congenital deficiency, physical weakness, yin and Yang two deficiency, or excessive masturbation, too frequent sexual intercourse, so that the kidneys dissipate too much energy, sealing and hiding, these are related to the kidneys, the liver meridians around the yin device, over the small abdomen, the yin device for the zong tendon will, the liver’s The liver’s drainage function is closely related to the normal drainage of semen, such as liver depression, liver failure to regulate the drainage of the liver, Qi stagnation, blood stasis, loss of nourishment of the zong tendons, and loss of the drainage of the seminal orifice, and premature ejaculation; in terms of diagnosis, the principle of simplicity should be used, and I divide it into hyperactive premature ejaculation and erectile weakness premature ejaculation.
This type of premature ejaculation belongs to the type of premature ejaculation with excessive yin deficiency and yang hyperactivity, which should be given priority to nourishing yin and clearing heat to lower the fire. This type of premature ejaculation is a type of premature ejaculation in which the penis is weak in erection and can barely enter the vagina and ejaculate soon afterwards, so it is caused by a deficiency of kidney yang and a deficiency of kidney yin, which causes a failure of sealing. The spleen also has a place in the treatment of premature ejaculation. Because the spleen is the main regulator, the spleen is the mechanism of sperm intake. In terms of the mechanism of premature ejaculation. The kidney, liver, heart and spleen are all related, but the kidney is the main one. The following are some of my preliminary views on the laws of Chinese medicine.
Most of the TCM understanding of premature ejaculation believes that its single internal organs occur less, are more intermingled with each other for the disease. The most common causes of premature ejaculation are: deficiency of kidney qi, loss of seal, depression of liver qi, abnormal drainage, inability to restrain, desire in the heart, delusional movement of phase fire, disturbance of the sperm pass, lack of intercourse between the heart and kidney, loss of solidity of the sperm pass, deficiency of the heart and spleen, and failure of the qi to take in sperm. Therefore, when prescribing medication, we should identify the internal organs, combine the tongue and pulse for comprehensive, individualized and multi-faceted identification, combine the four diagnoses and implement comprehensive treatment, especially to coordinate the physiological functions of the kidney, liver and heart, among which the kidney is the root, taking into account the heart, liver and spleen, which is the fundamental pathological basis for curing premature ejaculation.
1. Taking the kidney as the basis and taking into account the heart, liver and spleen
The kidney is the root of the innate nature, the house of sperm production and sperm storage, the root of yin and yang of the internal organs, the source of life, the main growth, development, reproduction and water metabolism. The Su Wen, Six Sections of the Organism, says: “The kidney is the master of dormancy, the source of enclosure, and the place of essence”. Essence is the basic substance of the human body, and is also the material basis for growth and development and various functional activities of the human body, and plays an extremely important role in all aspects of the organism. It plays an extremely important role in all aspects of the body. It is summarized as kidney yin and kidney yang. Kidney yin plays a nourishing and moisturizing role for all organs and tissues of the body. The kidney yang plays a role in promoting and warming the organs and tissues of the internal organs of the body, both of which are fundamental to the internal organs of the body, and the two are mutually constrained, interdependent and mutually useful to maintain the relative balance of the yin and yang of the internal organs. Premature ejaculation is also caused by various internal and external imbalances between the internal organs or between the internal organs and the outside world. The root is in the kidney, as both kidney yin and kidney yang are related to the lack of essence in the kidney. Therefore, the root of premature ejaculation treatment is the kidney. Premature ejaculation is related to the imbalance between kidney yin and kidney yang, so to treat premature ejaculation, we should take the kidney qi as the root and take other organs into consideration. The heart can move the essence, and the kidneys will respond to the heart’s movement. The heart’s desire can cause the phase fire to move and disturb the essence, and the essence will leave its place first because of the movement of the spirit, resulting in premature ejaculation. The “Jing Yue Quan Shu” cloud: “Cover the essence of the collection system in the kidney, the master of the essence is in the heart, the solid essence of the storage of the ejaculation is not only at the command of the heart.” The heart is equivalent to the role of the cerebral cortical premature ejaculation center. Therefore, in the treatment of the kidney, if the heart and kidney do not intersect, it is advocated to clear the heart fire, nourish the heart yin, nourish the heart qi, and fix the heart spirit.
The liver is the master of drainage, and the kidney is the master of storage. The liver and kidney regulate each other, complement each other, and work together to open and close the jingguan. The liver collects blood, uses qi as its function, has a yin body and uses yang, and is active in the ascension of sex. If the liver is depressed, liver qi is stagnant, worrying and pitying, the discharge will be out of order, and if it is too much, it will be premature ejaculation, and if it is not enough, it will not ejaculate. In the treatment is commonly used to dredge liver qi, nourish liver yin, liver blood, so commonly used to dredge the liver to relieve depression, nourish yin and subtle yang, calm the liver and rest wind. Sometimes excessive thinking and injury to the spleen (excessive work and study stress) can damage the heart and spleen, or the middle qi can sink and the spleen loses its control and the qi does not take in the sperm, leading to premature ejaculation. Benefit the qi, tonify the middle, and regulate the heart and spleen. Therefore, my experience is to take care of the kidney first, and take into account the heart, liver and spleen, and differentiate between deficiency and actuality for dialectical treatment.
2. Tonifying deficiency and resolving blood stasis.
I agree with the principle of tonifying deficiency and resolving stasis proposed by Sun Jisheng, which states that “to treat the disease at its root, the root should be used to dispel the symptoms”. If the disease is prolonged, the deficiency is in the kidney and spleen; if the deficiency is prolonged, the stasis is in the qi and blood. The kidney is the origin of the innate nature and the source of essence; the spleen is the origin of the postnatal nature, the essence of water and grain, and the source of essence production; once the two are out of balance, deficiency will result. Qi can move blood and “take in blood”. Qi deficiency also leads to blood stasis, such as Yin deficiency, deficiency of Yin and heat, resulting in deficiency of both Qi and Yin, which will lead to blood stasis. Therefore, Qi deficiency and Blood stasis are closely related, and supplementing Qi and Blood alone will cause stagnation, which is not only not beneficial but harmful. Therefore, the supplementation must resolve the stasis in order to get twice the result with half the effort and to treat both the symptoms and the root cause.
3. Combination of Chinese and Western medicine, complementary advantages
I think premature ejaculation is a difficult disease from the pathogenesis to the treatment, such as the use of a single treatment method, the effect is not good, not short-term effective, but can not last. Although the cause of premature ejaculation is not the cause of the disease, and the treatment is comprehensive, the effect is not obvious; although the cause of the disease is emphasized and the treatment is targeted, the lack of a holistic view increases the side effects and hurts the vital energy. From the treatment mechanism of Western medicine has proposed a clear disease mechanism that the glans local stimulation valve is low, the cerebral cortex sexual ejaculation center control ability is low, so we can examine the disease for solid, for local and central targeted treatment. For example, local treatment of Western medicine can be with double penis condom, pre-sex local anesthetic topical application, as well as behavioral therapy. In the treatment of the central, Western medicine using antidepressants, with selective pentazocine re-extraction inhibitors, selective blockade of pentazocine in the extraction, to promote the transfer of pentazocine and enhance its activity to prolong the latency of ejaculation, the representative drugs are sertraline, paroxetine, etc., while Chinese medicine in the central drugs and the heart and liver have a close relationship. There are methods to nourish the heart and calm the mind, dredge the liver and regulate the qi, nourish the yin and lower the fire, etc. All have good therapeutic effects with prolonging the ejaculation time. In addition, acupuncture and massage, through the regulation of meridians, have good therapeutic effect on local and central. Therefore, the combination of Chinese and Western medicine can not only treat the cause correctly, avoiding blindness, but also reduce and avoid side effects from a holistic view, without hurting the righteousness, considering both the recent curative effect and the consolidation of the curative effect, and preventing recurrence.
4. Combination of treatment and maintenance
Although there are many causes of premature ejaculation, most of them are caused by improper nourishment, such as depression, anxiety, anger, loss of drainage of the liver, excessive stress, fright and kidney injury, excessive sexual desire, frequent masturbation and kidney injury, excessive desire and failure to reach, burning of the fires of the jun phase, working and studying day and night, excessive thinking, strain on the heart and spleen, strain on the body and spirit, weak constitution, insufficient endowment, deficiency of kidney qi, and The “Nei Jing” has long mentioned that “the law in the yin and Yang, and in the art of number, eating and drinking in moderation, living in a normal way, not delusional labor, so that the form and God, degree of 100 years is gone.” The ancients have long reminded that the effect of treatment without nourishment is very little, but the combination of treatment and nourishment will get twice the result with half the effort.
Therefore, as a doctor, before defining the disease, we should ask the cause in detail, especially in the mood, living, diet, mind and brain need to make detailed inquiries, such as bad habits or imbalance in certain areas, in the process of treatment, we should promptly correct, and point out the specific methods to correct the balance, so as to cure premature ejaculation, but also to prevent its recurrence.
5. Identify the deficiency of yin and yang and treat it together
The causes of premature ejaculation are complex, and it is rare for a single internal organ to have a disease or a single deficiency without reality, but it is common for them to be intermingled. For this reason, I divide premature ejaculation into hyperactive premature ejaculation and insecure erection premature ejaculation, with the former being dominated by yin deficiency and fire, and the latter being dominated by kidney qi deficiency, heart and spleen qi deficiency, heart and kidney yang deficiency, kidney yang deficiency, and middle qi sink. In the latter case, the main treatment is to benefit the qi and tonify the kidneys, strengthen the spleen and nourish the heart, and take into account the nourishment of yin. Therefore, the treatment of premature ejaculation must identify the yin and yang, so that the yin and yang can be harmonized, and at the same time treat the actual symptoms such as damp-heat, qi stagnation, phase fire, blood stasis, etc. The deficiency and the actual are treated together, and it takes time to decide who should be the main treatment.
The term premature ejaculation has the same name as the Chinese and Western, because of the complex causes, there is no special medicine for the disease and because it is difficult to talk about it and damage the male style, it is often taboo, so its incidence is much higher than the formal statistics, and the efficacy is not good enough, so it needs a variety of effective means to improve the efficacy and consolidate its results, Chinese medicine is one of the herbal treatment means.
Western medicine treatment.
Western medicine really treat premature ejaculation more useful drugs; 1, the first antidepressant drugs, because the brain ejaculation center and dopamine, pentothal metabolism, as a new generation of antidepressants to delay ejaculation drugs, because he can increase the level of pentothal in the body thereby inhibiting the ejaculation center.
Selective pentraxin reuptake inhibitor, he can promote the transport of pentraxin, while its activity increases, prolonging the ejaculation latency, waldinger et al. conducted a randomized double-blind study. Paroxetine, fluoxetine and sertraline were significantly different compared to placebo controls, with paroxetine exhibiting the strongest delayed ejaculation effect.
1, sertraline 25mg/day (Zoloft), ug, paroxetine (Sellett) 20mg/day: all three drugs have a certain delayed ejaculation time roughly ranging from 2-5 minutes, sertraline tablets 25-50mg/day for a total of three weeks, ug 50mg/day for a total of 5 weeks, all three drugs may have mild nausea, fatigue, loss of appetite and other adverse effects, but does not affect the treatment.
2, clomipramine (anaphylaxis), antidepressant drugs, can delay the time of ejaculation, take 50mg each time before going to bed, a total of 8 weeks, after three months, the efficiency of 52%, can also be taken temporarily one hour before sexual intercourse, accompanied by thirst, nausea, headache dizziness and other mild adverse reactions, generally does not affect the continued treatment.
3, a receptor blocker: its treatment of premature ejaculation mechanism has two, one for the role of the vas deferens, the vas deferens is rich in adrenal receptors, and vas deferens contraction and peristalsis mainly mediated by a1 receptors practice has shown that a receptor blocker can significantly inhibit the contraction of the vas deferens tissue, the role in the process of secretion can inhibit the transport of epididymal fluid and sperm, so that the filling time of the seminal bundle is prolonged, thus prolonging the occurrence of ejaculation, the second The reason it can act on the prostate and posterior urethra, it has been confirmed that the smooth muscle tissue of the prostate stroma and the smooth muscle of the posterior urethra are rich in adrenergic nerve fibers, the application of a1 receptor blocker can make the smooth muscle in this area relax and slow down peristalsis, so that the ejaculatory valve time is delayed, thus delaying ejaculation, domestic Sun Xiaopeng et al. applied sertraline 50mg/day + sazosin extended release (a receptor blocker) 4mg/day x6 weeks showed significant improvement.