Patient 1 Q: I often masturbate for less than a minute before ejaculation, and I can’t fully enjoy the pleasure of ejaculation, how should I treat it?
A: Premature ejaculation is mainly for people who have actual sex. If you only have a “subjective perception of quick ejaculation” during masturbation, it is not called premature ejaculation and does not require any treatment. Therefore, please wait until you have actual sex and then make a judgment based on the situation at that time.
Patient 2 Q: I usually have only 1-2 minutes from penetration to ejaculation.
A: Premature ejaculation is generally defined as
① Ejaculation almost always occurs within 1 min after vaginal penetration;
② Inability to actively prolong the ejaculation time;
③ Causing negative emotions, such as worry, pain, frustration, etc. Generally all three conditions should be met at the same time before active intervention is recommended, so 1-2 minutes can be left untreated. However, if you do wish to have a longer ejaculation time, you can follow the treatment plan for premature ejaculation.
Patient 3 Q: I would like the time from insertion to ejaculation to be extended to more than 20 min, is it possible?
A: Men who desire to ejaculate more than 15min after penile insertion into the vagina, we believe that you are personally demanding too much in terms of the quality of your sex life. Unless the individual is capable enough, it may be difficult to achieve in the medical field alone.
Patient 4 Q: I usually finish the ejaculation process within a few seconds as soon as my penis enters the vagina, but my girlfriend and I don’t feel any discomfort because we have sufficient foreplay, does this situation need to be treated?
A: Actually, we cannot understand the definition of premature ejaculation in a mechanical way. I prefer to judge premature ejaculation not simply think that the short time must need treatment, but should be more men and women’s sexual satisfaction as an important reference standard. In other words, even if the man’s ejaculation time is short, it is not necessary to receive treatment if both men and women have achieved pleasure.
Patient 5 Q: My girlfriend and I are in a long-distance relationship, usually only see each other in the summer and winter, every time we meet we can’t wait to start doing that, but often when we are anxious to ejaculate within a few minutes, we are both very uncomfortable, is this situation premature ejaculation ah?
A: The first few times a man has sex with his regular sex partner, the first time he has sex after a long period of abstinence or the first time he has sex with other unfamiliar partners often ends in “failure”, which is a very normal physiological phenomenon and is an overly nervous psychological factor, so it must be viewed rationally. The only time “premature ejaculation” is really necessary is when the three conditions of a familiar environment, a familiar sexual partner, and more than three sexual encounters with this sexual partner are met at the same time.
Patient 6 Q: I have just been diagnosed with premature ejaculation by a doctor, how should I treat it now?
A: Early and initial treatment of premature ejaculation can be done by behavioral therapy. That is, when the male penis is inserted into the vagina to produce sexual pleasure and the desire to ejaculate, the penis should be withdrawn immediately, and all sexual stimulation can be eliminated by any reasonable way such as pressing the glans tightly and avoiding penile friction. After the sexual stimulation has smoothed out, reinsert and repeat this about 3 times before completing the final ejaculation process. In addition, for the expected upcoming sex, you can masturbate on your own to ejaculate first about 2 hours before this sex, which can also serve to delay ejaculation during actual sex.
Patient 7 Q: I am very, very distressed about premature ejaculation, how should I treat it now?
A: Behavioral therapy may only be useful for early, short-term premature ejaculation patients; long-term, more severe premature ejaculation patients are recommended to use medication. It is recommended to take oral sertraline for a long time to prolong ejaculation time, and also to apply lidocaine-proparacaine cream (trade name Enner cream) locally on the glans 20min before each sexual intercourse. All of them can generally make men ejaculate at least 3 min (average level can reach 10-15 min) after penile insertion into the vagina.
Patient 8 Q: I only have occasional premature ejaculation, is it possible that I don’t need to take medication every day?
A: For patients who only occasionally experience premature ejaculation and do not want to take medication for a long time, they can take the medication on demand, i.e., take Dapoxetine (trade name Brylcreem) 1-3 hours before the expected sexual intercourse, but it should be clear that taking the medication on demand is not as effective as taking it daily.
Patient 9 Q: What are the adverse effects of taking these medications for premature ejaculation?
A: Long-term use of sertraline may cause some adverse drug reactions, but the degree is generally mild, mostly tolerable, and does not require special treatment, and can gradually disappear with the discontinuation or reduction of drug dosage. Short-term as-needed doses of BILIPROGEN are generally free of adverse reactions.
Patient 10 Q: Can I use surgery to get rid of premature ejaculation “once and for all”?
A: Patients are strongly discouraged from using so-called dorsal penile nerve block or all other surgical treatments for premature ejaculation, as the effects of surgery are not only uncertain, but often bring irreparable and fatal damage to the patient!