With the continuous improvement of people’s living standard, the quality of sexual life is getting more and more attention and importance. In the process of sexual life, premature ejaculation, as the most common disease, easily causes distress to the other party or both parties and affects the relationship between husband and wife, so it is necessary to introduce to you the diagnosis and treatment of premature ejaculation. 1. What is meant by premature ejaculation? How do I know that I have premature ejaculation? Premature ejaculation, according to the definition of the International Society of Sexual Medicine, includes the following three points: (1) ejaculation always or almost always occurs within 1 minute of penile insertion into the vagina; (2) inability to delay ejaculation after all or almost all of the penis has entered the vagina; (3) negative personal psychological factors, such as distress, worry, frustration, and/or avoidance of sexual activity, etc. In layman’s terms, this means ejaculation within 1 minute, wanting to prolong the time but not being able to control it, and making oneself or both spouses feel distressed. In this case, you can check whether you meet the above three points, and all of them can be diagnosed as premature ejaculation. I often meet patients who say they are premature ejaculation, and when asked, they say they can last 5-6 minutes, but they come to the clinic because their wives are not satisfied. I would tell him that 5-6 minutes is normal for men, and that too much time for sex is harmful to men’s health. If the woman is not satisfied, you can do enough time from sexual foreplay, and make women enter the state through some caressing and kissing before starting sex. The actual fact is that you can find a lot of people who have been in the business for a long time. 2. How should premature ejaculation be treated? Medication is the first choice. Currently, selective 5-hydroxytryptamine reuptake inhibitors (SSRIs) and local anesthetic drugs have different efficacy in treating premature ejaculation. For patients with refractory or particularly severe premature ejaculation, the combination of the above two drugs is more effective than single medication. Specifically, they can be divided into the following therapies. (1) Drug therapy Selective 5-hydroxytryptamine reuptake inhibitors (SSRIs) can delay ejaculation time, currently commonly used drugs such as Bilirubicin, Zoloft, Prozac, etc. These drugs delay male ejaculatory impulses by inhibiting 5-hydroxytryptamine reuptake. It usually takes 2 weeks to take effect, and it’s best to stick with the treatment for 3 months because premature ejaculation is considered a conditioned reflex in which 5-hydroxytryptamine receptors play an important role, and it takes time to desensitize the receptors. It should be noted that it is best to use contraception while taking these medications, and that you should wait until you stop taking them before preparing for childbirth, and that the dosage should be taken according to your doctor’s instructions. Topical creams, mainly local anesthetics such as lidocaine cream, should be applied to the skin of the glans 30 minutes before sex, then foreplay can begin and condoms can be worn when ready for sex. PDE-5 inhibitors, such as Viagra, Albuterol, etc. It must be clear that a small percentage of premature ejaculation is caused by a lack of erectile hardness, and when the erection is not hard enough, the ejaculation weakens quickly after barely penetrating the vagina. It is important to know whether the patient has an erection of grade 3-4 hardness and whether he can easily penetrate the vagina and maintain intercourse until ejaculation before weakening. If you prescribe medication without distinguishing the condition, it is often ineffective and sometimes gets worse. (2) Psycho-behavioral therapy requires the cooperation of both spouses. Both husband and wife should be informed that premature ejaculation is a common problem, and both husband and wife need to know the necessity and possibility of rebuilding the conditioned ejaculatory reflex, eliminating the patient’s anxiety, anxiety, self-guilt and other abnormal psychology, and building confidence in curing the disease. The basic treatment method of sexy concentration training aims to teach patients to experience and enjoy sexual pleasure and overcome psychological barriers through tactile stimulation such as hugging, touching and massaging. You can also pull the scrotum and testicles downward before reaching orgasm, or squeeze the glans with your thumb and index finger to reduce sexual arousal and reduce erectile hardness by 10% to 25%. After a long period of training then have intercourse in the female superior position, still using the form of pumping-stopping-pumping again repeatedly to gradually improve the ejaculatory stimulation threshold, so as to achieve a more satisfactory artificial control before ejaculation. (3) Surgical treatment Circumcision + dorsal penile nerve block is not recommended. There are many patients who come to consult about these two surgeries in their regular work, and many of them say as soon as they come in to see the doctor, “Doctor, I want to be circumcised!” I asked him why he wanted to do it. He said it was because of premature ejaculation. Whenever this happens, I have to spend a lot of time explaining to him that circumcision is not beneficial for premature ejaculation, and many people still have premature ejaculation after circumcision. I even met a young man, 16 years old, who came in and said, “Doctor, I want to have a dorsal nerve amputation!” I told him clearly that it was not recommended and that there might be many problems afterwards. The words are full of disdain and contempt. I want to tell you: these two kinds of surgery should not try it, the domestic authoritative guidelines are not recommended surgery for premature ejaculation. (1) There are various reasons for premature ejaculation, such as too sensitive glans, too excited during sex, irregular sexual partners, irregular sex life, hard erection, severe prostatitis, diabetes, history of trauma surgery such as pelvic fracture, disorderly lifestyle, frequent long-term masturbation, bad relationship between husband and wife, etc. These problems can cause premature ejaculation, so the most crucial thing is The most crucial thing is to find the right cause and treat the cause, rather than blindly prescribe medicine. (2) Premature ejaculation is a conditioned reflex, just like shaking a bell before feeding the puppy at home, and every time the puppy shakes the bell after 3 months, the secretion of stomach acid will increase. It takes time to establish and remove the conditioned reflex, as little as 1 month or as much as 6 months, so it is best to stick to the treatment of premature ejaculation for 3 months, rather than just prescribing 1-2 times of medication and not looking at it. (3) Ladies, please be more understanding and tolerant and less contemptuous and blaming. I met premature ejaculation patients in my outpatient clinic, 8 out of 10 of them were guilty and felt sorry for their wives, and they wanted to be longer but just couldn’t control it, so your consideration and support is the best remedy for premature ejaculation. (4) Don’t do it for too long! I often have patients who come to me for follow-ups and tell me happily, “Doctor, I can do it for half an hour now, and my wife is very happy!” The actual fact is that you can find a lot of people who have been in the business for a long time, and you can’t be sure that you’re going to be able to get a good deal on your own. The actual fact is that you will be able to get a lot more than 10 minutes, so don’t think that you can do whatever you want. (5) Premature ejaculation does not affect fertility, as long as you can complete intravaginal ejaculation. (6) Surgery is not recommended!!!