Premature ejaculation also belongs to a kind of male sexual dysfunction, and epidemiological surveys show that premature ejaculation is the most common male sexual dysfunction. Data from a survey conducted by the Center for Health and Social Life in the United States showed that 21% of American men between the ages of 18 and 59 had a prevalence rate, which shows that many men suffer from this disease. Other reports have suggested from 5-30%, and such a big difference may be due to different understanding of the definition of premature ejaculation.
Causes of premature ejaculation
To date, the true cause of premature ejaculation remains a mystery, with a great deal of research and study, including from physiological, psychological, behavioral and even socio-cultural backgrounds.
There are some arguments that premature ejaculation is a problem on a purely psychological level, as men’s early sexual experiences (including masturbation) are often done under the tension of fear of being discovered, and a pattern of fast-action sexual behavior develops, which is difficult to change in later sexual behavior in marital relationships.
Some scholars have found that premature ejaculation patients really have different performance in terms of nerve conduction and sex hormone levels than normal people, and they believe that premature ejaculation patients have a physiological response that is easily aroused and overly sensitive.
Some scholars even believe that premature ejaculation represents an evolutionary behavioral pattern of the species. From an evolutionary point of view, males who are able to ejaculate within a shorter period of time have a higher chance of fertilizing females and reproducing offspring. In contrast, males that take longer to ejaculate and mate are more likely to be invaded or killed by other males or even other species during the mating process, so premature ejaculation may be the result of evolutionary selection.
Treatment of premature ejaculation
There are many treatments for premature ejaculation, but one thing is certain, namely that premature ejaculation can be cured! This is certainly a cause for rejoicing for the majority of premature ejaculation patients. Before treatment, it is important to discuss all the treatment options with the patient, as well as the benefits and disadvantages of the various treatment methods. The success of the treatment should also be evaluated by the satisfaction of the patient and the sexual partner. More importantly, since premature ejaculation is not a life-threatening condition, the safety of the treatment has to be put first.
I. Behavioral therapy.
Behavioral therapy includes increasing the frequency of ejaculation, adopting a woman-on-man** position, stop and start ejaculation, squeeze technique, pelvic floor muscle contraction exercises, etc. The short-term success rate reaches 95%, but long-term follow-up results found that 75% of patients are still the same as before treatment after 3 years, therefore, behavioral therapy is still only effective for Therefore, behavioral therapy still only has long-term effects on a small percentage of premature ejaculation patients.
Masters and Johnson proposed a male-under-female position, in which the man pauses when he feels he is about to ejaculate, and the woman lifts her body off the man’s and even presses three to four times below the glans. The woman can even press on the underside of the glans for three to four seconds to reduce arousal, and then continue after a break of 15 to 30 seconds.
Other methods include distraction, change of position, etc. can also be used. In addition, the improvement of the relationship between husband and wife or sexual partners, emotional rapport, open communication, mutual understanding of the sexual sensitive areas of both sides, as much as possible some sexual foreplay and care after sex, can improve sexual life satisfaction, natural solution to premature ejaculation on both sides of the sexual life caused by the tension and impact.
Second, drug treatment.
Traditionally, male doctors believe that premature ejaculation is almost always caused by mental factors, and therefore promote the concept of behavioral therapy, whether this view is right or not is open to question; in fact, in addition to mental factors, physiological factors also often cause premature ejaculation. For patients with premature ejaculation, a comprehensive and detailed assessment of their physiological and psychological factors is required before appropriate treatment can be given.
Research in basic medicine, especially advances in neuropharmacology, can provide several effective medications to treat premature ejaculation caused by physiological factors or other diseases, in the hope that patients with premature ejaculation can return to a normal sexual life.
With selective pentothal reuptake inhibitors (SSRI) drugs have been found to have the efficacy of prolonging ejaculation time, the problem of premature ejaculation in men has been brought to a new era, is no longer the psychological and physical barriers of the two parts, but complementary to provide a more complete and more personalized assessment and treatment strategy for patients with premature ejaculation, which is no less than an epochal page in the treatment of male sexual function!
Third, surgical treatment.
If the above treatments are not effective, surgical treatment can also be considered. The common surgical methods are selective dorsal penile nerve amputation and penile prosthesis implantation. As surgical treatment is somewhat invasive, doctors and patients should be cautious before choosing surgical treatment.
Whether it is premature ejaculation or any other sexual dysfunction, it is challenging for both the patient and the male surgeon. Patients must unload their psychological baggage and discuss their hidden problems with their physicians, while physicians must listen carefully to the patient and perform the necessary tests to understand the real cause of premature ejaculation, whether it is organic or psychological, whether it is due to the patient’s own factors or to the social and cultural background, etc.
If the cause of premature ejaculation is organic, the primary lesion should be actively treated and the problem can be solved. If it is functional, the factors that cause sexual tension should be excluded and the patient should be kept in a happy mood with correct sexual knowledge education and guidance, and both sides should cooperate and understand each other to achieve a harmonious interaction between the two sides in sexual life and normal life.