Premature ejaculation: possible causes, necessary tests, treatment. How to prevent premature ejaculation and prolong sexual intercourse

If during sex a man experiences orgasm much faster than he and his partner would like, it is customary to talk about premature ejaculation (premature ejaculation). Among the criteria that help diagnose this condition are usually the onset of ejaculation immediately after insertion of the penis into the partner and the inability of the man to delay ejaculation. On average, men ejaculate five minutes after the start of intercourse. Many men in the world are faced with the problem of premature ejaculation, and this makes them feel ashamed and irritated. Some men even begin to avoid sexual contact because of this. Don't despair! This problem can be solved by contacting a psychotherapist, starting to perform certain techniques to delay ejaculation, or resorting to medication. You will cope with the problem and will be able to enjoy sex with your partner again.

Steps

Application of behavioral techniques

Try the "stop-squeeze" method. During foreplay, you and your partner can try the "stop-squeeze" method to learn to control yourself and delay the moment of ejaculation.

Use self-help techniques. There are several methods you can practice on your own. This will give you the opportunity to learn to control the onset of ejaculation. Here are some of these techniques:

Masturbate before sex. If you plan to have sex this evening, try masturbating an hour or two before.
Use thicker condoms, which will reduce stimulation during sex. Try not to use condoms that are designed to increase stimulation for a man during intercourse.
Take a deep breath when you feel your ejaculation approaching. This may help stop reflex ejaculation. Also, try switching your thoughts and thinking about something boring until you feel that the peak of excitement has passed.

Try changing the position in which you have sex. If you usually prefer positions where you are on top, choose positions where your partner is on top. Try having sex in a position where she can easily stop and move away from you slightly when you feel her ejaculation approaching.
- When you feel that the sexual tension has passed, you can continue sexual intercourse.
See a psychotherapist. Both individual work with a psychotherapist and couples psychotherapy, when you come to sessions with a specialist together with your partner, can help you. Psychotherapy can be effective for the following problems:
Try using a topical anesthetic. These medications are available without a prescription and you can buy them as a spray or cream. Apply a special product to the penis before having sex. This will help you reduce sensitivity and delay the onset of ejaculation. Some men (and sometimes their partners) have reported that the use of such drugs leads to temporary loss of sensation and decreased pleasure during sex. Most often, such drugs are produced on the basis of:
- Ledocaine
- Prilocaine

Seek medical help

If you have used all the methods described above, but have not achieved the desired result, consult your doctor. Sometimes premature ejaculation is a symptom of other, more serious health problems that require treatment. The following reasons are possible:
- Different forms of diabetes
- High blood pressure
- Alcohol or drug addiction
- Multiple sclerosis
- Prostatitis
- Depression
- Hormonal imbalance
- Problems related to neurotransmitters. Neurotransmitters (neurotransmitters) are chemical substances responsible for transmitting signals in the nervous system.
- Pathological reflexes associated with the process of ejaculation
- Thyroid dysfunction
- Infectious diseases of the prostate and genitourinary system
- Tissue damage caused by surgery or trauma (in rare cases).
- Hereditary disease.
Ask your doctor about taking a drug that contains duloxetine (Cymbalta, Intriv). This substance is similar in its action to antidepressants from the group of selective serotonin reuptake inhibitors (SSRIs), but this drug was developed specifically for the treatment of premature ejaculation. If your doctor prescribes this drug, you will need to take it one to three hours before having sex.
- Do not take this drug more than once a day. Overdose may cause side effects such as headache, dizziness and general malaise.
- This drug is not suitable for men with heart, kidney or liver disease. This medicine may interact with other drugs, including antidepressants.
- Alternative options include the SSRIs paroxetine, sertraline, fluoxetine, and citalopram.
- The typical full effect of an SSRI (which is taken every day, not just when needed like Dapoxetine) will not be noticeable until about two weeks after you start taking it.
Talk to your doctor about other medications that can help delay orgasm. There are drugs that are not on the officially approved list of drugs used to treat premature ejaculation, but there is evidence of their effectiveness in delaying the onset of orgasm. Your doctor may prescribe these medications for you to take as needed or daily.
- Other antidepressants. You may be prescribed other serotonin reuptake inhibitor antidepressants, such as setralin (Zoloft), paroxetine (Paxil), fluoxetine (Prozac), or tricyclic clomipramine (Anafranil). Possible side effects of these drugs include nausea, dry mouth, dizziness, and decreased interest in sex.
- Tramadol. This drug is used as a strong pain reliever. Other side effects of tramadol, including nausea, headache and loss of coordination, have been noted to prolong the duration of sexual intercourse and delay ejaculation. In Russia, this drug is included in the list of narcotic substances, and its circulation is strictly regulated by the State Drug Control Service. For this reason, your doctor may not be able to write you a prescription for this drug.
- Phosphodiesterase type 5 inhibitors: These medications are commonly used to treat erectile dysfunction. These substances include sildenafil (Viagra and Revazio), tadalafil (Cialis) and vardenafil (Levitra). Side effects include headache, redness of the skin, blurred vision and nasal congestion.

Ejaculation is the process of ejaculation in men, accompanied by very pleasant sensations. There are a large number of disorders of this process, and very often men can suffer from premature ejaculation. In this article you will learn everything about what ejaculation is, what are the causes of early ejaculation and how you can get rid of it.

Processes that occur during ejaculation

Many men do not know what ejaculation is and what physiological processes occur in the human body. I must say that it is a very complex process. Semen is released during coitus and other types of sexual activity.

The stages of ejaculation are as follows.

Isolation of germ cells from the epididymis.
Spread of these cells towards the back of the vas deferens. At the same time, smooth muscles contract.
Adding fluid from vesicles, prostate, and bulbourethral glands to the semen. This is how sperm is formed.
Due to the rhythmic contraction of the muscles, the actual release of the seed occurs. This process is accompanied by very pleasant sensations in the head of the penis, the sexual organ itself and throughout the body. Sometimes there may be small convulsive twitches in it.

During ejaculation, the following changes occur in the male body:

jump in blood pressure;
a significant increase in the size of the penis, causing the head to become purple;
moisturizing the urethral mucosa;
significant increase in heart rate;
severe tension in the penis;
cessation of mental activity.

The onset of sperm discharge at the beginning of muscle contraction is inevitable and involuntary, that is, a man cannot restrain this process and reverse it.

Why do men develop premature ejaculation?

Premature ejaculation is a condition in which sexual intercourse lasts less than three minutes, and both partners receive incomplete satisfaction from this process. Sometimes there are situations when seminal fluid is released even before the penis is inserted into the vagina.

Any rapid ejaculation can be true or false. Causes of false ejaculation:

the man's inexperience;
various kinds of phobias, for example, fear of being accidentally discovered;
increased sensitivity of the glans penis;
excessive sexual arousal.

The reasons for true rapid ejaculation are as follows:

Knowing the reasons why men ejaculate quickly will help control and delay ejaculation - the so-called “rate of fire”

The influence of certain pathologies on ejaculation

The presence of certain pathologies of the reproductive system in men can negatively affect the time of ejaculation. In some cases, they may have hypersensitivity of the head of the penis. The pathology can be congenital or develop against the background of phimosis and other concomitant diseases. Sometimes ejaculation occurs even from touching the head. Sometimes in men.

If it develops in men, it very often leads to increased sensitivity and, as a result, to early ejaculation. In this case it has the following features:

The time of coitus in this case is very short;
the duration of sexual intercourse increases significantly from the use of intimate lubricant (lubricant) with an anesthetic;
repeated sexual intercourse is also very short and does not bring satisfaction;
emission of semen never occurs before coitus begins;
the use of small amounts of alcoholic beverages slightly prolongs coitus, relieving the symptoms of overstimulation in men.

In case of increased sensitivity, the problem can be solved by circumcision. It cures balanoposthitis caused by phimosis 100 percent.

As a result of prostatitis, in almost 100 percent of cases, hypersensitivity develops and the time of coitus is shortened. Against the background of inflammation of the prostate, men very often develop vesiculitis, or inflammation of the seminal vesicles. Inflamed vesicles contract very quickly, which contributes to the onset of male ejaculation. Sometimes just a few tens of seconds of stimulation of the head and penis are enough for this.

Pay attention! When the seminal vesicles become inflamed, a man very often ejaculates before sexual intercourse. For this, a slight excitement is enough, sometimes even the very thought of the upcoming contact. Orgasm during such an act is always very sluggish and never brings pleasure.

With paracentral lobe syndrome, there is a constant focus of excitation in the brain. It develops as a result of birth trauma and after suffering. Sometimes paracentral lobe syndrome leads to constant emissions - nocturnal ejaculation and disturbances in the processes of urine excretion (dysuria).

Finally, early release of semen in men can occur for the following reasons:

osteochondrosis (if the lumbar and sacral spine is affected);
herniated intervertebral discs;
curvature of this organ;
multiple sclerosis;
Bechterew's syndrome, or ankylosing spondyloarthrosis;
Parkinson's syndrome;
drug use;
chronic alcohol dependence;
severe kidney pathologies.

Difficult ejaculation occurs much less frequently. The physiological reasons for this phenomenon are fatigue and exhaustion. Orgasm without ejaculation can also occur with retrograde ejaculation.

How to eliminate early ejaculation

Sometimes a man may experience neurotic situations that significantly complicate normal sexual intercourse. He discovers that he “can’t get hard” and ejaculation is delayed. Often a man overly concentrates on the process of ejaculation itself, and not on the actual experience of sexual pleasure. Due to excessive tension, ejaculation occurs very quickly.

To eliminate excessively early ejaculation, you do not need to concentrate too much on this problem. Sometimes it resolves itself. A man’s main helpers in such an awkward problem are age and sexual experience. If the problem only grows, then you cannot do without the help of an experienced specialist.

You can prolong sexual intercourse and slow down ejaculation with the help of these simple tips:

use condoms with an anesthetic substance;
during coitus, try to think about neutral topics;
perform Kegel exercises that train the perineal muscles;
masturbate before coitus.

In some cases, the problem of early ejaculation can be solved by circumcision.

Pay attention! Pinching the urethra to delay ejaculation is strictly prohibited. This can cause chronic prostatitis or vesiculitis.

And other pills may be undesirable for this problem and in some cases may aggravate it. The onset of a rapid erection can lead to a rapid ejaculation of semen. This is why remedies can only be prescribed by a doctor. Sometimes this problem can be solved using folk remedies. A quick orgasm can be eliminated with the help of sedatives.

How to diagnose pathology

If early ejaculation syndrome occurs, a man should consult a urologist, neurologist, or andrologist. The doctor first of all collects and studies the medical history and is interested in the sexual characteristics of the man’s life. It is very important to answer all the doctor’s questions as honestly and truthfully as possible, without showing false modesty. The correct diagnosis and subsequently prescribed treatment depend on this. The doctor must take into account the man’s experience, his age and the presence of concomitant pathologies.

The patient can carry out such diagnostics independently at home. To do this, you need to lubricate it with lidocaine solution and put on a condom. If the time of sexual intercourse increases significantly, and the quality of sexual relationships also significantly improves, then the problem can be solved very simply. Usually a man is asked to undergo circumcision.

Remember that it is quite possible to cure this disease. Problems with ejaculation are very often psychological in nature, and the work of a psychologist or sex therapist will help solve it.

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Premature ejaculation (ejaculation) - causes, symptoms, diagnosis and effective treatment

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Premature ejaculation, or early ejaculation, is a disorder in which ejaculation occurs too early. Premature ejaculation is one of the most common types of sexual dysfunction in men around the world. Every man has experienced early ejaculation at least once in his life.

In the USA, there are statistics according to which 25% to 40% of men in this country suffer from premature ejaculation. In 1950, Alfred Kinsey, an American biologist, conducted an extensive statistical study, during which he showed that every representative of the stronger sex in America at least once during his life noted symptoms of this disorder. Most men do not attach any importance to this if ejaculation occurs prematurely once. But with the systematic development of the disorder, conflicts begin to occur in the family, the man cannot improve his personal life, and ultimately he develops psychological complexes and self-esteem decreases.

Premature ejaculation and other disorders in men

Early ejaculation is not the only type of ejaculation disorder. There are others:
1. Delayed ejaculation– this is the exact opposite disorder, in which ejaculation occurs after too long a time from the start of sexual intercourse.
2. Retrograde ejaculation- a phenomenon in which the seed does not flow out of the urethra, but in the opposite direction, flowing into the prostate gland.
3. Suppressed male orgasm. Also known as orgasmic dysfunction. In this case, the patient’s sexual satisfaction is inferior and does not bring proper pleasure.

All these violations are often difficult to verify and somehow rank. The fact is that ejaculation during sexual intercourse can occur at different times and in different ways for different men. The satisfaction of both partners with sexual intercourse is also not an accurate criterion. Sometimes even with prolonged and complete sexual intercourse on the part of the man, the partner remains dissatisfied. And sometimes a couple only needs two minutes to get pleasure from each other, and with such short sexual contacts it is quite possible to conceive a child.

Causes of premature ejaculation

The difficulty is that the causes of premature ejaculation are not always possible to accurately determine. Sometimes a disorder occurs without any visible provoking factors.

It is known that early ejaculation often occurs in adolescents. They can ejaculate without sexual intercourse. Over time, as a man grows up, he learns to control his physiological processes during sexual intercourse.
Often, by examining and questioning the patient, the doctor can identify the following causes of premature ejaculation:

Early ejaculation in a man can occur whenever he has sexual intercourse with a new partner.
Often, premature ejaculation occurs during sexual intercourse after a long period of sexual abstinence.
The role of psychological factors in the development of early ejaculation is quite high. Conditions such as depression, anxiety, restlessness, frequent stress, and feelings of guilt can lead to this type of sexual dysfunction in men.
Hormonal disorders. First of all, early ejaculation can be triggered by a disruption in the production of hormones involved in sexual function.
Some types of injuries.
Sex with very beautiful representatives of the fairer sex. Sometimes a man experiences such strong sexual arousal before sexual intercourse that ejaculation occurs even before the penis is inserted into the vagina.
Genetic causes of premature ejaculation have also been proven. It is known that 91% of men with this disorder have relatives who also suffer from early ejaculation.
Another factor that can lead to the development of pathology is malnutrition. The disorder occurs more often in men whose diet contains insufficient magnesium. This problem is common in major US cities. Unfortunately, statistics are not available for Russia.

Often men do not attach much importance to psychological factors as the causes of premature ejaculation. However, they are among the most important. It is believed that the consequence of depression, frequent stress or overwork is mainly erectile dysfunction (impotence). But often the first sign of beginning problems is early ejaculation. For example, it can occur when a man experiences stress related to financial problems.

It is very interesting to consider the causes of premature ejaculation from the perspective of interpersonal relationships. Thus, after a series of studies conducted in America, it was found that for many men the time of ejaculation depends on the phase of the partner’s monthly cycle. Another interesting observation: men who live with older partners ejaculate earlier during intercourse than those who live with women their own age or younger.

Organic diseases that can cause

premature ejaculation Early ejaculation develops much more often in men who have predisposing factors such as:

birth injuries - can affect many years later in this form;
shortening of the frenulum of the penis: a thin fold of skin that runs along the lower surface of the penis, connecting its head to the neck;
phimosis - narrowing of the foreskin, due to which the head is exposed with great difficulty, or is not exposed at all;
anatomical defects of the penis (for example, its curvature);
infectious and inflammatory diseases of the genitourinary system in men, especially prostatitis and urethritis (inflammation of the prostate and urethra);
benign prostate hyperplasia (adenoma);
diseases and injuries that affect the pelvic nerves: fractures of the pelvic bones, lumbar, sacral or coccygeal vertebrae, osteochondrosis;
alcohol abuse and alcoholism, smoking, substance abuse and drug addiction;
Hormonal changes in the body are most often a consequence of taking certain medications.

The mechanism of development of premature ejaculation

Let's delve a little deeper into male physiology and consider how the process of ejaculation occurs. It consists of two successive stages:
1. Emission phase. In this case, a large amount of seminal fluid is released, which accumulates in the back of the urethra (urethra). All sex glands take part in the process of the emission phase, including the prostate, seminal vesicles, and bulbourethral glands.
2. Release phase. This is what directly manifests itself as ejaculation. The muscles surrounding the junction of the bladder and the urethra contract and close the opening. At the same time, the walls of the urethra begin to move rhythmically, forcefully pushing the seminal fluid out.

Both processes are regulated by special nerves connected to the nerves of the genitals, organs and pelvic muscles. Moreover, in the cerebral cortex there are special nerve centers that clearly coordinate both phases of ejaculation.

Indeed, it is discovered that men suffering from early ejaculation have some peculiarities in the nervous regulation of the pelvic area. In particular, the pelvic muscles of such patients respond faster to electrical stimulation and are more excitable. Naturally, with the right approach, this problem can be dealt with.

The rate of ejaculation is influenced by some biologically active substances that are normally released in the human body. For example, a hormone-like compound such as serotonin can have a strong suppressive effect on ejaculation. Accordingly, if there is not enough serotonin in the corresponding areas of the brain, a man has a problem in the form of early ejaculation.

Symptoms of premature ejaculation

The most important problem for andrologists is to determine when the symptoms of premature ejaculation appear, when the norm ends and the disorder that needs to be treated begins.

Different researchers have different formulations and criteria:
1. A symptom of early ejaculation is considered to be a condition when a man ejaculates in 50% of cases before his partner experiences orgasm (Masters, Johnson).
2. At one time, sexologists believed that a reliable symptom of premature ejaculation was its onset within two minutes after insertion of the penis into the vagina. But this point of view was refuted after some research:

American Alfred Kinsey conducted a survey of men in 1950, during which it was shown that 75% of them ejaculated in 50% of sexual contacts within 2 minutes after insertion of the penis into the vagina;
the same Kinsey showed that half of men need no more than five minutes to complete sexual intercourse;
experts from the USA and Canada ranked sexual intercourse as follows: 1 – 2 minutes – too short; 3 – 7 minutes – normal; 7 – 13 minutes – desired for many couples; 10 – 30 minutes is too long;
It was also found that 75% of Americans ejaculate within 10 minutes of inserting the penis into the vagina.

As you can see, the time criterion turned out to be too unreliable. A man can ejaculate within a very short time, and both partners experience complete satisfaction.
3. When determining the symptoms of premature ejaculation, modern doctors focus on the general well-being of the man and the couple as a whole. If both partners experience satisfaction after sexual intercourse, do not suffer from any psychological complexes and characterize their life together as happy, then even with ejaculation in 1.5 minutes one cannot talk about its prematureness.
4. If ejaculation occurs in a man even before the penis is inserted into the vagina, it should be considered clearly premature.

Wrong approach on the part of many men

Many men tend to believe that their virility and physical health in the sexual sphere are mainly determined by three factors:

penis size, especially when erect;
erection hardness;
duration of sexual intercourse - it is believed that the longer it is, the more “full” the representative of the stronger sex is.

This is a fundamentally wrong point of view, inspired in men by society, upbringing, and traditionally established stereotypes. The quality of life together with a partner is actually influenced by many more factors. And size and duration are not always decisive.

However, if a man believes that he is suffering from premature ejaculation, this leads to deep psychological problems.

Negative experiences can provoke the development of the following disorders:

psychological complex, the belief that a man does not satisfy his current partner and is not able to satisfy those who will come after her;
disturbances in the personal sphere: a patient who has found “symptoms” of early ejaculation may refuse sexual activity altogether;
the man develops nervousness and poor sleep;
Often there are also problems such as depression, increased anxiety, emotional imbalance, isolation, etc.

However, such patient reactions to what is happening do not help him cope with the problem. On the contrary, they lead to the development of new ones. A kind of vicious circle closes. Psychological disorders lead to further aggravation of problems with ejaculation. In turn, worsening problems makes a man worry even more.

Sometimes such symptoms can be the first step on the path to erectile dysfunction.

Most men, with some exceptions, perceive sexual intercourse lasting 0.5 - 1.5 minutes as too short and incomplete. But we have already mentioned above that this point of view has not found any confirmation among doctors and researchers. In addition, you should always focus on the opinion of your partner. For some women, just one minute is enough to achieve a full orgasm. And for some it takes 30 – 60 minutes.

Ultimately, any man who shows signs of premature ejaculation should remember one simple truth: if you and your partner have an orgasm during intercourse, if you fully satisfy each other, then it is completely wrong to talk about early ejaculation, even if sexual intercourse lasts very little. There are no absolute standards here, and there is no need to measure up to anyone.

Partner's opinion

Sometimes a man claims that he suffers from premature ejaculation, relying only on the opinion of his partner. Time after time, a woman says that she does not experience orgasm during intercourse, blaming her partner for this. As a result, the man himself begins to believe in his “guilt”, begins to visit dubious specialists, and buy various means to slow down ejaculation in sex shops.

In fact, self-diagnosis and self-medication are unacceptable in these cases. Moreover, if they rely only on a single criterion - the opinion of their partner.

in this case, it often turns out that the man did not have early ejaculation at all - he and his partner are simply not quite suitable for each other;
If there is still a problem, it is often impossible to eliminate it using only products from a sex shop: each specific case requires separate consideration and an individual approach.

Many men are sure that they must certainly give a woman an orgasm during sexual intercourse only with the help of the penis. In this case, premature ejaculation is perceived as a big hindrance. In fact, there are many other completely normal ways to give a woman pleasure during sexual intercourse and, it should be noted, these are the ones that are used by many married couples around the world.

Concluding our review of the symptoms of premature ejaculation in men, we can give the most important advice: do not rush to conclusions. Early ejaculation is a common disorder, but it does not occur as often as many men “discover” it. Focus on satisfaction with sex life on your part and on the part of your partner. And if you have doubts or suspicions, it is better to immediately contact a specialist.

Diagnostics

Which doctors diagnose premature ejaculation in men?
These problems fall within the competence of andrologists and sexologists. It is better to visit sexologists, since they specialize in disorders of this specific nature.

If necessary, a man who has signs of premature ejaculation may be prescribed consultations with other specialists:

endocrinologist - a specialist who treats pathologies of the endocrine glands;
neurologist - a doctor whose competence includes all diseases of the nervous system;
a psychologist or psychotherapist - you have to resort to the help of this specialist very often, because, as discussed above, early ejaculation often has psychological problems behind it;
urologist - to identify other diseases of the genitourinary system that can increase the sensitivity of the nerve receptors of the penis;
a therapist and related specialists, if the sexologist suspects that the patient has other diseases that may be associated with premature ejaculation.

What happens in the doctor's office?

First of all, the sexologist carefully questions his patient. The first part of the question concerns general health data, and is carried out in the same way as at an appointment with any other specialist. The doctor is interested in the man’s past and current illnesses, the man’s general health, and his working and living conditions.

Then they move on to clarifying their sexual history. The specialist may ask about the timing of the onset of sexual activity, the number of partners, the regularity of sexual activity, etc. At this stage, it is very important to tell the doctor absolutely everything, without hesitation or hiding anything. After all, the correctness of diagnosis and, as a result, treatment depends on this.

Early ejaculation is a disorder that develops as a result of a large number of reasons. In order to identify them, the doctor will most likely prescribe a laboratory test after the examination.

In accordance with modern regulations, a doctor can consider the diagnosis of premature ejaculation proven if:
1. Ejaculation occurs even before the penis is inserted into the vagina, or against the will of the man when he tries to restrain it. Of course, the doctor takes into account such factors as the age and physical condition of the patient, the duration of abstinence, and how long the patient has been sexually active with a specific partner.
2. Premature ejaculation disrupts the patient's personal or family life. The disorder causes strong feelings and problems in a man.
3. Early ejaculation should not be caused by taking or, on the contrary, stopping any medications. For example, it is known that for some time after stopping opium-based drugs, men begin to ejaculate earlier.

Often, in order to understand the existing problem, the doctor must talk not only with the patient himself, but also with his partner.

Today, special tests have been developed that help identify the severity and likelihood of early ejaculation in a man.

What diseases need to be differentiated between premature ejaculation?
Most often, the imaginary signs of premature ejaculation are caused by erectile dysfunction, when the penis cannot become hard enough to be inserted into the vagina. At a certain stage, a man realizes that he needs additional stimulation for penetration. Often during this process not only an erection occurs, but also ejaculation.

It is worth distinguishing real premature ejaculation from sporadic cases that occur only from time to time and cannot lead to significant suffering in a man. This problem can be easily fixed.

Sometimes early ejaculation and erectile dysfunction can be caused by the use of opioids and their subsequent abrupt withdrawal. This condition also cannot be considered true early ejaculation.

Questionnaires for diagnosing premature ejaculation
Specialists from different countries have now developed special questionnaires that help identify early ejaculation and assess the degree of its severity.
Today there are quite a lot of such questionnaires, but two are mainly used:

PEDT (Premature Ejaculation Diagnostic Tool) – a questionnaire that contains only 5 questions;
AIPE (Arabic Index of Premature Ejaculation) - Arabic index of early ejaculation: a questionnaire consisting of seven questions.

Laboratory and instrumental examination for premature ejaculation
Below is a list of additional diagnostic measures that can be prescribed by a doctor in order to identify existing causes:

smears from the urethra with their bacteriological culture to identify hidden urogenital infections;
PCR diagnostics is a study of the level of antibodies in the blood, which helps to identify a specific infectious agent;
Ultrasound of the pelvic organs, genitourinary system: a simple, accessible, informative and completely painless diagnostic technique;
urethroscopy and cystoscopy - examination of the inner surface of the urethra and bladder using endoscopic equipment;
study of the level of sex hormones in the blood.

Treatment

Many men are interested in the question of how to treat premature ejaculation. Unfortunately, there is no clear answer to this. In each specific case, it is necessary to understand the causes of premature ejaculation in a particular man, and focus primarily on them. Therefore, a visit to the doctor before starting any treatment and a high-quality diagnosis of the problem are mandatory conditions.

Initial stages of premature ejaculation
If the cause of the disorder has not been established, and early ejaculation bothers you from time to time, you can use some special techniques to prolong sexual intercourse.

Start-Stop Method
Quite an effective method. Its essence is that during sexual intercourse a man must “catch” the moment when premature ejaculation begins. In this case, the penis is removed from the vagina, and its base is strongly compressed with the fingers. When sexual arousal subsides a little, penetration can be achieved again and sexual intercourse can continue. If a man feels the beginning of ejaculation again, then he repeats the break. The number of repetitions is practically unlimited.

Over time, the number and duration of such “respites” naturally decreases, and the duration of sexual intercourse increases.

Kegel method
This technique is based on the assertion that if a man suffers from early ejaculation, then his innervation of the pelvic organs is to some extent impaired. Accordingly, you can perform exercises that will help restore it.

During Kegel exercises, a man learns to regulate the tension and relaxation of certain muscles of the pelvis and tailbone. As a result, the skill of controlling ejaculation is simultaneously trained.

Drug treatment
The general principles of treatment for premature ejaculation are as follows:

the use of medications (both general and local) that delay ejaculation;
use of sedative medications.

If early ejaculation has psychological or nervous causes, then with the use of these medications they can go away quite quickly.

If sexually transmitted infections are detected, antibiotics are prescribed. First, the doctor must prescribe smears to identify the pathogen and determine its sensitivity to antibacterial drugs.

If a neurological disease has been identified that has led to premature ejaculation, appropriate treatment is prescribed: vasodilators, vitamins, neuroprotectors, etc.

Fighting psychological problems
Often, premature ejaculation can be successfully treated with the participation of only a specialist such as a psychotherapist or psychologist. This helps especially well at a young age, when existing disorders are mainly associated with psychological problems and are supported by them.

An experienced psychotherapist can eliminate problems such as increased anxiety, emotionality, irritability, depression, exposure to stress, self-doubt, and fear of failure. As a result, early ejaculation will cease to bother the patient on its own.

The importance of alternative medicine in the treatment of premature ejaculation
Various methods are widely used for early ejaculation alternative medicine :

acupuncture - involves a reflex effect on the nerves that innervate the pelvic organs (including the male genitourinary system);
massage - some of its varieties can have an effect on the nerves and blood flow in the pelvic area, improve a man’s control over various muscles responsible for erection and ejaculation;
medicinal baths – widely used in spa treatment;
mud therapy – also used in various sanatoriums and resorts;
physiotherapy – influence on the male genitourinary system using various physical factors.

Masturbation
Even masturbation can be a therapeutic measure for premature ejaculation. It should not be performed independently and uncontrollably, but under the guidance of a sexologist. The doctor must explain to his patient how, when and in what environment it is best to do this, and how often.

The main difference between masturbation and sexual contact with a partner is that at this time the man completely controls the degree of his sexual arousal. By masturbating, he can learn to control ejaculation and restrain it when necessary.

After the sexologist questions and examines the man, he may well ask to bring his partner to the appointment. The doctor will talk with the woman, find out additional details, give her recommendations and advise how to help the man.

All of the above methods for treating early ejaculation are not applied at once together. In each specific case, the doctor prescribes a combination that should be as effective as possible.

Additional recommendations can be given to men undergoing treatment:

a rational regime of work and rest, adequate sleep of at least 6 hours a day;
good nutrition, the presence of all necessary substances in the daily diet;
exclusion of promiscuity, at least for the duration of treatment;
avoidance of conflict and stressful situations;
it is advisable to give up all bad habits, smoking, drinking alcohol;
frequent stay in the fresh air, active recreation, sports.

If you follow all the doctor’s recommendations, the prognosis is most often favorable. Before use, you should consult a specialist.

How to cure premature ejaculation– one of the most common questions among representatives of the stronger sex. According to statistics, a third of men worldwide suffer from rapid ejaculation, and according to other information - almost half.

Signs and types

Before you start treatment for rapid ejaculation, it is necessary to understand when a pathology is already such and when it is not? As a rule, medicine does not consider accelerated ejaculation a pathology unless it is associated with a lack of fertility. But that doesn't mean that early ejaculation treatment impossible. On the contrary, knowing what it is premature ejaculation, and which doctor to contact With consultation, almost any man can normalize his intimate life.

On average, sexual intercourse lasts from 7 to 14 minutes. If most sexual intercourse lasts less than 5 minutes, it makes sense to talk about premature ejaculation. Doctors identify at least five signs of the disease:

orgasm is spontaneous and its onset cannot be controlled;
orgasm occurs before the penis is inserted into the partner’s vagina;
sexual intercourse consists of less than 25 frictions.

Each case must be considered individually. Rapid ejaculation from time to time is quite normal, for example in young men whose sex life is not yet regular. In other cases, it is necessary to consult a doctor to understand how to treat rapid ejaculation.

Causes and treatment of premature ejaculation in men

Knowing what is premature ejaculation, it makes sense to determine reasons for early ejaculation in men.

They can be divided into primary and secondary. Primary ones are extremely rare, and, as a rule, they are organic lesions of the brain or genital organs.

Secondary reasons for rapid ejaculation in men, on the contrary, are very common. They are the result of various pathologies. And to understand how to cure premature ejaculation, you need to carefully understand the classification of causes.

Treatment for rapid ejaculation, which is guaranteed to relieve pathology, must be etiological. That is, to influence precisely the root cause of the deviation.

Causes of rapid ejaculation: what could it be?

Secondary causes of premature ejaculation in men is a pathology in the body, one of the symptoms of which is accelerated ejaculation.

pathological;
physiological;
psychological;
genetic.

Pathological, that is, resulting from somatic pathology in the body, causes are most common. First of all, we are talking about inflammatory processes in the genital area, some of which are a consequence of unprotected sexual relations.

Secondly, we are talking about serious diseases that affect the activity of the entire body. These are endocrine (hormonal) disorders, chronic renal failure, atherosclerosis.

And finally, the third common cause of early ejaculation in men bad habits appear - drug addiction and alcoholism. However, even smoking can lead to sexual dysfunction, as it negatively affects the functioning of the entire body.

Physiological reasons are also very common. This is either increased sensitivity of the glans penis or irregular sex life

Reasons for rapid ejaculation in men under 30 years of age, for the most part, psychological. This could be fear of sexual contact, stress, chronic fatigue, depression. Sometimes a man may distrust a particular partner or find her so attractive that his emotional state will provoke rapid ejaculation. Most often this happens with a new partner, and after the moral relationship between a man and a woman becomes more trusting, the problem goes away on its own. However, in some cases, due to an unsuccessful one-time experience, a man begins to get very worried and look for a solution, how to get rid of rapid ejaculation with a girl. And then the problem may arise again and again.

Genetic causes are the inheritance of the problem of early ejaculation. In this case, the problem is permanent; the man may not have experience of normal sexual life at all. Such pathologies are the most difficult to treat, but they are rare.

Diagnostics

Correct diagnosis is half the success in business. To detect what is the reason for rapid ejaculation in men, you need to contact a urologist or sex therapist as soon as possible and tell in detail about the frequency of such cases and the accompanying circumstances. This could be a chronic disease, medications you are constantly taking, or recent injuries or surgeries.

After this, the doctor finds out Why a man ejaculates quickly, assigning him laboratory tests and functional diagnostics:

hormone tests;
tests for sexually transmitted infections;
cystoscopy of the bladder;
urethroscopy;
Ultrasound of the pelvic organ.

A specific diagnostic method is the lidocaine test. It allows you to determine the physiological causes of the disease. To do this, the doctor suggests that the patient purchase a special product that contains lidocaine or a local anesthetic in the form of a spray. The product is applied to the head of the penis, after which sexual intercourse takes place. If in this case the sexual contact lasts, then the reason lies in the increased sensitivity of the head of the penis.

In the event that diagnostic manipulations what to do if you ejaculate early, no pathology is detected, and the lidocaine test does not bring results, there is reason to talk about the psychological causes of the disease.

Treatment methods for premature ejaculation

Definition causes and treatment of rapid ejaculation carried out only by a doctor. It is strictly forbidden to try to get rid of the disease on your own: firstly, it is impossible to accurately determine the root cause of early ejaculation, and secondly, there are many different ways to how to cure rapid ejaculation.

Medication therapy

Drug therapy is an almost indispensable condition for treatment. With the help of medications, infections that affect sexual function can be eliminated. Drugs also used for treatment:

antidepressants;
adrenergic blockers;
tranquilizers.

The danger of such therapy is that these groups of drugs affect not only a person’s sexual abilities, they affect the entire body.

Psychotherapy and sex therapy

Psychological treatment of premature ejaculation sometimes required against the background of eliminating physiological and pathological causes.

If a man's fertility persists despite early ejaculation, treatment is not necessary. The duration of sexual intercourse is an individual factor that depends on many reasons, many of which a man cannot influence at all.

But if sexual intercourse is too short, the man’s partner does not receive proper satisfaction. For a man, this can become a serious psychological problem that will affect the person’s quality of life. That's why how to treat premature ejaculation– a question not only of improving the technique of sexual intercourse, but also of a man’s entire life.

How does the elimination of psychological causes and treatment of premature ejaculation? A psychotherapist or sexologist helps a man find the necessary positive attitudes that will allow him to be calmer about the problem and overcome his fear of intimate contacts.

If then what causes rapid ejaculation- nothing more than depression or chronic stress, the doctor will select the necessary medication treatment: antidepressants, tranquilizers, nootropics.

Reduced sensitivity of the head

Increased sensitivity of the glans penis is a common reason why a man experiences rapid ejaculation. In some cases it is necessary to resort to surgical methods to treat early ejaculation. But sometimes you can do it on your own.

A quick way to reduce the sensitivity of the genital mucosa is to use a thick condom; in some cases, you can wear two protective devices at once.

A more permanent way to reduce sensitivity is to roughen the skin of the head of the penis. To do this, you need to rub it regularly with a hard sponge. But it is important not to get carried away with the procedure too much: if the mucous membrane is damaged too much, inflammation will occur. In this case, inflammation will increase the risk of sexually transmitted infections, which can also lead to premature ejaculation.

Stop start technique

Methods, how to treat early ejaculation, usually involve delaying orgasm or stop-starting. This is a technique that requires preliminary training. For a man whose question of how to treat early ejaculation is not relevant, delaying the emission of semen is not problematic. To do this, you should monitor the onset of orgasm, and then take actions to delay orgasm: remove the penis from the girl’s vagina and hold it at the base, or pull the scrotum down with your hand.

But also for a man who views the technique as a way treating symptoms of premature ejaculation, it can be an excellent way to increase the duration of sexual intercourse. First, you should train during masturbation, then start implementing the method together with your partner, who should be better warned about the problem and the treatment method used.

Surgical treatment

If treatment of causes of rapid ejaculation does not help, you can turn to surgical treatment. Surgery is used for physiological causes of pathology. Most often, the doctor offers one of two methods of therapy: circumcision of the foreskin or plastic surgery of the frenulum of the penis.

The principle of these operations is that after them the mucous head becomes coarser. But in some cases, sensitivity can be so strong that even its reduction after surgery will not lead to an improvement in the quality of sexual life. In this case, denervation of the head can be performed.

Prolongation of sexual intercourse

The term prolongation means lengthening, and if a man is looking for a solution, how to deal with premature ejaculation, successfully implemented prolongation techniques allow you to instantly see the effect.

This category includes all methods that can prolong sexual contact - interruption of sexual intercourse, breathing practices, many other methods, how to avoid premature ejaculation in men.

Use of prolonging agents

Sometimes it involves the use of special preparations - ointments, sprays and even special condoms.

The effect is based on how to prevent rapid ejaculation in men using local anesthetics. To do this, a special lubricant is applied to the head of the penis, and then, when slight numbness appears, you need to put on a condom and begin sexual contact. If you ignore the need to put on a condom, your partner may experience discomfort during sex.

Physiotherapeutic activities

Physiotherapy can give good results with regular and systematic treatment. For treating the reasons why men ejaculate quickly, The following methods are used;

visual color pulse stimulation;
acupuncture;
laser therapy;
electrosleep therapy;
galvanization;
electrophoresis.

Before how to prevent early ejaculation With the help of physiotherapy, the doctor examines the patient’s medical history for contraindications to procedures, and then prescribes a complex that will eliminate the problem.

Treatment with folk remedies for premature ejaculation

Many men do not know how to get rid of rapid ejaculation; they do not even realize that this can be done using folk remedies. There are a large number of alternative medicine methods that help solve this male problem. The healing properties of plants help a man prolong ejaculation. Let's consider the most effective recipes for treating rapid ejaculation using traditional methods.

Lovage.

This is a folk remedy that can prolong sexual intercourse, can be prepared in two ways:

To prepare a healing tincture, you will need crushed lovage root in the amount of 2 tbsp. l., add 0.5 l to it. medical alcohol or vodka. Leave to stand for 3 weeks in the dark. At the end of this time, the infused alcohol liquid should be separated from the sediment. Take 2 tsp. medications three times a day before meals.
You can also be treated with a decoction based on lovage root. To make it you will need 1 tbsp. l. crushed plant root, add 1 cup of boiled water. Bring to a simmer over low heat for 10 minutes. Then leave for another 30 minutes. The medicine should be taken 1 tbsp. l. three times a day.

Regular use of this folk remedy ensures prolongation of sexual intercourse.

Oregano and calendula.

Another folk method to prolong ejaculation. To prepare it you will need crushed dried oregano flowers in the amount of 2 tbsp. l. and calendula - 1 tbsp. l. Add 1 glass of water from a just boiled kettle to the ingredients and leave for several hours. At the end of this time, strain the prepared infusion and consume 1 tsp. three times a day before meals. Long-term use of this folk remedy will help prolong sexual intercourse in the future.

Oak bark.

This folk remedy helps get rid of rapid ejaculation. To prepare it, you will need 50 g of dried small oak bark and 1 glass of alcohol or vodka. Combine the components and leave to brew for 2 weeks. At the end of this time, separate the finished product from the sediment. Liquid take 3 tsp. three times a day before meals.

Motherwort and hops.

You can prolong sex with another folk remedy. In order to prepare it, you should take 2 tbsp. l. dried motherwort and 1 tbsp. l. small hop cones. Pour 0.5 l of ingredients. just boiled water. Leave for 4 hours. Then strain the finished infusion. You need to drink this medicine three times a day, 1 tbsp. l.

Periwinkle.

Conduct rapid ejaculation can be treated with a folk remedy prepared from periwinkle. To do this, take 1 tbsp. l. herbs of this plant, add 1 glass of water. Place on the fire, bring to a boil, cook for about 15 minutes. After cooling the broth slightly, it needs to be strained. Drink 2 times a day according to this scheme: 10 drops in the morning, 5 drops in the evening. Under no circumstances should you take more, since a decoction based on periwinkle is a toxic substance, an excessive amount of which can negatively affect a man’s health.

Clefthoof root.

Another a way to get rid of rapid ejaculation using traditional methods. To prepare it, you will need 1 tsp. coffin root, add 1 glass of just boiled water to it. Place over medium heat and simmer for 40 minutes with the lid closed. Cool the broth slightly, remove the sediment and take 1 tbsp. l. 5 times a day.

Mint, oregano, motherwort.

Given A folk remedy for premature ejaculation is prepared in this way: All ingredients should be taken in equal proportions. Mix the herbs thoroughly. Take 4 tbsp. l. mixture, add 1 l. boiling water. Leave covered for about 30 minutes. At the end of this period, strain the infusion. Drink 1 glass of tea 2 times a day.

Rosehip, motherwort, three-leaved watch.

You can prolong the rise with this folk remedy: finely chop the rose hips, add the same amount of motherwort grass and trifoliate herb. Mix the ingredients, take 3 tbsp. l. mixture, add 1 l. water. Boil the liquid and cook for half an hour. Cool the prepared broth slightly, drink 1 glass per day. The duration of such treatment takes longer when compared with other methods of exposure.

Coriander.

Early ejaculation can be treated using a folk remedy such as coriander decoction. To prepare it you will need 1 tbsp. l. coriander seeds to which you should add 1 glass of water. Place in a water bath for 15 minutes. After the liquid has cooled, take 50 ml three times a day.

Yellow egg capsule.

Here's another one folk remedy how to increase ejaculation: You will need the roots of the yellow egg capsule, crushed using a blender or grater, and vodka in a 1:1 ratio in quantity. Leave to infuse for 2 weeks. Strain the infusion, extract 150 ml from it, add 2 glasses of vodka. Take 1 tsp. every day for a week. For the next 7 days, take 1 tsp. more.

Folk remedies for prolonging sexual intercourse in most cases give positive results. But for the correct use of alternative medicines, you should consult a specialist, since some medicinal plants contain toxic substances. Excessive amounts of them in the body can negatively affect not only erectile function, but also the health of a man’s body as a whole. It should also be remembered that folk remedies can be used for prophylactic purposes to prevent primary or secondary premature ejaculation.

The effectiveness of traditional medicine for premature ejaculation

Medicinal plants, on the basis of which medicinal products are prepared, not only help prolong a man’s sexual intercourse, but also improve his overall well-being. The essence of the action of medicinal herbs is the following effect on the male body:

dullness of the sensitivity of the penis;
prevention of nervous tension and stressful conditions;
normalization of sleep;
improvement of emotional state.

The principle of action of folk remedies for early ejaculation is a beneficial effect on the central nervous system. Such medications have a relaxing effect on the male body.

But before treating premature ejaculation using traditional methods, it is better to consult a qualified specialist and undergo an examination. Perhaps the cause of this problem is a certain disease of the genitourinary system. By eliminating it, you can get rid of early ejaculation.

Prevention of early ejaculation

Folk remedies for premature ejaculation help solve the problem, but the result should be consolidated by observing preventive measures. Good health will not allow this ailment to develop either initially or repeatedly. For this the following rules should be followed:

Maintaining a daily routine. A man should devote a sufficient amount of time to rest. You need to sleep at least 8 hours a day. But in no case should you lead a sedentary lifestyle. This leads to stagnant processes in the pelvic organs, resulting in premature ejaculation. Also, the daily routine includes eating at the same time, which has a beneficial effect on health.
Healthy lifestyle. Adverse habits have a negative impact on men's health. Not only can they cause early ejaculation, but they also gradually lead to erectile dysfunction. Therefore, it is imperative to get rid of bad habits, such as smoking or uncontrolled consumption of alcoholic beverages.
Physical activity. It should not be forgotten that excessive physical activity, as well as a sedentary lifestyle, have a negative impact on a man’s health. Therefore, for normal well-being, a representative of the stronger sex should regularly visit the gym, and it is useful to go to the pool. At the same time, we should not forget that physical overexertion during training is harmful.
Regular sex life. Sex life should be stable. In this case, random connections should be neglected. This can lead to sexually transmitted diseases, which will lead to more serious consequences than premature ejaculation.
Proper and balanced nutrition. For everyday meals, you need to choose foods rich in vitamins, minerals and other beneficial substances. There is no need to interrupt yourself with dry food and snacks during the day. Food intake should correspond to the daily routine. It's good to eat as many seasonal fruits and vegetables as possible. Try to minimize the consumption of fatty, fried, spicy, and excessively salty foods.
If rapid fire in a man is caused by increased sensitivity of the penis, then at the moment of intimacy it is better to use a condom. This will help not only protect against sexually transmitted, viral and infectious diseases, but also dull sensitivity, which will prolong sexual intercourse.
Protected sexual intercourse.
Regularly visit a doctor to diagnose sexually transmitted infections.

In cases where treatment of premature ejaculation with folk and other means does not give the desired result, you need to seek help from an andrologist or sexologist. After a thorough examination using ultrasound diagnostics and tests for sex hormones, the doctor will determine the exact cause of premature ejaculation and prescribe appropriate treatment.

It is impossible to completely eliminate the risk of rapid orgasm. But using the rules described above, you can minimize the risk of pathological and psychological reasons why a man experiences rapid ejaculation.

In addition, knowing why it occurs premature ejaculation, what is it? And what to do if you ejaculate quickly, which doctor? contact, the man will be able to quickly and correctly cope with the problem that has arisen.

– a disorder of sexual function, manifested by untimely ejaculation before or during sexual intercourse and which does not bring sexual satisfaction to partners. Leads to disruption of the harmony of sexual relationships. It represents a serious psychological problem for a man, leading to the development of feelings of inferiority and self-doubt, which further aggravates sexual dysfunction. Diagnosis of premature ejaculation falls within the competence of a urologist-andrologist and sex therapist. In order to correct sexual dysfunction, psychotherapy, drug therapy, and sometimes surgical treatment can be performed.

Premature ejaculation is a disorder of ejaculation and accounts for 25-60% of all forms of functional sexual disorders in men. Premature ejaculation is not considered an organic disease, it is a sexual dysfunction, which consists of the inability to control ejaculation sufficiently to achieve sexual satisfaction during coitus by both partners. According to WHO, at least 40% of men of all ages around the world face the problem of premature ejaculation. Different authors consider the time factor (duration of sexual intercourse less than 1-2 minutes) or the number of frictions (less than 8-15) to be criteria for premature ejaculation.

The problem of premature ejaculation

The problem of premature ejaculation is mostly a social problem, since from a medical point of view there are no organic changes or obvious reasons for this. There is no single norm for the duration of sexual intercourse, but the average duration of the friction period ranges from 2 to 10 minutes, depending on the characteristics of the body, the situation during coitus and the period of abstinence. However, the subjective opinion of men can cause a false belief that there is a problem with premature ejaculation and short intercourse, which in turn has an adverse effect on family relationships, reduces the self-esteem of both partners and often leads to family breakdown.

Premature ejaculation is considered if ejaculation regularly occurs before both partners have received sexual satisfaction, provided that the frictional period was less than 2 minutes. With a long period of foreplay, strong sexual arousal, especially after significant abstinence, ejaculation can occur even before genital contact, which is not considered a pathology. Many people mistake the inability to obtain vaginal orgasm or anorgasmia in women for premature ejaculation, since the frictional period, often lasting more than 20 minutes, is not enough to satisfy the partner.

That is, from a medical point of view, premature ejaculation is often repeated ejaculations after minimal sexual stimulation before or after insertion of the penis into the vagina. The idea that uncontrolled ejaculation is premature is incorrect, and it also gives rise to serious and intractable psychological problems.

Causes of premature ejaculation

To date, numerous studies in the field of andrology prove that most premature ejaculations are of a psychogenic nature and belong to the psychogenic form of premature ejaculation. The lack of sexual experience and theoretical knowledge at the time of the onset of sexual activity, coupled with false reviews of sexual experience from peers, subsequently form a persistent syndrome of failure. Because once unsuccessful sexual intercourse occurs with the development of phobias, it leads to a repetition of the scenario. The psychophysical reasons for the development of repeated premature ejaculations lie in the formation of a reflex arc, which, after formation, contributes to premature ejaculation, and subsequently the secondary phenomena of colliculitis (inflammation of the seminal tubercle) develop.

Inflammatory diseases of the appendages of the gonads, especially in the absence of treatment and the addition of psychogenic factors, can form a persistent syndrome of premature ejaculation. Thus, with colliculitis of an inflammatory or hypertrophic nature, the blood supply to the seminal mound increases, which is especially pronounced at the time of sexual intercourse. This strengthens ascending nerve impulses and, in response to irritation of the central nervous system, orgasm and premature ejaculation occur. If left untreated, irritation of this area increases, as a result of which the quality of the orgasm itself is lost, and frequent premature ejaculations are formed. Often the prostate gland is also involved in the inflammatory process, or inflammation of the prostate is first observed, which later spreads to the seminal mound. Therefore, when correcting premature ejaculation, it is important to carry out anti-inflammatory therapy of all appendages of the gonads.

With neurological changes that are accompanied by hypersensitivity of the glans penis, the number of receptors in the neural arch increases, resulting in premature ejaculation. A short frenulum as a cause of premature ejaculation is practically not considered, since after plastic surgery of the frenulum, sexual life returns to normal.

Diagnosis and treatment of premature ejaculation

In addition to subjective data based on a patient interview, the andrologist performs a number of tests, including a test with lidocaine and a condom. It is also necessary to conduct an examination for the presence of inflammatory diseases of the urogenital area, which could cause sexual dysfunction. And after a comprehensive examination, a course of procedures to correct sexual dysfunction is prescribed on an individual basis. In this case, the goal of treatment is to restore the normal duration of sexual intercourse and relieve the psychologically caused failure syndrome.

All patients undergo a psychotherapeutic course to learn how to control ejaculation. Sexopathologists agree that with premature ejaculation of a psychogenic nature, psychotherapy is sufficient to successfully develop the recognition of pre-orgastic sensations. However, the effect of psychotherapy is observed only with the conscious and adequate participation of a permanent partner. The “stop-start” technique begins to produce results within 2 to 10 weeks, but it takes at least another 2-3 months after the end of the procedures to consolidate them. Moreover, effectiveness largely depends on the patience of both partners and the absence of negative emotions at the time of sexual intimacy.

Stopping or slowing down frictional movements simultaneously with conscious relaxation of the muscles at the moment of approaching orgasm allows you to continue sexual intercourse, in addition, constant training strengthens the pelvic floor muscles, which additionally helps to achieve complete control over ejaculation and solve the problem of premature ejaculation. Moreover, treatment will be effective only if you have a permanent partner who is not indifferent to the man’s problems and has a positive attitude, along with a reserve of patience and perseverance.

Drug treatment of premature ejaculation is indicated for inflammatory processes in the prostate gland and seminal tubercle, as well as for increased sensitivity of the glans penis. To reduce sensitivity, use ointment with lidocaine or anesthesin, and it is recommended to use a condom. The drug is applied 10-15 minutes before sexual intercourse to the frenulum area to prevent complete loss of sensitivity and not cause anejaculation. This method can only be used if there is a regular partner, as it is associated with psychological and physical discomfort during preparation for coitus, however, when using ointments, a good clinical effect is achieved and a minimum of adverse reactions are observed.

Due to their selective effect on regulatory mechanisms, drugs from other pharmacological groups can also be used to correct premature ejaculation. However, not a single pharmacological group of drugs has received widespread use. Thus, antipsychotics block dopamine receptors at the central level. The effectiveness of tranquilizers in correcting premature ejaculation directly depends on the dose, but ejaculation is inhibited rather than controlled. In addition, when the dose is increased, a medicinal sedative effect occurs, which is not always appropriate at the time of sexual intercourse.

When using alpha-blockers, the ejaculatory reflex is inhibited due to the effect on the sympathetic link. But despite this, while maintaining control over premature ejaculation and maintaining orgasm, the drugs have not found widespread use due to frequent retrograde ejaculation, when seminal fluid is thrown into the bladder because its valve does not close.

Premature ejaculation can be inhibited by tricyclic antidepressants, although these drugs are dose-dependent and their effectiveness is no more than 15%, which, together with many side effects, has not given antidepressants widespread use in the treatment of premature ejaculation.

The most popular drugs for correcting premature ejaculation are antidepressants that increase serotonin levels by selectively blocking its reuptake. These are fluoxetine, sertraline and others; When taking the drugs, there is a good effect, a small number of adverse reactions. It is the drugs of this pharmacological group that are promising for the effective correction of premature ejaculation.

Intracavernosal injections, which have gained popularity recently, significantly increase the friction period by reducing the sensitivity of nerve fibers. But, unlike drugs taken orally, an erection remains even after ejaculation, which allows a man to continue sexual intercourse, feeling more confident.

Surgical treatment of premature ejaculation is resorted to if the main cause is a short frenulum. In such cases, surgical frenuloplasty is performed. If there is no effect from conservative treatment of premature ejaculation, a microsurgical operation is performed to denervate the glans penis. As a result of surgical interventions, the sensitivity threshold of the glans penis changes and a positive effect is observed in 90% of patients, with a primary increase in the duration of sexual intercourse by 2-4 minutes. The postoperative period spent in the hospital is no more than 2 days, and after the operation, complete psychological rehabilitation of patients is possible.