Delayed ejaculation in men: classification, symptoms, causes and treatment. Complex character of a teenager

The period of puberty in girls is quite long - about ten years. It is characterized by the presence of several stages of improving the puberty of a girl.

The onset of puberty occurs at the age of eight or nine years, which is characterized by an acceleration in the growth of girls.

The appearance of further signs of puberty - enlargement of the mammary glands, growth of pubic hair begins at about ten to twelve years of age.

On average, two years after the above external transformations, the first menstruation appears.

The final stage of puberty for girls is considered to be the age that occurs after four to six years after the onset of the first menstrual bleeding. Usually, this happens at the age of seventeen or eighteen.

However, there are groups of girls who, due to their developmental characteristics, can begin puberty at the age of nine. This means not only the accelerated growth of the body and its limbs, but the formation of secondary sexual characteristics - the development of the mammary glands and so on. It happens that absolutely healthy girls begin to enter puberty from the age of seven or eight years, which is associated with genetic features their development.

Also, the onset of puberty in some categories of girls can be delayed until the age of thirteen to fifteen. At the same time, girls are healthy and normally developing, and such delays in maturation are caused by hereditary factors.

Beginning of puberty in girls

The onset of puberty occurs at the age of eight to nine years. This stage is characterized by a strong jump in the growth of girls, which can reach about ten centimeters per year. It happens that girls at this time overtake their male peers in growth.

During this period of puberty, the skeletal system, muscular system, and nerve endings grow at different rates. Therefore, outwardly, girls who have entered puberty may seem clumsy and awkward, somewhat angular.

Often, such changes in the figure cause suffering to girls and fears that they will forever look like funny grasshoppers. Parents need to reassure the girls by telling them that their figures will soon acquire positive transformations.

In the future, at about eleven - thirteen years, secondary sexual characteristics begin to change rapidly - the mammary glands grow, the waist decreases, body shapes become rounded, and so on.

Age of puberty in girls

The age of puberty in girls is as follows:

1. The onset of puberty occurs at about eleven to thirteen years of age.
2. The end of puberty occurs at the age of seventeen - eighteen years.

There are several categories of teenagers who do not mature in the same way. Some of the girls begin to enter puberty earlier and, accordingly, earlier and finish puberty. Such teenagers are called accelerators. They have the onset of puberty in the form of an increase in the mammary glands observed at the age of nine - ten or eleven years. And the growth spurt occurs about a year before. Accordingly, the appearance of the first menstruation in the above girls occurs at the age of ten to eleven.

In another category of adolescents, the onset of puberty is delayed until the age of thirteen - fourteen - fifteen years. This is manifested in growth retardation and the formation of secondary sexual characteristics. The first menstruation appears in these categories of girls at the age of thirteen, fourteen or fifteen. Accordingly, puberty ends in more late age, at eighteen. Such teenagers are called retardants, that is, slowed down in their development, which is absolutely normal and genetically determined.

However, there are certain developmental anomalies and hormonal disorders in girls, which cause delayed puberty and the appearance of menstruation. Therefore, if there are no signs of puberty at fourteen or fifteen years old and menstruation has not begun by the age of fifteen, it is recommended to show the girl to a gynecologist and endocrinologist.

Signs of puberty in girls

The signs of puberty in girls are as follows:

• A sharp growth spurt - a girl can grow up to ten centimeters a year. At the same time, girls are ahead of the growth of their male peers. Leveling differences in height is carried out at the age of seventeen or eighteen years, that is, by the end of puberty in girls. At this time, the girls are stunted, while the boys continue to grow.
• Change in the figure of a teenage girl in the initial stage of puberty - an increase in the length of the limbs compared to the length of the body. Because of this, there is a change in the proportions of the body, which leads to a visual impression of its awkwardness.
• In the future, secondary female sexual characteristics begin to form. First of all, the mammary glands begin to increase. Then, after a while, smooth pubic hair appears on the pubis. After a short time, pubic hair begins to change in structure - it becomes wavy. The following changes in the girl's body relate to the appearance of axillary hair growth.
• The small and large labia increase in size.
• Soon comes the first menstruation - menarche.
• Changes in the appearance of the girl continue - the volume of the hips increases, the waist becomes thinner, the shoulders narrower, and the figure acquires rounded, smooth outlines characteristic of the female body.
• The amount of hair on the girl's arms and legs increases, and they become darker.
• going on hormonal changes body of a girl, as a result of which the appearance of her skin and hair changes. Activation starts sebaceous glands located in the skin. Therefore, the skin and hair become more fat look; the girl's face, neck and back begin to become covered with red pimples and blackheads.
• The overall percentage of fat in the girl's body increases, and fat deposits are seen mainly in the pelvis, abdomen and hips.

Stages of puberty girls

The stages of puberty in girls are correlated with the appearance of each sign of puberty.

• Spike in growth - in a normally developing girl, this increase in height occurs at about eleven years of age. If before this period, at about seven to eight years old, girls add five to six centimeters a year in height, then entering the age of puberty is marked by an increase of eight to ten centimeters a year. At this time, the child grows out of the newly bought clothes and shoes so quickly that it surprises not only his parents, but also the girl herself.

At this time, the annual weight gain reaches the mark of four to nine kilograms, although before this period the usual weight gain averaged two and a half to three and a half kilograms.

An increase in growth affects the increase in the child's appetite and the amount of food eaten, because such transformations require an increased influx of energy and building materials.

• Such changes may appear even earlier, around the age of nine, in girls who are formed earlier than their peers.
• In the future, there is an increase in the size of the pelvis and hips, which refers to the formation of secondary sexual characteristics. It happens that such changes occur at the age of nine.
• Further changes in the girl's body are manifested in an increase in the mammary glands. First of all, the nipple and areola around the nipple are enlarged. Six months later - a year mammary glands become like small cones. At this time, it is not recommended to use a bra, which can stop the formation of the mammary glands.
• Approximately, around the beginning of the first menstruation, the entire mammary gland increases in size and becomes round shape like the mammary glands of adult women. This usually occurs during the onset of the first menstruation. It is at this time that it is worth putting on the first bras, which will contribute to the convenience of the girl's movements.
• At the age of twelve - thirteen, the formation of secondary sexual characteristics continues: hair grows in the pubic area and a waist is formed, which is characteristic of the structure of the female body. Primary sexual characteristics also develop - there is an increase in the external genitalia (labia minora and labia majora).
• There are various skin changes associated with the activation of sebum secretion. Such "innovations" are due to the process of hormonal and physical changes in the girl's body. An increase in the amount of sebum provokes the appearance of red acne on the skin of a girl and acne, and also causes increased oily hair.

Such changes do not at all please the matured girls, who are very worried about the deterioration in appearance that has occurred. Parents need to consult with hairdressers and cosmetologists about the purchase of special shampoos and cosmetics for the skin, with which you can maintain good condition of the skin of the body and hair, as well as preserve the girl's external attractiveness. It will not be superfluous to undergo special cleansing cosmetic skin procedures in the cosmetologist's office. In addition, an adult girl must be taught the rules of thorough personal hygiene so as not to provoke a deterioration in the condition of the skin and hair.

• The appearance of the first menstruation, called menarche. This fact means that the girl is already sexually mature, that is, capable of reproductive function. At first - within two years - the menstrual cycle is most often unsteady. This is manifested in the unidentified rhythm of bleeding, as well as in their strength and duration. After the menstruation becomes cyclical, we can say that the girl is ready for conception and the birth of a child (but only from a physiological point of view, and not psychological and social).

As noted above, in the first two years, menstruation in girls has an unidentified cycle, that is, deviations of a different nature appear. These features are not a violation of the normal development of the girl, but are considered fluctuations that do not go beyond the normal physiological stages of the manifestation of puberty. First of all, this concerns violations of the regularity of the menstrual cycle, which has two phases. During the period when menstrual bleeding have just begun, the primordial eggs may not fully mature, and therefore there is no separation of mature eggs from the ovaries. The formation of the corpus luteum in this case either does not occur at all, or is underdeveloped, which does not stimulate the production of an increased content of progesterone in the girl's blood.

The first phase of the menstrual cycle leads to enhanced growth the lining of the uterus (endometrium), which occurs under the influence of estrogen. This provokes the appearance of uncomfortable sensations and prolonged uterine bleeding, called juvenile. Approximately five to ten percent of girls have similar manifestations.

Sometimes, menstruation may not take place every month, but at intervals of two to three months. Perhaps the manifestation of other violations in the cyclical nature of menstruation, but such deviations, as already mentioned, disappear after a couple of years.

It is very important for the period of menstruation to prepare the girl for recurrent bleeding. It is necessary to tell the girl about hormonal changes in her body, that her body is already ready for reproductive functions. Such a conversation can be conducted by the girl's mother and / or a gynecologist. It is worth preparing the girl to accept the fact that menstruation is a common occurrence in women's life. But if bleeding is accompanied by pain and other unpleasant sensations that can disturb the girl and cause her inconvenience, you should definitely consult with a gynecologist.

It is also necessary to have a conversation with the girl about the dangers of an early onset of sexual activity and possible pregnancy in this case, which leads to tragic consequences at this age.

• Since the onset of menstruation, the increase in the growth of the girl does not occur at an accelerated pace. At this age, on average, by the age of thirteen, the growth rate is reduced to one and a half - two and a half centimeters per year.
• At the age of fourteen - sixteen, the girl's figure begins to take on a feminine shape - in addition to the already grown breasts and thinned waist, the hips begin to round, the pelvis grows, the shape of the legs changes, and so on. Hair growth appears in the armpit area. Menstruation becomes rhythmic. Development skeletal system, bone growth stops.

To maintain hygiene, the girl must be taught how to use a razor for women to shave the hair in the armpits. Pubic hair should not be removed, as it is not necessary at this age.

Early puberty in girls

Early sexual development is considered the appearance of secondary sexual characteristics and the occurrence of menstruation (in some cases) in girls about ten years old. Such developmental manifestations insignificant degree norms ahead of the deadlines are not considered a deviation or violation. Therefore, we can say that for some girls, a slight lead in terms of development is a variant of the norm. Such features of development are observed in accelerated girls, who differ from their peers in early physical, sexual, psychological and emotional development.

Early puberty in girls should not worry parents. But in these cases, it is recommended to conduct special conversations that can explain to the girl the changes in her own body and teach her personal hygiene skills.

Precocious puberty in girls

Precocious puberty is characterized by the appearance of a full set of secondary sexual characteristics (or some of them) in girls under the age of eight years. Sometimes at this age there is the appearance of menarche - the first menstruation. There are several forms of precocious puberty in girls:

1. True precocious sexual development. This form of premature development is considered cerebral, that is, arising due to the processes occurring in the brain. Early onset of puberty leads to an early manifestation of the activity of the hypothalamus or adenohypophysis, which are responsible for reproductive functions. The activity of these glands stimulates the production of luteinizing hormone (LH) and follicle-stimulating hormone (FSH).

Activation of LH leads to the production of estrogen in the girl's body, which leads to changes in her body due to puberty. The activity of FSH leads to the beginning of the growth and maturation of follicles in the ovaries.

True precocious puberty has a number of features:

• isosexual in nature, that is, it correlates with the female sex genetically and on a gonadal basis;
• complete in its manifestations, that is, it is characterized by the presence of thelarche (growth of the mammary glands), adrenarche (the appearance of pubic and axillary hair) and an acceleration in the growth rate of the body.
• completed, that is, characterized by the premature appearance of menarche.

The causes of the cerebral form of true precocious puberty may be infections that were transferred by a girl under the age of one year. Such manifestations lead to organic lesions the brain, which puts pressure on the hypothalamus, as well as certain problems that arose during the period of maternal pregnancy.

There is not only a cerebral form of true precocious puberty, but also a constitutional form. The latter form of deviation in puberty is more rare and has a hereditary character.

False precocious puberty

This type of premature maturation occurs due to the increased release of estrogens in the adrenal glands or ovaries. The use of drugs containing estrogens or gonadotropic hormones in the treatment of a girl also provokes the appearance of false puberty.

The false type of premature development is characterized, like the true one, by the accelerated growth rate of the girl. But false development always has an incomplete character, which is manifested in the absence of premature menarche. Also, false development can take place both in isosexual and in heterosexual type.

Characteristics of a false isosexual type of development (according to female type):

• fast growth rate;
• there is an increase in the mammary glands;
• hair growth of the pubis, inguinal zones and armpits occurs.

Characteristics of a false heterosexual type of development (according to the male type):

• before the age of eight, the clitoris enlarges, which begins to resemble a penis in shape;
• rod hair appears in the area of ​​​​the upper lip and chin;
• bones grow faster than in girls developing according to the isosexual type;
• the fat layer is distributed according to the male type.

It should be noted that the heterosexual type of development is quite rare and is caused by hormonal disorders in the body of girls who were injected with androgen hormone preparations. If there was a timely appeal to specialists, deviations in the development of the girl can be reversed, into the female direction. The application of the correct method of treatment, which is carried out for a long time, can completely restore the correct sexual development of the girl. The mammary glands will form in due time, the menstrual cycle will be established on time. In the future, the cured girl's reproductive functions will be preserved, she will be able to conceive and bear a child well, as well as give birth normally. If treatment is neglected, then the development of the female type in such girls will not occur at all.

Incomplete precocious puberty

This type of premature puberty is caused by the appearance in the girl's body of an excess of gonadotropic hormones. strong magnification estrogen can also lead to similar abnormalities in sexual development.

Characteristics of incomplete precocious puberty:

• not accompanied by accelerated growth;
• only the mammary glands are formed, without the appearance of other secondary sexual characteristics;
• only hair growth of the groin, pubis and armpits appears without the formation of other secondary sexual characteristics.

Diseases of a different nature that provoke the appearance of premature sexual development. These diseases include:

• the occurrence of follicular ovarian cysts,
• the presence of ovarian tumors,
• the appearance of primary hypothyroidism,
• McCune-Albright syndrome,
• Russell-Silver syndrome.

These diseases are characterized by spotting that resemble menstrual bleeding. But secondary sexual characteristics do not receive their development.

Films about girl puberty

Films about the puberty of girls are recommended to be watched with a mother or another adult woman who can explain to the girl any incomprehensible or embarrassing moments. Parents are advised to watch the film on their own before watching it together with their child to make sure that it is useful and that there are no frames and information that, in the opinion of mom or dad, are premature for their daughter. It is worth starting watching such films at the age when the first signs of the girl's puberty appeared, and also when she became interested in such issues.

Films about the puberty of girls are represented by the following documentaries and cartoons:

• A film about the formation and protection of the reproductive functions of girls "When a girl grows up ...", which won the main prize in the nomination "Applied animation" of the Open Suzdal Festival in the city of Suzdal in 2003. The film was created with the support of the Russian Ministry of Health and the pharmaceutical company Gedeon-Richter.
• Documentary"Girl Power" from the Discovery Channel.
• Documentary film produced in Great Britain in 1998 “The human body. Puberty».
• Documentary film created in 2008, "About sex - Puberty".

Puberty is the period of a person's life during which his body reaches biological puberty. This period is called puberty and is characterized by the appearance of secondary sexual characteristics (see), the final formation of the genital organs and sex glands. The onset of puberty depends on many factors - nationality, climatic conditions, nutrition, living conditions, gender, etc. In boys, it begins on average from 15-16 years old, in girls from 13-14 years old and ends, respectively, by 20 and 18 years old. It should be emphasized that significant individual deviations are noted in the timing of the onset of puberty. In physiological terms, this period is characterized by the maturation and the beginning of the functioning of the gonads. In the adrenal cortex, androgens begin to be intensively produced (see), the secretion of pituitary gonadotropins increases (see Gonadotropic hormones), which accelerates the development of the gonads. In girls with an increase in the function of the ovaries that produce, the mammary glands, external and internal genital organs begin: uterus, labia. At the age of 14-15 years, sometimes earlier, there is a formation of a menstrual cycle (see). An objective criterion for the maturity of the gonads is menstruation in girls and (see) in boys. The most common sequence of appearance of sexual characteristics is presented in the table.

The sequence of appearance of signs of puberty

Age in years	Signs of puberty
	girls	boys
8	The pelvis becomes wider, the hips are rounded
9	Increased secretion of sebaceous glands
10-11	The beginning of the development of the mammary glands	Beginning of growth and testicles
12	The appearance of hair on the genitals, enlargement of the genitals	Larynx growth
13	The alkaline reaction of the vaginal secretion becomes sharply acidic	Enlargement of testicles and penis. Slight appearance of hair on the genitals. The beginning of the formation of the male type
14	The appearance of menstruation and the appearance of hair in the axillary cavities	Voice change (breaking), slight increase (swelling) mammary glands
15	Pronounced changes in the size of the pelvis and its proportions according to the female type	scrotum, the appearance of a mustache and the appearance of hair in the axillary cavities. Significant testicular enlargement
16-17	Menstruation occurs regularly, with ovulation (see).	Increased hair growth on the face, body; male type of pubic hair. The appearance of wet dreams
18-19	Skeletal growth stops	Deceleration of skeletal growth

Often, normal puberty proceeds in a slightly different sequence. In these cases, it is sometimes very difficult to find a clear boundary between the norm and pathology. One of the reasons for such deviations are violations of hormonal systems, in other cases, the constitutional features of a teenager during the puberty period, as well as psychogenic factors that can cause severe endocrine disorders, acquire certain significance. It is extremely important to consider these cases, since the irrational use of hormonal drugs in the treatment can lead to significant damage to many systems. During puberty, sometimes small temporary deviations are observed, that is, variations in the normal developmental process. They are regarded as physiological phenomena. Girls may have significant growth of the mammary glands (macromastia), and precocious puberty does not occur. Physiological variations of puberty also include juvenile uterine bleeding, amenorrhea (see). Painful menstruation is often observed, accompanied by headaches, vomiting, and weakness. These disorders are usually observed in girls with an unstable nervous system. Boys may have a slight enlargement of the mammary glands (pubertal gynecomastia) that resolves completely.

Late(pubertas tarda) is considered puberty, observed in girls at 18-20 years old, in boys at 20-22 years old. With this pathology medical measures should be aimed at improving living conditions, nutrition and the introduction of male, female sex hormones and drugs containing pituitary gonadotropic hormones. Delay of sexual development and growth retardation is observed at infantilism (see). Underdevelopment of the reproductive apparatus and the absence of sexual characteristics of this sex - hypogenitalisl (see) - are due to dysfunction endocrine glands especially the pituitary gland.

Early(pubertas parecox) is considered puberty, occurring in girls under 8 years old, in boys under 10 years old and characterized by the premature appearance of secondary sexual characteristics, the rapid development of the genital organs and accelerated growth. In boys, this manifests itself in accelerated growth, and then an early cessation of growth (which subsequently leads to short stature), rapid growth genital organs and the appearance of secondary sexual characteristics (hairiness, low timbre of voice, pronounced skeletal muscles). There are also wet dreams. In girls, there is an acceleration of growth, and then an early cessation of growth, it becomes wide, the size of the uterus and ovaries increase. There are cases of menstruation at preschool age.

Early puberty, combined with accelerated growth, but a sharp disproportion of the skeleton, short stature and mental retardation, is defined as macrogenitosomia praesox.

The question is closely related to the problem of puberty. This is a system of medical and pedagogical influences on adolescents with the aim of educating them in certain norms of behavior in their sexual life. The task of sex education is to create a physically healthy generation whose sexual life must be subject to the moral standards of our society. Joint education and upbringing of boys and girls, their early involvement in public life, the combination of education with industrial work, broad development and among young people create the basis for a reasonable tribal education.

Puberty (Latin pubertas) is the process of growth and differentiation of the sex glands, genital organs and secondary sexual characteristics. Puberty proceeds with the most complex changes in the nervous, endocrine, cardiovascular and other systems of the body, as well as in physical development, and ends with the onset of puberty.

An important role in puberty is played by the hypothalamic region, which is in an inextricable functional relationship with the pituitary gland. During puberty, the activity of gonadotropic hormones of the pituitary gland increases markedly, and the content of androgens and estrogens in the blood and urine increases. Estrogens synthesized by the ovaries cause an increase in the uterus, vagina, labia minora, mammary glands and keratinization of the vaginal epithelium. Androgens determine sexual hair growth, growth of the penis and scrotum in boys, and in girls - the clitoris and labia majora. Sex hormones, especially androgens, stimulate the growth and differentiation of bone tissue, promote the closure of growth zones, and enhance muscle development. In these processes, the protein-anabolic effect of sex hormones is manifested. The relationship between the various systems that regulate puberty is shown in fig. 1.

Rice. 1. Scheme of relationships between various systems that regulate growth and sexual development (from Gillenswerd, according to Wilkins).

Puberty begins earlier in girls than in boys. During this period, the excretion of estrogens and gonadotropins in the urine increases markedly in girls, and androgens in boys. Recently, in all countries, the timing of the onset of puberty has shifted to more early period. So, according to the observations of V. S. Gruzdev, relating to 1894, menstruation began at the age of 15 years 8 months; at the present time (1965) they begin more frequently at 13-14 years of age. In young men, the date of onset of puberty is determined by the first ejaculations. The beginning and duration of the pubertal period depend on family (constitutional) characteristics, body structure and environmental conditions (nutrition, climate, living conditions, etc.). Puberty begins in girls from 8-11 and usually lasts up to 17 years, in boys - from 10-13 to 19 years.

During puberty, hypertonic reaction and hypotonic state, pulse lability, acrocyanosis, Trousseau spots, orthostatic albuminuria, spontaneous hypoglycemia, and sometimes mental disorders. The degree of puberty is judged by secondary sexual characteristics - pubic hair (11-13 years) and in armpit(12-15 years), in girls, in addition, according to the timing of the onset of menstruation and the development of the mammary glands (10-15 years), as well as using radiographs of the hand and distal ends of the bones of the forearm. The beginning of puberty corresponds to the ossification of the sesamoid bone, then synostosis appears in the first metacarpal bone and terminal phalanges; at the end of puberty, complete synostosis of the epiphyses of the radius and ulna occurs. Assessing the degree of puberty in boys by the size of the external genital organs must be carefully, since their growth is often somewhat behind.

precocious puberty(pubertas praecox) is true and false. When true, there is a relationship between the hypothalamic-pituitary region, the sex glands and the adrenal glands. There are constitutional (essential) and cerebral forms of true puberty.

The constitutional form is observed almost always in girls and is due, apparently, to a family predisposition. Secondary sexual characteristics appear early, even from birth, but more often at 7-8, and menstruation - at 8-10 years. Menses are ovulatory. In boys, secondary sexual characteristics can appear as early as 9-11 years old, less often earlier. There is macrogenitosomia (premature enlargement of the external genitalia). At 12-13 years of age, puberty ends.

Initially, children with precocious puberty are ahead of their peers in physical development. However, in the future, due to the closure of growth zones, some of them experience short stature and disproportion - lower limbs relatively short in relation to the body (Fig. 2). The mental development of such children often corresponds to age, and if it lags behind, then by about 2 years. In girls, excretion of follicle-stimulating hormone and estrogen in the urine reaches the level of puberty. The content of 17-ketosteropds in the daily urine exceeds the age norm. In tumors of the adrenal gland and gonads, the level of excretion of hormones is much higher. A vaginal smear confirms a normal menstrual cycle.

The prognosis for the constitutional form of precocious puberty is favorable. Treatment is not carried out.

In the cerebral form of true puberty, there are lesions of the hypothalamic region (tumors, hemorrhages, congenital defects of the brain, encephalitis) or a tumor of the pineal gland. Currently, most researchers believe that even with tumors of the pineal gland, premature sexual development is due to secondary changes in the hypothalamus due to internal hydrocephalus. In children, early and rapid development of the genital organs and secondary sexual characteristics is noted. Mature Graafian follicles develop in the ovaries corpus luteum. In the testicles, interstitial cells are formed and spermatogenesis occurs. The content of gonadotropins, estrogens, 17-ketosteroids in the urine corresponds to the pubertal period.

Premature puberty is also noted in multiple fibrous dysplasia, in which there are changes in the skeletal system, skin pigmentation and increased activity of the thyroid gland.

False puberty (pseudopubertas praecox) occurs with pathological changes in the adrenal glands, ovaries or testicles. Ovulation and spermatogenesis are absent. After removal of the tumor, the reverse development of secondary sexual characteristics is possible.

Delayed puberty(pubertas tarda) is characterized by the late development of the genital organs and glands, as well as the appearance of secondary sexual characteristics. In boys, it is diagnosed at 20-22 years old, in girls at 18-20 years old. Most often occurs under the influence of a constitutional (family) factor, less often due to insufficient hygiene conditions and nutritional reasons. Late puberty is observed sometimes up to 15-16 years. At the same time, physical and often mental development lags behind. The differentiation of the skeletal system also lags behind, more often by 2-4 years. Most children in the coming years reach their peers in sexual development.

The assessment of puberty should be carried out on the basis of a number of signs and especially radiological data on the differentiation of the skeletal system. Correspondence of ossification processes to actual age, as a rule, excludes a lag in puberty.

Variations in puberty. Premature development mammary glands (premature thelarche) in girls may be the only sign of deviation. Lack of secondary sexual characteristics, estrogenic changes vaginal smear and enlargement of the internal and external genital organs makes it possible to distinguish this process from true puberty. It is assumed that premature telarche is based on an increased reaction of mammary tissue to estrogens. In the future, this reaction may disappear. Treatment is not required.

In boys, pubertal gynecomastia is often observed (see), expressed more often on the left and disappearing without treatment. Treatment with male sex hormones is contraindicated.

Premature secondary hair growth (premature pubarche) develops on the pubis, in the armpits without other signs of virilization and is more often observed in girls. Only from 10-12 years old it is combined with an increase in the mammary glands, external and internal genital organs. Later, children develop normally. Urinary excretion of 17-ketosteroids corresponds to the age norm or slightly exceeds it. Children with precocious puberty require medical supervision and should be examined periodically.

During puberty, sometimes there is an increase in the thyroid gland II and III degree without dysfunction. Treatment is not carried out. Often, especially in boys, acromegaloid phenomena (also physiological) develop. Possibly male predominance feminine. The prognosis is favorable. In the same period, the so-called pseudo-Freilich type of obesity is sometimes noted, somewhat similar in appearance to obesity in adipose-genital dystrophy (see). At the same time, the distribution of fat is uniform with some predominance in the chest, abdomen and thighs. The arms and legs are often shortened. Body length and bone differentiation correspond to actual age. Hypogenitalism is absent or slightly expressed. Urinary excretion of 17-ketosteroids and 17-hydroxycorticosteroids is normal. Basal metabolism is reduced or normal. Puberty occurs at the usual time or somewhat late. Medical treatment not required.

During puberty, girls with symptoms of basophilism (basophilic cells of the pituitary gland function intensively) have female-type obesity, strips appear on the hips, buttocks, and chest. Blood pressure is often elevated. However, sexual development is not disturbed or even accelerated. Menstruation occurs on time, and the cycle is preserved. The prognosis, as with the obesity options described above, is favorable.

Pubertal wasting occurs predominantly in girls. The first symptoms: lack of appetite, abdominal pain, belching and vomiting, often repeated. The skin is dry, wrinkled. Bradycardia, muffled heart sounds, arterial hypotension, amenorrhea are noted. Unlike pituitary cachexia, there is no atrophy of the mammary glands and hair loss. The main exchange is reduced. Thyroid function is not impaired. The content of 17-ketosteroids in the urine is reduced, after the introduction of ACTH it reaches the norm. Follicle-stimulating hormone in the urine is often absent or reduced. The prognosis is usually favorable. Treatment - requires careful care, chlorpromazine, protein-anabolic steroids. Methandrostenolone (or nerobol) 5 mg per day, nerobolil intramuscularly 25-50 mg once a week (4-6 injections).

The diagnosis, prescription of medications, especially hormones, as well as the prognosis of diseases and conditions during puberty must be approached with caution.

Rice. 2. Girl 2.5 years old: early sexual and physical development (height 110 cm).

The logical conclusion of sexual intercourse is an orgasm. A man at this time not only enjoys, but also spews out a seed, which, once in the woman's vagina, provokes the development of a new life. There are a number of problems that a man, with age or under the influence of certain factors, begins to experience during ejaculation. One such problem is delayed ejaculation.

Causes of delayed ejaculation

If there are problems with ejaculation, the man experiences sexual arousal and has an erection sufficient for sexual intercourse, but even intense stimulation of the penis does not lead to the release of seminal fluid for a long time. Delayed ejaculation is often accompanied by difficulties in obtaining an orgasm, as well as psychological dissatisfaction of partners.

long ejaculation -this is a fairly rare phenomenon, it occurs in 1 man out of a thousand.

Some women may note that in general, the situation is not so bad, because the sexual intercourse lasts longer than usual, and this is in any case better than premature ejaculation. Problems with ejaculation of this type also entail problems with conception, but women who do not want to become mothers also like this state of affairs, which cannot be said about men.

Delayed orgasm in men can be triggered by a huge number of reasons, among them are noted:

• injuries of the scrotum and penis;
• genital infections;
• prostatitis;
• urethritis;
• BPH;
• urethral strictures;
• transferred operations on the prostate gland;
• kidney failure;
• diseases of the endocrine system.

Prolonged sexual intercourse in a man may be associated with neurological problems such as recent stroke, diabetes, Parkinson's disease, multiple sclerosis, and spinal cord disease. If ejaculation is constantly delayed, the problem may be hiding in physiological moments, that is, the partner may have a too small penis or the woman may have a too wide vagina.

Delayed ejaculation in men can be caused by psychological factors, such as fear of not satisfying a partner, interpersonal problems (lack of sexual desire between partners), and the presence of complexes. Quite often, orgasm delay occurs in people who have an "autosexual" orientation, that is, they experience greater satisfaction from masturbation than from traditional sexual contact.

Prolonged intercourse can provoke the use of some medications. This side effect occurs after regular use of antidepressants, antipsychotics, antihypertensives and diuretics. A similar result is observed with the abuse of drugs and alcohol.

Only a qualified specialist can determine exactly why ejaculation may be delayed based on a thorough examination and test results. Do not try to self-diagnose yourself, you will only worsen the situation and complicate, as a result, the work of doctors.

Classification of delayed ejaculation

Delayed ejaculation even has several types. Depending on the degree of violation, anejaculation is distinguished - in which ejaculation does not occur for more than 20 minutes, while partners are forced to stop sexual intercourse, and relative anejaculation, characterized by the absence of ejaculation during intercourse, but its achievement during masturbation. There is also retrograde ejaculation, a man enjoys sexual intercourse, but the ejaculation does not occur in the usual way. Sperm enters the bladder instead of the opening of the penis. This method of ejaculation is also called "dry orgasm." It is generally not dangerous for a man, but it is impossible to conceive a child without treatment.

Pathology can be primary, that is, occur from the onset of sexual activity, or secondary, that is, occur after a certain period of life. Depending on the circumstances, doctors distinguish between permanent dysfunction and situational. In the first case, ejaculation is always delayed, regardless of the situation, and in the second, pathology occurs depending on certain conditions.

Each of the forms of sexual dysfunction has its own characteristics and requires an individual approach to treatment.how to speed up ejaculationThe doctor will tell you, having studied in detail the history of the disease and other features of your body.

Delay symptoms

The main symptom of dysfunction is, as the name suggests, delayed ejaculation. At the same time, a man can fully ejaculate outside of sexual contact, that is, with the help of petting and masturbation. The consequences of such a state are not critical, because similar phenomenon does not threaten the lives of partners, but necessarily requires correction. Delayed ejaculation in rare cases can cause a man discomfort in the lower abdomen. At the same time, there are no additional symptoms, such as itching, burning or redness.

It should be noted that a man who is not able to finish quickly tends to blame the woman for the situation, ignoring the problem with his health. This moment only strengthens mutual reproaches and claims. As a result, both partners develop a dislike for each other, and, accordingly, the family is destroyed. If a man in such a situation does not change his mind in time, this will happen again in a new relationship, and will last until he turns to a doctor.

Treatment for delayed ejaculation

Before the doctor prescribes a course of therapy, he is obliged to conduct a diagnosis, that is, to determine the cause that caused such an unusual state of sexual function. After listening to the patient's complaints, the urologist or andrologist will rectal examination prostate, ultrasound of the penis and organs of the scrotum. In order to exclude torch infections, prostate juice will be taken for analysis. To assess the hormonal state of a man, an androgenic profile study (testosterone level, SHPS) will be carried out. If there are prerequisites for believing pathology, a consultation with a neurologist, endocrinologist and cardiologist is required. If physiological abnormalities are not found, a psychosexual examination of the patient is due.

The approach to treatment is chosen by the doctor individually, depending on the cause of the pathology and the violations found. Therapy can consist of several stages, treatment begins, as a rule, with medicines and physiotherapy. If they fail, the patient is referred to a surgeon for corrective surgery..

Some doctors say that you can correct the situation by choosing the right position for sex or by determining the tactics of action. The best therapy is the following:

1. Ejaculation caused by masturbation alone.
2. Calling ejaculation by masturbation in the presence of a partner, but without her participation.
3. Calling ejaculation by stimulating a partner.
4. Stimulation of the penis by the partner, which leads to fully prepared to ejaculation, and then the rapid introduction of a member into the vagina.

According to doctors, after a man ejaculates several times in the vagina, the pathology and the psycho-emotional problems associated with it disappear and the man fully restores full-fledged ejaculatory function.

Medicines and preparations

In the treatment of delayed ejaculation, there is not one drug, but several at once, because the funds must comprehensively remove not only the cause, but the possible consequences of a long absence of therapy. Most often, doctors prescribe:

• dopaminergic drugs;
• dopamine reuptake inhibitors;
• drugs alpha-2 antagonists, alpha-1 agonists, blockers calcium channels;
• serotonin 5-H receptor antagonists.

In the presence of retrograde ejaculation, the patient may be prescribed medications such as: Ephedrine sulfate, Midodrine, Brompheniramine maleate or Desipramine. Although all of the above medicines are dispensed in pharmacies without a prescription, it is strictly forbidden to buy them at your own discretion. The duration and mode of administration should be indicated by the doctor, on an individual basis.

If the cause of the pathology is congenital anomalies or defects that have developed as a result of injuries and surgical interventions, then the treatment is only surgical. If there is pain during ejaculation or when it is delayed, it is imperative to go for treatment for concomitant diseases, they can be prostatitis, urethritis and sexually transmitted diseases.

Summing up, we can say that the prognosis for the treatment of delayed ejaculation will be positive, only with timely complex treatment. There is no prevention that avoids such a situation, and there is no folk remedy that would help correct the pathology. Only a qualified andrologist or urologist can help to gain full-fledged male power and conceive children.

Sluggish ejaculation is a problem that should not be left to chance. It is possible that problems with ejaculation have arisen under the influence of stress or extreme fatigue, but the influence of factors such as inflammatory diseases or neurological ailments cannot be ruled out, which are highly desirable to cure.

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How is sluggish ejaculation manifested?

Prolonged ejaculation may manifest various symptoms. With this violation, the ejaculation reflex is involuntarily suppressed under the influence of physiological or psychological reasons. A man may feel that he cannot come to the conclusion of sexual intercourse, i.e. the process of ejaculation does not occur. Erection in this case can be quite normal.

Other men may note that ejaculation occurs without delay, but the ejaculation itself is not the same as before: sperm can be released slowly and for quite a long time, and does not “shoot out”. This symptom may also indicate problems with ejaculation.

In general, difficult ejaculation in men is much less common than weak potency or accelerated ejaculation. At the same time, at least 75% of patients with delayed ejaculation can achieve it without problems during masturbation. But in some cases, ejaculation does not occur at all - this condition is called anejaculation. This is an extreme degree of delayed ejaculation, which requires specialist advice.

Why does ejaculation delay occur?

Problems with ejaculation in men, in which there is too long ejaculation, the following can be distinguished:

1. Absence of sexual contact for more than a week.
2. Active sports and a small intake of water in the body.
3. Inflammatory processes of the prostate gland or a decrease in the function of this organ. Most often, prostatitis leads to a slowdown in ejaculation.
4. Urinary tract infections.
5. Surgical interventions on the prostate, including resection of this organ.
6. Neurological ailments: spinal cord pathologies, diabetic neuropathy, etc.
7. Hormonal disorders, including hypothyroidism (lack of thyroid hormones) and hypogonazidm (lack of testosterone).
8. Damage to the nerves that control the process of orgasm.
9. Taking certain drugs, mainly antidepressants or medicines for hypertension, as well as diuretics.
10. Psychological problems: conflicts with a partner, lack of confidence in their "male" abilities, etc.

To accurately determine the cause of delayed ejaculation, you should perform a diagnosis by passing a spermogram and undergoing an external examination. It is highly desirable to do this, because the neglect of medical examinations and subsequent treatment can even lead to irreversible male infertility, especially in the presence of inflammatory processes in the pelvic region.

How to speed up ejaculation?

To speed up the onset of ejaculation, experts recommend using the following methods:

1. Treatment of inflammatory and other diseases, if they have caused sluggish ejaculation.
2. An increase in the duration of the foreplay, i.e. preliminary intimate caresses, at the very beginning of intimacy. This will contribute to a stronger arousal of the man and, as a result, will reduce the time before the onset of ejaculation.
3. Changing technique during intercourse. So, men are advised to refuse the introduction of the penis into the vagina until the feeling of the strongest excitement - preferably before the feeling of an approaching ejaculation. It is at this moment that the penis should be inserted into the vagina - in this case, strong ejaculation will be practically ensured.
4. Using such a technique as abstaining from orgasm during the first 10 minutes of sexual intercourse. Such a seemingly paradoxical effect allows you to improve blood flow and accelerate the onset of ejaculation later and make it more intense.
5. Stimulation during sexual intimacy at the same time the prostate and the frenulum of the penis. You can ask your partner to perform similar actions - this in most cases will speed up the onset of ejaculation.
6. If a man is used to reaching orgasm only with the help of masturbation, then he will have to enlist the help of a partner. It is advisable to gradually get used to a new (and more natural) way of getting pleasure. So, first you can try to achieve orgasm by self-stimulation of the penis, then ask the woman to perform the necessary movements. The next time you can start sexual intercourse by stimulating the penis with your hands, and complete it by inserting the penis into the vagina. A new conditioned reflex will gradually develop, and ejaculation will occur with the usual method of sexual intercourse.
7. Refusal to watch porn movies and other similar products. Oddly enough, watching the corresponding video, although it leads to a quick readiness for sexual intercourse, but subsequently reduces the excitement from appearance and the actions of a real partner, so in the end the effect is negative.

In addition, a man who wants to normalize the process of ejaculation should give up alcohol abuse. It is known that alcoholic beverages only at first increase sex drive, and it becomes quite difficult to achieve an orgasm in a state of intoxication.

If, in addition to giving up bad habits, a man maintains his body in an acceptable physical shape, begins to eat well and tries to minimize the impact of stress, then sooner or later problems with ejaculation will become a thing of the past.

In the treatment of sluggish ejaculation, medications can also be used both to combat existing chronic diseases that caused this problem, and to normalize the ejaculation process.

If psychological factors are the cause of early ejaculation, then a drug such as Generic Dapoxetine can help a man. This tool enhances erection, ensures its sufficient duration, promotes speedy recovery male body after intimacy.

In addition, the use of the drug relieves a man of nervousness, increases his self-confidence, which is important for normalizing the duration of sexual intercourse.

Therefore, Dapoxetine can be used both for early ejaculation and for ejaculation failure due to low potency. You can buy Dapoxetine on this site, getting the desired result at an affordable price.

If you combine taking the drug with the treatment of existing diseases, take care of yourself and avoid various harmful factors, then you can successfully solve problems with ejaculation and enjoy full-fledged intimate relationships. An integrated approach to the elimination of violations in the sexual sphere will allow a man to restore his former abilities within a fairly short period of time.

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How to speed up ejaculation? Give a couple of tips, because nothing comes out

Can interfere with the onset of orgasm accompanying illnesses such as diabetes, spinal and sacral injuries, prostate disease, or pain in the urethral region. In most men, however, an implicit delay in ejaculation is still caused not by physiological, but by psychological reasons. The first and foremost is stress. Eternally anxious and in constant doubt, a man keeps the muscles of the perineum under control all the time, thus preventing himself from relaxing and freeing himself from nervous tension. At the same time, anxious men are conditionally divided into two categories. The first is those who have just started sexual life and due to upbringing (or other reasons) is paralyzed by guilt and fear. The second category includes older men who, due to circumstances, are accustomed to keeping all emotions under control, or who are too casually related to sex and need stronger stimulation. In addition to physiological and psychological reasons, ejaculation can be prevented by: taking certain medicines, including a number of antidepressants; chronic alcoholism and excessive alcohol consumption in episodic cases; sexual fatigue associated with an overly active sex life, or due to distractions during sex; physiological incompatibility: for example, the partner's vagina is too wide for a small penis of a man, which reduces mechanical stimulation during friction.
A man suffering from delayed ejaculation needs stronger stimulation and increased eroticism with foreplay. A woman should delay sexual intercourse by engaging in love game until the partner is on the verge of orgasm, and only then can he allow him to insert a member into the vagina. For the most intense stimulation, some couples are advised to switch to the “woman on top” position, when the partner is on her knees with her legs spread out to the sides. In this position, a woman can increase stimulation by performing penis-expelling movements. You can alternate oral sex with attempts at vaginal sex to increase arousal. Or vaginal sex with mutual masturbation. A partner can help a man relax by stimulating both the frenulum and the prostate at the same time. And finally, sexologists recommend such a non-trivial way: a man should set a goal to refrain from orgasm for 10 minutes of sexual intercourse. Often such a paradoxical technique just helps to speed up the onset of ejaculation before the scheduled date.

Big cock: to be or not to be

What is the most important organ in men? Right! Who said "heart"? The Chekists have a hot heart and cold hands, and it is his dignity that makes a man a man. There is no other organ in the male body that would cause so many emotions and conversations.

great chinese sex

Most people in China are completely satisfied with their sex life. The views of modern Chinese on sex are explained by the peculiarities of Chinese culture. The spiritual leader of the Celestial Empire, Confucius, said: “Love is the beginning and end of our existence. Without love, there is no life."

devil deflorator

The Devil is an ancient ritual deflorator in an animal mask, which until recently performed its functions during the Sabbaths. According to Margaret Murray, the devil is a horned deity of the Paleolithic era, against whom the church waged a fierce struggle from the 13th to the 17th century.

Late sexual life of men

The findings of various socio-sexological studies show that the vast majority of men begin sexual activity before the age of 21. This statistical pattern has been noted in the past, which is probably why parents begin to get worried if their son is 20 years old and he has not yet crossed the sexual Rubicon.

Tricks during orgasm and before it

Caresses during orgasm do not increase the intensity of arousal if they do not involve pain nerves in the game. Muscular contraction, pinching, patting, biting, excite the same type of nerves as those that produce orgasm. This increases the sexual wave. However, no rudeness should be allowed.

Sexual infidelity gene found in women

The French have a saying: you can find a woman who has not had lovers; but it is impossible to find a woman who has had only one lover. In this regard, I don’t even want to think what an explosion of righteous feminist anger will cause a message about a study by a group of British scientists led by Robin Baker, who proved that almost one hundred percent of women (100%) are unfaithful to their legal husbands.

threesome love

According to various sources, from three to 15 percent of married couples have tried a threesome at least once. Among non-married couples, this percentage is at least twice as high. Threesome - the topic is far from unambiguous. Even those who believe that there are no prohibitions in sex for them relate to this kind of bed fun in very different ways. Someone is sure that sex is a matter of two and only two, and everything that goes beyond this framework is dirty and immoral.

How to learn to kiss

All over the world, people, getting into a romantic situation, feel an unconscious need to kiss. This is one of the most useful discoveries that I made during my research activities. It seems that representatives of the opposite sex are programmed to kiss and are just waiting for this.

The man who "doesn't want" and who "can't"

The sexual life of a person depends on many factors. In order for a man's sex life to be normal, it is required that he has the desire to have intimate relationships (sexual desire) and the opportunities for this (sufficient erection and the ability to make frictional movements in the vagina for a certain time without ejaculation), that is, normal potency.

Sexual harmony

What to do for those who are dissatisfied with their intimate life and want to change it? At the very first stage - learn to find mutual understanding with a partner (partner) and not be afraid to tell him (her) what you want, master sexual literacy, and then "aerobatics", seek, experiment and most importantly: do not forget that sex is the communication of two equal partners, and not the search for only one's own pleasure.

Oriental sex rules

As you know - sex begins with the head. The sexual culture of the East is based on other than European principles. This, for example, is the cult of the naked body, the worship of sensual pleasure. Everyone knows that in countries such as Japan, China, India, Nepal, sexuality is seen not so much as an art, but as a science.

Vaginismus: when a woman can't

If sexual disorders men are more diverse, then women are easier. Basically, the weaker sex faces three problems. This is pain during intercourse, lack of sexual desire and difficulty with orgasm and the onset of arousal. Men believe that they are much more vulnerable sexually.

Habits will tell about erogenous zones

At the dawn of its development, sexology "professed" an extremely mechanistic approach, attaching decisive importance to erogenous zones. Nobody "cancelled" them, they really exist in women and men. They are very individual. How can they be "calculated"? The fact is that if a woman constantly licks her lips, touches them with her fingers or bites a fountain pen, this indicates the sensitivity of the so-called oral zone.

sexual pretense

Sexual pretense - deception of one's partner by acting out sexual reactions or one's own satisfaction. In some cases, pretending may be the best way out, allowing the person to spare the partner's feelings; however, once it becomes common, it can create many problems. A woman who fakes an orgasm is more likely to undermine communication with her partner, rather than support him.

intimate massage

Pleasure, both men and women, can receive in different ways. But if you really want to elevate your partner to the pinnacle of bliss, you should learn how to give him an intimate massage - as, in principle, to you. After all, it is these games, alternating with gentle strokes, that give us no less pleasure than making love.

About masturbation

Masturbation can be defined as a way to give sexual pleasure to oneself through some form of physical stimulation. Most often, masturbation is done by rubbing, stroking, squeezing, or otherwise influencing the genitals; however, it can also be produced by self-stimulation of other parts of the body - the chest, inner thighs or anus.

What happens to our body during physical love

In the physiology of sexual intercourse, an important role is played by excretory system, circulation, musculature and nervous system. During sexual intercourse, the functioning of a number of glands becomes more intense. If the discharge which follows the satisfaction of instinct is too late, salivation decreases.

Fashion kisses: world practice

As it happens in high fashion, some kisses become popular for a while, and then they are replaced by others. Take, for example, the lip-sucking kiss: it was described 2,000 years ago in the Indian love manual, the Kama Sutra. Then he was temporarily forgotten, and now, with the development of mass media, the creation of cinema and television, kisses of this type have become especially popular.

natural aphrodisiacs

As soon as they are not called: these are “stimulating food, the name of which comes from the name of the Greek goddess of love Aphrodite”, and “substances and products that stimulate sexual instincts”, and “substances that can enhance sexual energy, sensuality”, “agents that stimulate sexual desire, etc., etc.

Sexual incompatibility is not a reason for divorce

There is an opinion that divorce is like a tsunami in which no one is to blame, it just “happened”. In fact, like any disaster, it has its own cause. Its name is "sexual incompatibility".

Delay ejaculation- This is a serious violation of male sexual function, which is expressed in the difficulty of ejaculation. Some men need prolonged sexual stimulation to achieve ejaculation, while others don't even get the desired results.

All men are concerned not only with the size of the penis, but also with the ability to satisfy a woman, giving her maximum pleasure. Problem with ejaculation in men may be temporary and arise on the basis of constant stress or chronic diseases.

But in case slowing down ejaculation becomes permanent cause, you should definitely consult a doctor, as it may indicate serious disorders in the male body. But despite this, problem with ejaculation is not a disease. With the help of special techniques, exercises and drugs, you can fully control restraint of ejaculation.

What is delayed ejaculation?

In order to understand how to delay ejaculation, you need to know exactly what this problem is, preventing men from achieving full sexual satisfaction. In medicine, it is also called anejaculation.

The process of ejaculation itself consists of several stages:

1. Increasing sexual arousal.
2. Increased arousal.
3. Ejaculation.

long ejaculation accompanied by the necessary level of sexual arousal and a full erection, but the release of seminal fluid does not occur for a long time after the onset of sexual intercourse. Accordingly, as a result of this, there are serious problems with achieving orgasm, which introduces a serious imbalance in the intimate relationship of the couple.

Premature ejaculation is considered an equally common problem among the representatives of the stronger half. Ejaculation containment recommended if the duration of sexual intercourse is less than 4-6 minutes. Such a short sexual contact will not bring the desired satisfaction to either the man or his partner.

slow ejaculation is diagnosed if the duration of sex increases to 30-60 minutes and even after that the man does not ejaculate. In order to find out how to delay ejaculation, what taking medications will require the help of a specialist - a sexologist, andrologist, psychotherapist, endocrinologist, neurologist.

Many men have the exact opposite problem with premature ejaculation. As a rule, this happens within a few minutes after the onset of sexual intercourse. That is why the question often arises - how to delay ejaculation?

Classification of delayed ejaculation

Approximately 82% of men ejaculation problems do not prevent them from reaching orgasm - but most often this happens during oral sex, manual stimulation of the penis. The remaining 18% of men, under no circumstances, can not achieve an orgasm despite all efforts.

In such cases, before how to delay ejaculation, you should definitely consult a doctor. In no case should you self-medicate and use any methods or medicines on your own.

Men who are interested how to speed up ejaculation, you need to know that there are several varieties given state. According to the severity, the following types are distinguished:

• relative anejaculation - a man cannot get an orgasm during classic sex, only through oral sex or petting;
• complete anejaculation is the most severe form of pathology, in which, in any case, in any type of sex, a man fails to achieve orgasm.

Depending on when and how problems with ejaculation, the following varieties are distinguished:

• primary form - the problem continues from the very beginning of sexual relations;
• secondary form - delayed ejaculation occurred some time after the start of sexual life.

According to the frequency of manifestations of this problem, permanent and situational delayed ejaculation. With a permanent form of pathology, problems with orgasm occur extremely often and deprive a man of confidence in his sexual powers. The situational type of delay appears only sometimes, depending on certain circumstances - against the background of frequent stress, chronic fatigue, and various diseases.

Disadvantages of prolonged intercourse

Long ejaculation how to speed up this process - such questions often arise before men. But in some cases, prolonged sex can only bring benefits. Many women do not have time to get full sexual pleasure in the process of sexual intercourse, which lasts 5-7 minutes. With prolonged sex, which lasts more than half an hour, a woman may experience an orgasm several times.

But for most women, 10-15 minutes of sex is enough to experience an orgasm, possibly multiple times. The duration of sexual intercourse of 30–60 minutes leads to the fact that both the woman and the man are completely exhausted, and they have no way to complete the sexual intercourse.

In addition, it should be understood that difficult ejaculation very often becomes the cause of serious problems that arise in a married couple who dream of having children.

Symptoms of delayed ejaculation

In order to find out how to control ejaculation, it is necessary to know exactly all the manifestations of this pathology. The main symptom of the problem is long ejaculation. If sexual intercourse lasts more than 30-50 minutes, this indicates serious problems with male sexual function.

How to induce ejaculation? This question arises in every man who, even after prolonged sexual contact, does not ejaculate. If it did happen, the amount of semen released is much less than usual.

At the same time, more than half of men can still achieve orgasm during masturbation, a little less often - when stimulating the partner's penis. If a partner has delayed ejaculation, methods the treatment of which can be very diverse, it brings serious discomfort to the intimate life of the couple.

Delayed ejaculation, causes which can be both psychological and physical in nature, in the vast majority of cases makes a woman doubt her attractiveness. She is sure that if a man cannot get full pleasure from a sexual act, the whole reason lies precisely in her - that is, in the complete absence of her attractiveness for a partner. Accordingly, this introduces a serious imbalance in the life of the couple.

Causes of delayed ejaculation

how to get ejaculation, you need to know exactly what reason provoked the development of the problem. Doctors conventionally divide all the factors that provoke the development of problems with timely ejaculation into two groups:

1. Physiological.
2. Psychological.

In most cases problems with ejaculation associated with chronic or infectious diseases, and various pathologies in the male body.

In some cases, in order to find out how control ejaculation, it is necessary to take into account the psychological factor. Frequent stresses, problems at work and in personal life lead to the fact that a person literally completely loses his sexual abilities.

The reasons for the development of delayed ejaculation can also be attributed frequent use alcoholic beverages, as well as certain medications. Quite often, the development of a problem is observed with a combination of several factors, and therefore, in order to determine the root cause of the pathology, it is imperative to seek help from a doctor.

Physiological causes

Before how to learn to control ejaculation, it is necessary to take into account all factors of physiological origin. They can be associated with various pathological changes in the body, diseases and other disorders.

The main reasons for the physiological nature:

• congenital pathologies of the organs of the male reproductive system;
• inflammatory process in the prostate gland;
• any damage to the nerve endings in the pelvis;
• diseases of the cardiovascular system;
• infectious processes in the body;
• pathology of the urinary tract;
• disturbances in the hormonal system;
• surgical interventions performed on internal or external genital organs;
• neurological pathologies - stroke, sclerosis;
• spinal cord pathology.

In some cases, the main factor provoking the issue, how to control ejaculation, factors of physiological disproportion of partners act. For example, the reason may lie in a too small penis of a man or a large vagina of a girl.

Psychological reasons

In order to find out how to delay ejaculation it is necessary to take into account the psychological state of the man. In most cases, the main psychological factors include the following:

• depression, increased nervousness;
• lack of confidence in their male abilities;
• problems in personal life;
• frequent stressful situations, problems at work;
• insufficient or incorrect sex education, religiosity;
• dissatisfaction with the appearance of a partner.

Some men are accustomed to frequent masturbation, during which they get a bright, intense orgasm. This leads to the fact that during normal sex they cannot be fully satisfied.

Medicines and preparations

Turning to the doctor with a question, how to speed up male urination be sure to tell him about all the medications you take. In some cases, they can provoke serious problems in a man's sexual life:

• diuretic drugs;
• antidepressants;
• drugs for hypertension;
• preparations containing alcohol;
• psychotropic drugs.

In addition, the control of ejaculation is greatly influenced by alcoholic beverages and drugs consumed before sex. The age of the person is also important. The older a man is, the more difficult it is for him to achieve orgasm.

Diagnosis of delayed ejaculation

In order to find out how to speed up ejaculation, you need to consult a doctor - a urologist or andrologist. He will conduct a complete examination of the body, prescribe everything necessary tests and laboratory research. This will help determine the root cause of the problem, as well as choose the best method of treatment.

Basic diagnostic methods:

1. Visual inspection and palpation of the patient's genitals.
2. Analysis of urine.
3. Blood test to determine testosterone.
4. Laboratory study of hormone levels.
5. Ultrasound of the pelvic organs.

In order to answer the question, is it harmful for a man to restrain ejaculation, in some cases, additional consultation with a psychotherapist or sexologist may be necessary.

Treatment for delayed ejaculation

If a man is worried delayed ejaculation treatment prescribed only by the attending physician. The specific method of therapy depends on the cause that provoked the violation of sexual function.

If there is an addiction to alcohol or drugs, a special rehabilitation course is prescribed, aimed at the destruction of this type of addiction. frequent stress and depressive states are treated with sedative drugs, sometimes antidepressants are also used.

If problems in a man's sexual life are caused by taking certain medications, the doctor will definitely cancel them or prescribe other medications with a similar effect.

Drugs that speed up ejaculation appointed exclusively by the attending physician. In no case should you take any medications on your own, since the consequences of self-medication can be the most dangerous for the male body.

Medicinal and with the help of procedures

Problems with ejaculation in a man caused by physiological factors are treated with medications. The main goal of therapy is to eliminate the root cause of the pathology.

Pharmacology offers:

• cyproheptadine;
• amantadine;
• yohimbine;
• buspirone.

An effective addition to drug therapy will be physiotherapy procedures that significantly enhance the effectiveness of drugs. All procedures can be divided into two main groups - soothing and stimulating.

Calming physical therapy:

• electrosleep;
• treatment with color radiation;
• acupuncture;
• electroacupuncture;
• pine baths.

Stimulating physiotherapeutic procedures have an activating effect on the state of the male reproductive system. The main incentive methods are:

• ultrasound therapy;
• electrical stimulation;
• laser puncture;
• galvanization;
• electrophoresis.

In addition, the patient is definitely recommended to completely abandon bad habits and lead a healthy, active image life. Difficulty ejaculation - who treated what And what methods proved to be the most effective? Such a question quite naturally arises in every representative of the stronger sex, faced with a similar problem. But only a doctor can answer it, who will select the optimal method of treatment.

Psychotherapy

If the cause of problems in a man's sexual life lies in psychological factors, psychotherapy becomes an indispensable element of treatment. The patient is recommended regular consultations with a psychotherapist. At the same time, in order to achieve the most effective result, it is best for a man to attend psychotherapy sessions with his woman.

The help of a sex therapist can be invaluable. An expert will help you decide sexual problems and improve the intimate life of the couple. Consultations should be regular. The doctor will recommend special ejaculation control exercises that will help a man improve the quality of intimate life.

Prevention of delayed ejaculation

In order to prevent the development of problems in the sexual life of partners, you must be extremely careful about your lifestyle. ejaculation control requires a person to completely abandon any bad habits - smoking, the use of drugs and alcoholic beverages.

Very important good sleep and rest. Even with maximum workload, you need to sleep at least 7-9 hours a day. It will help male body fully recover and gain strength.

It is recommended to regularly engage in your favorite sport, take walks in the fresh air, and eat right. The diet of a man should consist of a large number of fresh fruits, berries, vegetables, seafood, nuts and dried fruits. Such products have an effective effect on the male reproductive system and normalize its functioning.

BOOKING AN APPOINTMENT WITH A UROLOGIST-ANDROLOGIST IN VOLGOGRAD

What is delayed ejaculation and anejaculation?

Difficulty in ejaculation is an involuntary suppression of the ejaculation reflex. Delayed ejaculation, “when it is impossible to finish,” can be said in cases where ejaculation occurs only after a very long period from the moment the sexual intercourse began, despite the desire to speed it up. This period can last for an hour or more. Throughout this time, the erection may be quite normal or its intensity may fluctuate slightly. A man can experience sexual arousal, have a full erection, but stimulation of the penis does not lead to ejaculation. Delayed ejaculation is much less common than accelerated ejaculation. The disorder may be permanent, or it may occur from time to time. Delayed ejaculation is noted in 2 out of 1000 men. At the same time, about 75% of men with delayed ejaculation can achieve it through masturbation. It is necessary to distinguish between normal delayed ejaculation and pathological. In the first case this violation is a consequence of the characteristics inherited from parents, manifested during the normal process of puberty. Pathophysiological factors include injuries, diseases, surgical interventions, hormonal disorders, the use of certain medications that have affected normal process jaculations. Anejaculation - extreme form delayed ejaculation, in which the latter does not occur for such a long time that the patient and his partner stop intercourse. All variants of ejaculation disorders can be divided into two categories:

1. absolute inability to achieve ejaculation
2. relative anejaculation, when ejaculation is absent during intercourse, but is present during masturbation during petting or in sleep.

What causes delayed ejaculation?

1. Psychogenic causes - delayed ejaculation due to psychological disorders. One of the most common causes elongation of sexual intercourse in a man turns out to be the formation of an inadequate erotic stereotype, which does not coincide with the sensations characteristic of sexual intercourse. In some cases, with high sexual excitability, the method of masturbation was formed as a result of receiving discharge from random mechanical or emotional influences not related to the genitals. Subsequently, there is a desire to repeat the orgasm from this stimulus and the formation of dependence on it. Ordinary intimate relationships could not provide the desired scenario needed to achieve ejaculation. On the contrary, with reduced excitability of the ejaculatory center, masturbation was carried out against the background of the need to further enhance stimulation. With the onset of sexual activity, it turned out that mechanical impact on the genitals during intimacy "too weak". As a result, the excitement did not increase to the level necessary to obtain sexual release. At the same time, sexual fantasies, including the desired actions, can cause ejaculation without any problems.
2. Alimentary causes - alcohol abuse. At chronic alcoholism there is a decrease in the excitability of the center of ejaculation in the lumbar spinal cord. In chronic alcoholics, organic causes can be superimposed by functional factors associated with marital conflicts and suspicions of the wife of infidelity.
3. Cervical malformations Bladder- Muller's cyst, anomalies of the Wolffian duct.
4. Iatrogenic: due to damage to organs after surgical operations on the prostate or bladder and due to postoperative neurological problems - proctocolectomy, aneurysmectomy abdominal region, aortic lymphadenectomy.
5. Neurogenic causes - diabetic neuropathy, Parkinson's disease, multiple sclerosis, spinal cord injury.
6. Infectious causes - urethritis, tuberculosis genitourinary system.
7. Endocrine causes - hypogonadism, hypothyroidism.
8. Medicinal causes - taking diuretics, antidepressants and serotonin reuptake inhibitors.

What are the psychogenic causes of delayed ejaculation?

A common psychological cause is the unconscious suppression of ejaculation by the man himself when he fears the woman's pregnancy or when he considers sex a "dirty and shameful" activity. In some cases, there may be a fear of not satisfying a woman, an unconscious fear of "sexual insufficiency", which leads to an involuntary lengthening of intimacy until the ejaculation disappears. For some men, moral and ethical considerations can influence the duration of sexual intercourse. The reason for the delay may also be the lack of erotic attractiveness of the partner, to whom the man does not experience a pronounced sexual attraction, or imbalances in the structure of the genital organs (too wide vagina compared to the size of the penis), which reduces mechanical stimulation during friction. Delayed ejaculation is also noted as a result of fairly deep conflicts related to the personality of the partner (for example, sexual trauma, which is a specific brake and is associated with real or perceived infidelity of the partner), as well as in the presence of deviant inclinations, for example, homosexual, sadistic, masochistic, etc. ., which are also a specific brake. In addition, there is the concept of “autosexual” orientation, when a man with delayed ejaculation notes much more pronounced arousal and satisfaction from masturbation than during normal intercourse. The most common form (about two-thirds of all cases) is primary ejaculation failure, in which the patient has never been able to ejaculate into the vagina at all. Secondary insolvency is called in cases where a man whose ejaculation had previously proceeded normally loses the ability to intravaginal ejaculation or achieves this extremely rarely. In either case, ejaculation can usually be induced by masturbation (in about 85% of our patients) or stimulation by a partner (in about 50% of our patients), but outside of intercourse.

What is the diagnosis of this pathology?

The task of diagnosis is to identify possible physiological and psychological causes of the disease. The anamnesis, especially medical, the fact of taking pharmacological preparations, as well as data from the examination of the external genital organs, is of leading importance. With absence obvious reasons, a thorough psychosexual examination is indicated.

Hospital Anxiety and Depression Scale (HADS)

This questionnaire is designed to help your doctor understand how you are feeling. Calculate each statement carefully and in the right column select the answer that best matches how you felt last week. Circle the number corresponding to your chosen answer (ignore the meaning of these numbers). Don't think too long about each statement, as your first reaction will always be the correct one. Each statement corresponds to 4 response options, reflecting the gradations of symptom severity and coding according to the severity of the symptom from 0 (absence) to 3 (maximum severity). The total scores are calculated separately for the anxiety subscale and for the depression subscale. Odd items (1,3,5,7,9,11 and 13) make up the anxiety subscale, even ones (2,4,6,8,10,12,14) make up the depression subscale. Fill out the questionnaire, calculate the score and bring it to the doctor.

Age-related androgen deficiency assessment scale.

Fill out the scale, count the points, and bring it with you to your doctor's appointment.

What is the treatment for delayed ejaculation?

It is carried out on the basis of the reasons that influenced this violation. Here it is important to distinguish a clearly expressed sexual disorder from episodes that occur from time to time, when a man is unable to intravaginally ejaculate or when he needs prolonged intercourse and long frictions for it to occur. Occasional difficulty with ejaculation is not a sign of a sexual disorder and is often due to fatigue, tension, ill health, excessive intercourse, alcohol or drugs. In addition, a man may be unable to ejaculate if he does not have any special feelings for his partner (for example, if he has sexual intercourse simply because he thinks it is expected of him).

1. Sexual education includes explaining the features of the orgasmic function, ridding the patient of his myths, teaching stimulating techniques, starting moments of orgasm. Treatment is aimed at eliminating ejaculation problems and is designed to help the couple adapt their behavior to the existing difficulties. Success here depends, first of all, on the partner's willingness to cooperate, on her ability to rebuild intimate relationships in such a way as to eliminate or compensate for the factors that prevent ejaculation.
2. Reducing the effect of waiting for failure is achieved by prohibition of ejaculation during masturbation, sexual activity should only be with a sexual partner.
3. The patient should be focused on genital stimulation and, if possible, intensify it.
4. Sometimes it is recommended to resort to anal stimulation, such patients are often helped by prostate massage.
5. With emotional disorders, medication and physiotherapy are carried out.
6. Neurological disorders are successfully corrected by electrical stimulation.
7. Psychogenic disorders are eliminated with the involvement of a partner. The treatment of ejaculatory failure is based on a deep analysis of the underlying psychological factors combined with sensation focusing exercises.

What is the technique of sex with delayed ejaculation?

It consists of several successive steps:

• ejaculation caused by masturbation alone;
• ejaculation caused by masturbation in the presence of a partner;
• ejaculation caused by manual stimulation from the partner;
• vigorous stimulation of the penis by the partner, carried out until the state of inevitability of ejaculation, and then the rapid introduction of the penis into the vagina.

In most cases, after a man has ejaculated into the vagina once or twice, the suppression of this act or the fear associated with it completely disappears. In some cases, if these procedures fail, ejaculation (induced by manual stimulation) on the woman's vulva may help. After a man gets used to the sight of his sperm on his partner's vulva, he can make intravaginal ejaculation much easier.

What drugs are used for delayed ejaculation?

The basis of drug therapy for delayed ejaculation is the effect on the central dopaminergic and antiserotonergic mechanisms.

• dopaminergic drugs are used for delayed ejaculation caused by antidepressants.
• dopamine reuptake inhibitors are effective in 66% of antidepressant-induced anzyculations.
• drugs alpha-2 antagonists, alpha-1 agonist, calcium channel blockers (achiv with yohimbe), are used to prevent delayed jaculation 1.5 hours before sexual intercourse in cases of clomipramine-induced anorgasmia.
• 5-HT1A receptor agonists eliminate slow ejaculation in 8 out of 10 patients, if this disorder is due to anxiety disorders.
• serotonin 5-H receptor antagonists may be recommended for continuous or intermittent use.

What physiotherapy techniques are used for delayed ejaculation?

Sedative methods:

• Therapy with the use of special artificial color emitters acting directly through the eyes is called the method of visual color stimulation. At the same time, it is carried out complex impact four factors: color, rhythm, modulation of light signals and illumination level of the light field. The human eye serves as a receiver for drug-free and non-invasive correction of the regulatory structures of the brain (hypothalamus, pineal gland, pituitary gland), and through them - neuroendocrine, immune and other systems.
• Electrosleep therapy. It has a sedative effect due to the inhibition of the activity of the reticular formation and the activation of serotonergic neurons. Transcranial electrical stimulation works on the same principle.
• To eliminate pathological dominant relationships in the central nervous system it is necessary to create a new, stronger focus of excitation, i.e. new dominant. Most effective method is the galvanization of the reflex collar zone according to Shcherbak. It is possible to use electrophoresis with vitamins and other medicinal substances by the orbital or endonosal method.
• It is expedient to influence physical factors to reflex zones. Perform laser puncture or electroacupuncture. With acupuncture, the first stage is carried out 1-3 courses of 10-12 procedures for 60 minutes (braking method) - general strengthening, removal of neurosis. The second stage - 1-2 courses of acupuncture at local points for 5 minutes (stimulating method), and common points, (braking method) 60 min.
• baths. Aromatic substances contained in coniferous baths have a sedative effect by influencing the olfactory nerve. Iodine and bromine, able to penetrate the blood-brain barrier, have a sedative and tranquilizing effect directly at the level of the central parts of the nervous system.

Trofostimulating methods:

• SMT on reflex zones spinal centers of erection and ejaculation. Taking into account the leading role of disorders of the neuroreflex centers of the spinal cord, the impact is carried out at the level of the SI-SV segments, which ensures the activation of blood circulation in this area and an increase in efferent and autonomic impulses in response to the involvement of sensitive conductors.
• Rectal electrical stimulation. A special electrode is inserted into the rectum and anal stimulation is performed. The mechanism of therapeutic action is:
  • - emptying the prostate from stagnant secretion and its decay products;
  • - improvement of lymph and blood circulation in this organ;
  • - increasing the tone of muscle tissue;
  • - stimulation of metabolic processes.
• ultrasound therapy. Ultrasound has a trophic, anti-inflammatory effect by stimulating reparative regeneration, activating microcirculation in the area of ​​influence and increasing the activity of cellular lysosomal enzymes. Impact on the sacral spinal segments in a continuous mode.
• Galvanization of the panty zone is used to improve the trophism of the spinal segments and restore disturbed neuro-reflex connections.
• Peloid therapy. The use of mud applications on the panty zone causes local hyperemia, stimulates repair processes. Irritation of thermomechanoreceptors of the skin causes the formation of reflex reactions in the segmental and subcortical structures of the brain, which are closed on the corresponding reflex zone effectors. Perhaps a combination with the treatment of rectal mud tampons.
• Ultratontherapy. The spine and perineum are affected by moving the electrode with longitudinal and circular movements along the spine D8-L2, then along the perineum and along the inner crotch of the two third thighs.

What problems arise in a married couple with delayed ejaculation?

Delayed ejaculation in a normal marital relationship may even initially be conducive to achieving sexual satisfaction in the wife, who, with prolonged intercourse, may repeatedly experience orgasm. Ejaculatory failure can be a source of sexual pleasure because it makes prolonged intercourse possible. Some patients say that they are able to maintain an erection for 1-2 hours to the great pleasure of their partners, many of whom admire this. However, when a woman discovers that her partner is incapable of intravaginal ejaculation (completing sexual intercourse in the vagina), her reaction most often changes. Relationships become burdensome for both women and men, despite the desire of the man, they cannot reach orgasm in certain time. Even worse circumstances develop in conflict relations between spouses, when they have ceased to attract each other in an erotic relationship. It begins to seem to her that the partner finds her not attractive enough, that he does not enjoy it, or that he "delays" the onset of orgasm out of selfishness. If sexual partners want to have children, then the inconsistency of ejaculation can cause even more grief and even mutual accusations and quarrels that can destroy the most beautiful relationship. The situation can become dramatic when a woman experiences sexual indifference to a man, and instead of sexual pleasure, she has an aversion to sexual intercourse with him. If a woman, at the insistence of a partner, is forced to have intercourse with him, then it is difficult for her to endure too long intercourse, and she usually shows impatience about this. This causes subsequent conflicts and further delays the onset of ejaculation. Thus, a vicious circle is created, which worsens both life together and the condition associated with delayed ejaculation.

What is retrograde ejaculation?

This disorder of ejaculation is characterized by the release of seminal fluid into the bladder. The diagnosis of retrograde ejaculation is established by detecting spermatozoa during a urine test after intercourse.

What are the reasons for the lack of ejaculation after intercourse?

• congenital malformations of the posterior urethra and bladder neck, urethral valves, congenital anomalies of the bladder triangle, exstrophy of the bladder.
• acquired disorders of the normal structure: strictures of the urethra, sclerosis of the bladder neck.
• iatrogenic disorders: transurethral resection of the prostate, bladder neck incision, transcystic adenomectomy, sympathectomy, colorectal or anal surgery.
• neurological causes: spinal cord injury, multiple sclerosis, diabetic neuropathy.
• pharmacological causes: antihypertensive drugs, alpha-blockers, antipsychotics and all antidepressants that lead to partial paralysis of the bladder neck.
• idiopathic causes: in cases where it was not possible to establish the etiological factor.

What are the treatments for retrograde ejaculation?

Drug therapy can be effective in the absence of anatomical and neurological disorders. Usually use the following drugs: ephedrine sulfate, midodrine, brompheniramine maleate, imipramine. If the cause of retrograde ejaculation is congenital, acquired or iatrogenic changes in the bladder neck, sometimes resort to special surgical correction techniques.

When does painful ejaculation occur?

Painful ejaculation or odynoorgasmia occurs with many problems: the presence of prostate adenoma, infections, exacerbation of chronic prostatitis, chronic pelvic pain syndrome, colliculitis, obstruction of the ejaculatory ducts. Also occurs while taking antidepressants, alpha-blocker.

The material was prepared by a urologist-andrologist, physiotherapist, dermatovenereologist Akimov Oleg Viktorovich.

Why does premature ejaculation occur, delayed ejaculation? How to deal with these problems? This is what we will look at in this article. This problem affects many men and causes concern on the part of sexual partners.

Ejaculation, or ejaculation, is the release of sperm from the male genital organ during arousal. Delayed ejaculation is caused by a violation of the functionality of the reproductive system in men. In addition, there are still such pathologies of ejaculation:

Anejaculation - the absence of ejection of seminal fluid during orgasm in a man;

Anorgasmia - the absence of orgasm in general;

Retrograde ejaculation - the ejection of seminal fluid occurs towards the bladder. Outwardly, it can be observed as a fact of the absence of ejaculation.

It should be noted that the delay in ejaculation during intercourse can also be observed primary and secondary. Primary - a process that is observed in men from the very beginning of sexual activity. The secondary is acquired after some time. She can be called stressful situations or psychological problems, eliminating which you will return to a normal sexual life.

After contacting a urologist and passing the necessary tests, the doctor will help determine the exact cause of this disease.

Physical reasons

Now consider the main causes of delayed ejaculation.

There are two main aspects that affect the occurrence of this problem - these are psychological and physical disorders in a man.

Physical, affecting the delay in ejaculation, can be caused by injuries of the scrotum or penis, prostate adenoma, various surgical interventions into the male reproductive system, certain infections, or urethritis.

Neurological problems with the patient's spinal cord, bilateral sympathectomy, diabetic neuropathy, or stroke can also cause delayed ejaculation.

Hormonal disorders caused by the presence of problems in the functioning of the endocrine glands can lead to this problem in men. Among them, the most common are hypogonadism and hypothyroidism.

Congenital pathologies in the structure of the urethra, a cyst of the Müllerian or Wolffian duct, as well as the “plum belly” syndrome, are the cause of delayed or absent ejaculation. Such disorders are already present at birth and may not be visible until the onset of sexual activity. Delayed ejaculation in men is only an indicator of the presence of pathology in the development of the organs of the genitourinary system.

Disorders acquired as a result of surgical intervention in the sacro-lumbar spine, organs of the small or greater pelvis, injuries of the genital organs as a result of hypothermia or burns cause problems with ejaculation.

If you have severely burned your genitals, you should immediately seek medical attention. medical care so that there are no negative consequences for the body.

Psychological reasons

Among psychological problems a delay can be provoked by stress, nervous strain or overwork, depression, fear of intimacy. Strict religious upbringing and oppression also matter.

Other reasons that can provoke such a delicate problem

Taking certain medications can cause temporary dysfunction of the genital organs, as well as the abuse of alcoholic beverages or drugs. Intoxication with these substances causes deterioration general condition organism as a whole.

Wearing tight underwear can delay ejaculation. Because it compresses the blood vessels leading to the penis. As well as underpants made of synthetic fabric, in which the skin can sweat, adversely affect the health of the male genitourinary system. It can also lead to infections.

Symptoms of delayed ejaculation

There is a main symptom of this problem, characterized by the forced prolongation of sexual intercourse in order to achieve ejaculation. According to statistics, about 75% of men accelerate the onset of ejaculation by masturbating their penis with the participation of a partner. This is due to the fact that they fail to achieve orgasm directly during intercourse.

Pain during ejaculation is also the main symptom of ejaculation disorders. This may indicate the presence of other possible diseases the genitourinary system of a man, especially if there is a darkening of the urine after intercourse.

The inability to conceive a child is another symptom of an ejaculatory disorder. If the woman's body is healthy, but the girl does not become pregnant, then most likely the reason is the infertility of the man. It was developed against the background of a violation of ejaculation or diseases of the reproductive system.

Disease diagnosis. What tests are prescribed?

First of all, if this problem occurs, you should contact a urologist or andrologist. First, the doctor listens to the man's complaints, the symptoms that he noticed in himself, and also collects a detailed history. Then the specialist examines the patient, fixing any changes or violations. After that, tests are assigned that must be passed:

• general urine analysis;
• bakposev;
• analysis for the presence of sexually transmitted infections;
• ultrasound examination of the genitourinary system.

After all the tests, a secondary consultation of the doctor follows, where he carefully examines the results and conducts another examination (if necessary).

If during the study no problems were identified, then the patient is sent for examination to a psychiatrist or psychosexologist. Consultations with these specialists help to identify the presence of psychological problems that cause such dysfunction.

Delayed ejaculation: treatment. What methods are used in this case?

Treatment depends directly on the diagnosis made by the doctor. This may be drug therapy with the use of drugs prescribed by a doctor. If the violation of ejaculation was caused by taking certain medications, then the dosage and method of using these drugs must be adjusted. Or in some cases, a complete abolition of medication and the selection of more suitable analogues is required.

Medical treatment most often includes antibiotics and painkillers.

Sometimes doctors prescribe drugs to be injected directly into the penis. Treatment in this way is considered radical. This therapy is carried out extremely rarely, but as a result, the problem disappears completely.

Physiotherapy is also used (electrophoresis, electrosleep, ultrasound therapy), herbal medicine. They also prescribe massage procedures to restore blood circulation in the genitals. When conducting rectal stimulation with electricity or transcranial electrical stimulation, pain may occur. But such treatment is considered very effective for problems with ejaculation in men. A sex therapist or psychotherapist can prescribe treatment only if no organic causes dysfunction of the genital organs. For the effectiveness of therapy, the patient's sexual partner is most often involved in consultations. Then everything is more productive.

In general, the treatment of ejaculation disorders should be a whole range of procedures. It is impossible to cure it by eliminating only physical pathologies. Therefore, this problem is usually caused by more than one reason. Need to support healthy regimen nutrition and sleep, conduct regular sports training, exclude alcohol. Psychological training will help reduce stress and nervous exhaustion after a working day.

Sexologists say that delayed ejaculation is most often welcomed by a woman. Because this gives her time to experience multiple orgasms, but as a result of these manipulations, the man begins to feel like a bad sexual partner.

Some men have the opposite problem - premature ejaculation. In this case, ejaculation occurs too early. If you need to delay ejaculation, but you can’t do it yourself, you can use some of the tips that sexologists give:

Protect yourself with tight condoms;

Do Kegel exercises daily;

Use various techniques in sexual intercourse;

Take drugs to delay ejaculation.

Data medicines should be taken only as prescribed by a doctor and under his supervision. Since they can be addictive and adversely affect human health.

ring for men

Many men prefer to buy an ejaculation delay ring, as it stimulates even the female genitals, thereby delivering more pleasure to the partner. This remedy can be purchased at the sex shop.

The price can vary greatly for different models depending on the manufacturer and the included features. Also in the sex shop you can buy anesthetics to prolong sexual intercourse, but you must follow the instructions. A large number of the applied anesthetic can lead to a complete loss of sensitivity in a man. Just before intercourse, wipe off the remnants, otherwise your partner will not feel the penetration.

Delayed ejaculation in men is still treated with drugs such as Viagra or Levitra. These funds can be purchased at the pharmacy only by prescription. Since they are very strong in their action and are addictive with constant use.

Gel lubricant

Delayed ejaculation also causes a negative attitude towards sex in some women, especially if the girl has an insufficient amount natural lubricant. Therefore, before moving on to intimacy, find out the preference for your sexual partner. If necessary, use an intimate gel lubricant to reduce friction. It is designed to prolong sexual intercourse and increase the sensitivity of the head of the penis. And the woman experiences the strongest excitement and reaches orgasm faster.

Do not hesitate, contact a specialist in time!

If delayed ejaculation causes great discomfort, consult a urologist for a genital examination. Men are usually embarrassed to admit even to themselves the gaps in the intimate area, and contacting a specialist causes panic. Therefore, many prefer treatment folk remedies if there is a delay in ejaculation not for the first time.

A small conclusion

Modern urological clinics offer their qualified assistance, ensure the anonymity of their customers, and also approach this problem with understanding.

In such an institution, you can not only undergo an examination, but also pass the necessary tests and conduct research. Do not self-medicate. It is better to immediately contact a specialist who will help you get rid of this intimate problem.

Receiving a signal from the brain, the gonads begin to produce hormones that stimulate libido, as well as the growth and change of organs such as the brain, bones, muscles, blood, skin, hair, breasts and genitals. As a result of these changes, active physical growth of the body begins, which ends after the child develops to the state of puberty.

Changes in the body of boys

In the process of puberty in boys, an increase in testicles is observed, which is the first physiological manifestation of the process. The testicles reach their maximum size approximately 6 years after the onset of puberty. The size of the penis also increases, which is associated with changes in hormonal levels. Boys begin to produce testosterone, which promotes the formation of sperm. On average, the potential ability of fertilization in children appears at the age of 13.

Simultaneously with other signs, the phenomena of morning erection and pollutions begin. There is an increase in pubic hair and an increase in androgen activity, which in turn contribute to the appearance of visible hair throughout the body, namely in the armpits, perianal region, on the upper lip and in the chin area. The characteristics of vegetation and places of its occurrence are determined by individual features organism. Yes, often appears on final stages pubertal development, but in some people its formation may begin much later.

Among other signs, the appearance, changes in the voice, the appearance of a specific body odor and acne are noted. The maturation period usually ends by 16-17 years.

Changes in the body of girls

During puberty, girls experience breast growth, which is one of the most obvious and early signs of puberty. Formation begins with the appearance of a small and relatively sensitive formation, which subsequently increases, softens and takes on more distinct forms.

The growth of pubic hair is considered the second manifestation of a hormonal surge. There are noticeable changes in the structure of the vagina, uterus and ovaries. Due to the increase in estrogen levels, the girl gradually gains the ability to fertilize. Menstruation begins, which over time becomes more and more regular. The first can occur at the age of 12-13, but some may have an earlier or, conversely, later manifestation of the symptom (up to 16 years).

Other factors of the pubertal period are a change in the shape of the body, the appearance of fat reserves in, on the hips, and abdomen. There are also changes in body odor. The period of active transformations in the body of girls ends by the age of 15-17.