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

If during sex a man experiences an orgasm much faster than he and his partner would like, it is customary to talk about premature ejaculation (premature ejaculation). Among the criteria that help diagnose this condition are usually called the onset of ejaculation immediately after the introduction of a member into a partner and the inability of a man to delay ejaculation. On average, men ejaculate five minutes after initiating intercourse. Many men in the world face the problem of premature ejaculation, and this makes them feel ashamed and annoyed. Some men even begin to avoid sexual contact because of this. Do not despair! This problem can be solved if you turn to a psychotherapist, begin to perform certain techniques to delay ejaculation, or resort to medication. You will get over the problem and be able to enjoy sex with your partner again.

Steps

Applying Behavioral Techniques

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

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

Masturbate before sex. If you're planning on having sex this evening, try masturbating an hour or two before.
Use thicker condoms to reduce stimulation during sex. Try not to use those condoms that are designed to increase the stimulation of a man during intercourse.
Take a deep breath when you feel ejaculation coming. It can help stop reflex ejaculation. Also, try to switch your thoughts and think about something boring until you feel that the peak of arousal has passed.

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

Seek medical attention

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

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

Processes that occur during ejaculation

Many men do not know what ejaculation is and what physiological processes take place in the human body. Needless to say, it is a very complex process. Semen is released during coitus and other types of sexual activity.

Stages of ejaculation such.

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

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

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

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

Why Do Men Develop Premature Ejaculation?

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

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

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

The causes of true rapid ejaculation are as follows:

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

The influence of certain pathologies on ejaculation

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

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

the time of coitus in this case is very small;
the duration of sexual contact increases significantly from the use of intimate lubricant (lubricant) with an anesthetic;
repeated sexual contacts are also very short, do not bring satisfaction;
ejaculation never occurs before coitus begins;
the use of a small amount of alcoholic beverages slightly prolongs coition, relieving the symptoms of overexcitation in men.

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

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

Note! With inflammation of the seminal vesicles, a man very often ejaculates before intercourse. For this, a slight excitement is enough, sometimes even the very thought of an upcoming contact. Orgasm with such an act is always very sluggish and never brings pleasure.

With the syndrome of paracentral lobules, the focus of excitation is constantly located in the brain. It develops as a result of birth trauma and after suffering. Sometimes the syndrome of paracentral lobules leads to constant pollution - nocturnal ejaculation and violations of the processes of urine excretion (dysuria).

Finally, early ejaculation in men can occur for the following reasons:

osteochondrosis (if the lumbar and sacral spine are affected);
herniated discs;
curvature of this organ;
multiple sclerosis;
Bechterew's syndrome, or ankylosing spondylarthrosis;
Parkinson's syndrome;
the use of narcotic drugs;
chronic alcohol dependence;
severe kidney pathology.

Difficulty ejaculation is much less common. The physiological causes of this phenomenon are fatigue, exhaustion. Orgasm without ejaculation can also occur with retrograde ejaculation.

How to eliminate early ejaculation

Sometimes a man may experience neurotic situations that greatly complicate the conduct of a normal sexual intercourse. He discovers that he "does not get up", ejaculation is delayed. Often a man is unnecessarily concentrated on the very process of ejaculation, and not on the very receipt of sexual pleasure. Due to excessive tension, ejaculation occurs very quickly.

To eliminate excessively early ejaculation, you do not need to focus too much on this problem. Sometimes it resolves itself. The main assistants of a man in such an awkward problem are age and sexual experience. If the problem only grows, then you can not do without the help of an experienced specialist.

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

use condoms with an anesthetic;
during intercourse, try to think on neutral topics;
perform Kegel exercises that train the muscles of the perineum;
masturbate before coitus.

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

Note! Clamping the urethra to delay ejaculation is strictly prohibited. This can cause chronic prostatitis or vesiculitis.

And other pills may be undesirable for this problem and in some cases can aggravate it. The upcoming fast erection can lead to a rapid eruption of the seed. That is why funds for can only be prescribed by a doctor. Sometimes this problem can be solved by folk remedies. A quick orgasm can be eliminated with the help of sedatives.

How to diagnose pathology

With the appearance of early ejaculation syndrome, a man should contact a urologist, neurologist, andrologist. The doctor first of all collects and studies the anamnesis, is also interested in the sexual characteristics of a man's life. It is very important to answer all the questions of the doctor as honestly and truthfully as possible, without showing false modesty. The correct diagnosis and subsequent treatment depends on this. The doctor must take into account the experience of the man, his age and the presence of concomitant pathologies.

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

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

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

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premature ejaculation, or early ejaculation is a disorder in which ejaculation occurs too early. Premature ejaculation is one of the most common types of sexual dysfunction in men around the world. At least once in a lifetime, early ejaculation occurred in every man.

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

Premature ejaculation and its other disorders in men

Early ejaculation is not the only type of ejaculation disorder. There are others:
1. Delay ejaculation- This is the opposite violation, in which ejaculation occurs after too long a time from the onset of sexual intercourse.
2. Retrograde ejaculation- a phenomenon in which the seed does not flow out of the urethra, but in the opposite direction, flowing into the prostate gland.
3. Suppressed male orgasm. Also known as orgasmic dysfunction. At the same time, the patient's sexual satisfaction occurs inferiorly, does not bring proper pleasure.

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

Causes of premature ejaculation

The difficulty lies in the fact that the causes of premature ejaculation are not always possible to accurately establish. Sometimes a violation occurs without any visible provoking factors.

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

Early ejaculation in a man can occur whenever he has sexual intercourse with a new partner.
Often, premature ejaculation also occurs during sexual intercourse after a long period of sexual abstinence.
The role of psychological factors in the development of early ejaculation is quite high. Conditions such as depression, anxiety, anxiety, frequent stress, guilt can lead to this type of sexual dysfunction in men.
Hormonal disorders. First of all, early ejaculation can be triggered by a violation of the production of hormones involved in sexual function.
Some types of trauma.
Sex with very beautiful representatives of the weaker sex. Sometimes a man experiences such a strong sexual arousal before intercourse that ejaculation occurs even before the introduction of the penis into the vagina.
Genetic causes of premature ejaculation have also been proven. It is known that 91% of men with this disorder have relatives who also suffer from early ejaculation.
Another factor that can lead to the development of pathology is malnutrition. The disorder occurs more often in men whose diet contains insufficient amounts of magnesium. This problem is common in major US cities. Unfortunately, no statistics are available for Russia.

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

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

Organic diseases that can cause

premature ejaculation Early ejaculation is much more likely to develop in men who have such predisposing factors as:

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

The mechanism of development of premature ejaculation

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

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

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

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

Symptoms of premature ejaculation

The main problem for andrologists is to determine when the symptoms of premature ejaculation appear, when the norm ends and the disorder begins, which must be treated.

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

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

As you can see, the time criterion turned out to be too unreliable. Ejaculation in a man can occur within a very short time, and at the same time both partners experience complete satisfaction.
3. Modern doctors are guided in determining the symptoms of premature ejaculation on the general well-being of a man and a married couple as a whole. If both partners experience satisfaction after sexual intercourse, do not suffer from any psychological complexes and characterize their life together as happy, then even with an ejaculation of 1.5 minutes, one cannot speak of its prematureness.
4. If ejaculation occurs in a man even before the introduction of the penis into the vagina, it should be recognized as obviously premature.

Wrong approach from many men

Many men tend to believe that their male power and physical health in the sexual area is mainly determined by three factors:

the size of the penis, especially in an erect state;
erection hardness;
the duration of sexual intercourse - it is believed that the longer it is, the more "full" is the representative of the stronger sex.

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

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

Negative experiences can provoke the development of the following disorders:

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

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

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

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

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

Partner's opinion

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

In fact, self-diagnosis and self-treatment in these cases are unacceptable. Especially if they rely only on the only criterion - the opinion of the partner.

at the same time, it often turns out that the man did not have early ejaculation at all and does not exist - it’s just that he and his partner are not quite suitable for each other;
if there is still a problem, then it is often impossible to eliminate it using only means from a sex shop: each specific case requires separate consideration and an individual approach.

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

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

Diagnostics

Which doctors diagnose premature ejaculation in men?
These problems are within the competence of andrologists and sexologists. It is better to visit sexologists, as they specialize precisely in violations of this specificity.

If necessary, a man who has signs of premature ejaculation may be given advice from other specialists:

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

What happens in the doctor's office?

First of all, the sexologist carefully asks his patient. The first part of the questioning concerns general health data, and is carried out in the same way as at the reception of any other specialist. The doctor is interested in past and current diseases, the general health of a man, his working and living conditions.

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

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

In accordance with modern regulations, the doctor can consider the diagnosis of premature ejaculation proven if:
1. Ejaculation occurs even before the introduction of the penis into the vagina, or against the will of the man when he tries to hold it back. Of course, in this case, the doctor takes into account such factors as the age and physical condition of the patient, the duration of abstinence, the duration of the patient's sexual life with a particular partner.
2. Premature ejaculation disrupts the patient's private or family life. The disorder causes a man strong feelings and problems.
3. Early ejaculation should not be caused by taking or, on the contrary, the abolition of any medication. For example, it is known that for some time after the withdrawal of drugs based on opium, ejaculation in men begins to occur earlier.

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

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

With what diseases it is necessary to distinguish premature ejaculation?
Most often, the imaginary signs of premature ejaculation are caused by erectile dysfunction, when the penis cannot become hard enough to be inserted into the vagina. At a certain stage, the man understands that he needs additional stimulation to penetrate. Often during it comes not only an erection, but also ejaculation.

It is worth distinguishing true premature ejaculation from sporadic cases, which occur only from time to time, and cannot lead to severe suffering in a man. This problem is easily fixable.

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

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

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

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

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

Treatment

Many men are interested in the question of how to treat premature ejaculation. Unfortunately, there is no single answer to it. In each case, it is necessary to understand the causes of premature ejaculation in a particular man, and focus primarily on them. Therefore, a visit to the doctor before the start of any therapeutic measures, and a qualitative diagnosis of the problem, are indispensable conditions.

Early stages of premature ejaculation
If the cause of the violation is not established, and early ejaculation bothers from time to time, some special techniques for prolonging sexual intercourse can be used.

Start-Stop Method
Quite an efficient method. Its essence lies in the fact that during sexual intercourse a man must "catch" the moment when he starts premature ejaculation. In this case, the penis is removed from the vagina, and its base is strongly compressed by the fingers. When sexual arousal decreases slightly, penetration can be made again and sexual intercourse can be continued. If a man again feels the beginning of ejaculation, then he repeats the break. The number of repetitions is practically unlimited.

Over time, the number and duration of such "respite" naturally decreases, and the duration of sexual intercourse increases.

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

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

Medical treatment
The general principles for treating premature ejaculation are as follows:

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

If early ejaculation has a psychological or nervous cause, then with the use of these drugs, they can pass quite quickly.

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

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

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

An experienced psychotherapist can eliminate such problems as increased anxiety, emotionality, irritability, depression, susceptibility to stress, self-doubt, fear of failure. As a result, early ejaculation will cease to disturb the patient by itself.

The value of alternative medicine in the treatment of premature ejaculation
With early ejaculation, various methods are widely used alternative medicine :

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

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

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

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

All of the above methods of treating early ejaculation are not applied immediately together. In each case, the doctor prescribes such a combination of them, which should be as effective as possible.

For men undergoing treatment, additional recommendations can be given:

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

If all the recommendations of the doctor are followed, the prognosis is most often favorable. Before use, you should consult with a specialist.

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

Signs and types

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

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

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

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

Causes and treatment of premature ejaculation in men

Knowing what is premature ejaculation, it makes sense to define causes of early ejaculation in men.

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

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

Rapid ejaculation treatment, which is guaranteed to get rid of pathology, must be etiological. That is, to act on the root cause of the deviation.

Causes of rapid ejaculation: what can it be

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

pathological;
physiological;
psychological;
genetic.

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

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

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

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

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

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

Diagnostics

Proper diagnosis is half the battle. to discover, what is the cause of rapid ejaculation in men, you need to contact a urologist or a sex therapist as soon as possible, tell in detail about the frequency of such cases and the accompanying circumstances. This may be a chronic disease, constantly taking drugs, recent injuries or operations.

After that, the doctor finds out why a man has fast ejaculation, appointing him laboratory tests and functional diagnostics:

hormone tests;
tests for sexual infections;
bladder cystoscopy;
ureteroscopy;
Ultrasound of the pelvic organ.

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

In the event that diagnostic manipulations, what to do with early ejaculation, do not detect any pathology, and the lidocaine test does not bring results, there is reason to talk about the psychological causes of the disease.

Methods for the treatment of premature ejaculation

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

Therapy with medicines

Drug therapy is an almost indispensable condition for treatment. With the help of medicines, infections that affect sexual function can be eliminated. Also for the treatment are used drugs:

antidepressants;
blockers;
tranquilizers.

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

Psychotherapy and Sexual Therapy

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

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

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

How is the elimination of psychological causes and treatment of premature ejaculation? A psychotherapist or sexologist helps a man find the necessary positive attitudes that will allow him to take the problem more calmly, to overcome the fear of intimate contacts.

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

Decreased head sensitivity

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

A quick way to reduce the sensitivity of the genital mucosa is to use a tight condom; in some cases, you can wear two protective equipment at the same time.

A longer way to reduce sensitivity is to coarsen the skin of the head of the penis. To do this, it must be regularly rubbed with a hard washcloth. But it is important not to get carried away with the procedure too much: if the mucosa is damaged too much, inflammation will occur. In this case, inflammation will increase the risk of sexual infection, which can also lead to premature ejaculation.

Stop start method

Methods, how to treat early ejaculation, usually involve delaying orgasm or "stop start". This is a technique that requires prior training. For a man for whom the question of how to treat early ejaculation is not relevant, delaying the release of the seed is not problematic. To do this, you should monitor the onset of orgasm, then take actions to delay orgasm: remove the penis from the girl's vagina and hold it at the base, or pull the scrotum down with your hand.

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

Surgical treatment

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

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

Prolongation of sexual intercourse

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

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

The use of prolongation agents

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

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

Physiotherapy activities

Physiotherapy can give a good result with regular and systematic treatment. For treatment of the reasons why rapid ejaculation of men occurs, the following methods are used;

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

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

Treatment of folk remedies premature ejaculation

Many men do not know how to get rid of rapid ejaculation, they do not even realize that this can be done with folk remedies. There are a large number of alternative medicine methods that contribute to solving this male problem. The healing properties of plants help a man prolong ejaculation. Consider the most effective recipes for the treatment of rapid ejaculation by folk methods.

Lovage.

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

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

Regular use of this folk remedy ensures the extension of sexual intercourse.

Oregano and calendula.

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

Oak bark.

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

Motherwort and hops.

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

Periwinkle.

Conduct treatment of rapid ejaculation can be a folk remedy prepared on the basis of periwinkle. To do this, take 1 tbsp. l. herbs of this plant, add 1 cup of water. Put on fire, bring to a boil, cook for about 15 minutes. After a slight cooling of the broth, it must be filtered. Drink 2 times a day according to this scheme: 10 drops in the morning, 5 drops in the evening. In no case should you take a larger amount, since periwinkle-based decoction is a toxic substance, an excessive amount of which can adversely affect a man's health.

Hoof root.

Another a way to get rid of rapid ejaculation by folk methods. To prepare it, you need 1 tsp. hoof root, add 1 cup of just boiled water to it. Put on medium heat to cook for 40 minutes under a closed lid. Cool the broth a little, remove the sediment and take 1 tbsp. l. 5 times a day.

Mint, oregano, motherwort.

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

Rosehip, motherwort, three-leaf watch.

You can extend the riser with such a folk remedy: finely chop the rose hips, add the same amount of motherwort herb and three-leaf watch. Mix the ingredients, take 3 tbsp. l. mixture, add 1 liter. water. Boil the liquid, cook for half an hour. Cool the prepared broth a little, drink 1 glass a day. The duration of such treatment takes longer when compared with other methods of exposure.

Coriander.

You can treat early ejaculation with the help of such a folk remedy as a decoction of coriander. To prepare it, you need 1 tbsp. l. coriander seeds to which you should add 1 cup of water. Put in a water bath for 15 minutes. After the liquid has cooled, take 50 ml three times a day.

Yellow pod.

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

Folk remedies for prolonging sexual contact in most cases give a positive result. But for the correct use of non-traditional medicines, you should consult a specialist, since some medicinal plants contain toxic substances in their composition. Excessive amounts of them in the body can negatively affect not only erectile function, but also the health of the body of a man as a whole. You should also not forget that folk remedies can be used as a preventive measure to prevent primary or secondary premature ejaculation.

The effectiveness of traditional medicine in premature ejaculation

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

dulling the sensitivity of the penis;
prevention of nervous tension and stress conditions;
normalization of sleep;
improvement in emotional state.

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

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

Prevention of early ejaculation

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

Compliance with the daily routine. A man should devote enough time to rest. Sleep is required at least 8 hours a day. But at the same time, in no case should you lead a sedentary lifestyle. This leads to stagnant processes in the pelvic organs, resulting in premature ejaculation. Also, the daily routine provides for eating at the same time, which has a beneficial effect on health.
Healthy lifestyle. Addictions have a negative impact on men's health. They not only can cause early ejaculation, but also gradually lead to erectile dysfunction. Therefore, it is imperative to get rid of bad habits, such as smoking or uncontrolled consumption of alcoholic beverages.
Physical activity. It should not be forgotten that excessive physical activity, like a sedentary lifestyle, has a negative impact on a man's health. Therefore, for normal health, a representative of the stronger sex should visit the gym regularly, it is useful to go to the pool. At the same time, one should not forget that physical overstrain in training is harmful.
Regular sex life. Sexual life should be stable. In this case, random connections should be neglected. This can lead to sexually transmitted diseases, which will lead to more serious consequences than premature ejaculation.
Proper and balanced nutrition. For everyday eating, you need to choose foods rich in vitamins, minerals and other beneficial substances. No need to interrupt dry food and snacks during the day. Meals should be in line with the daily routine. It is good to eat as many seasonal fruits and vegetables as possible. Try to minimize the consumption of fatty, fried, spicy, overly salty foods.
If the rate of fire in a man is caused by increased sensitivity of the penis, then at the time of intimacy it is better to use a condom. This will help not only protect against sexually transmitted, viral and infectious diseases, but also dull the sensitivity, which will prolong sexual intercourse.
Protected sexual intercourse.
Regular visits to the doctor to diagnose genital infections.

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

It is impossible to completely get rid of the risk of a quick orgasm. But with the help of the above rules, you can minimize the risk of pathological and psychological reasons why a man has rapid ejaculation.

In addition, knowing why premature ejaculation what is it and what to do with rapid ejaculation, which doctor contact, the man will be able to quickly and correctly deal with the problem.

- a disorder of sexual function, manifested by untimely ejaculation before or during sexual intercourse and does not bring sexual satisfaction to partners. It leads to a violation of the harmony of sexual relations. Represents a serious psychological problem for a man, leads to the development of feelings of inferiority and self-doubt, which further exacerbates sexual dysfunction. The issues of diagnosing premature ejaculation are within the competence of the urologist-andrologist and sexologist. In order to correct sexual dysfunction, psychotherapy, drug therapy, and sometimes surgical treatment can be carried out.

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

The problem of premature ejaculation

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

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

That is, from the point of view of medicine, premature ejaculation is often repeated ejaculations after minimal sexual stimulation before or after the introduction of the penis into the vagina. The notion that uncontrolled ejaculation is premature is wrong, and it also creates serious and intractable psychological problems.

Causes of premature ejaculation

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

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

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

Diagnosis and treatment of premature ejaculation

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

All patients undergo a psychotherapeutic course on teaching methods of controlling ejaculation. Sexopathologists agree that with premature ejaculation of a psychogenic nature, psychotherapy is enough to successfully form the recognition of preorgasmic sensations. However, the effect of psychotherapy is observed only with the conscious and adequate participation of a permanent partner. The “stop-start” technique begins to give its results in 2 to 10 weeks, but it takes at least 2-3 months after the end of the procedures to consolidate them. At the same time, the effectiveness largely depends on the patience of both partners and on the absence of negative emotions at the time of sexual intimacy.

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

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

Drugs from other pharmacological groups, due to the selective effect on the regulatory mechanisms, can also be used to correct premature ejaculation. But however, not a single pharmacological group of drugs has received wide application. So, antipsychotics block dopamine receptors at the central level. The effectiveness of tranquilizers in the correction of premature ejaculation is directly dependent on the dose, but ejaculation is inhibited rather than controlled. In addition, with an increase in the dose, a medicinal sedative effect occurs, which is not always appropriate at the time of sexual intimacy.

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

Premature ejaculation can be inhibited by tricyclic antidepressants, although these drugs are dose-dependent and their effectiveness is not more than 15%, which, together with many side effects, has not given antidepressants widespread use in the treatment of premature ejaculation.

The most popular drugs for the correction of premature ejaculation are antidepressants that increase the level of serotonin due to the selective blockade of its reuptake. These are fluoxetine, sertraline and others; when taking drugs, a good effect is noted, a small number of adverse reactions. It is the drugs of this pharmacological group that are promising for the effective correction of premature ejaculation.

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

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