Premature ejaculation occurs in 1 in 3 men.
Very often the penis is highly sensitive.
The patient is usually easily tensed and sometimes depressed.
Counseling and sex education involving the couple such as Master and Johnson squeeze methods has help to reduce the incidence of premature ejaculation.
Stopping alcohol and smoking may also help to improve the health of the men.
Drug abuse such as ecstacy and amphitamines should be stopped.
New treatment such as new medicine Priligy may help to reduce the incidence of premature ejaculation.
Premature Ejaculation is defined by the failure for a man to control his ejaculation for a sufficient period of time during sexual intercourse to satisfy the female in at least 50% of coital attempts.
The incidence of premature ejaculation is common in adolescence
Most cases are currently under diagnosed and under treated.
More than 65% of all men 20-70 years old are likely to experience it.
Premature ejaculation can be due to:
1.Medical causes
2.Lifestyle causes
3.Psychosocial causes
4.or a combination of these.
Medical causes:
1.hypersensitive nerves of the glans of the penis
2.central nervous stimulants drugs such as ecstasy or
amphetamines
Lifestyle causes:
1.alcohol -
over stimulation of the penis.
2.Smoking-
toxic chemicals in the cigarettes can affect nerves and blood vessels to the penis.
3.Sedentary lifestyle-
Lack of exercise may lead to poor control of nerve and muscles of penis
Psychosocial Causes:
1. Performance anxiety -
nervousness and worry about poor sexual performance
2. Stress due to any cause
3. Depression
4. Relationship Problems
- marital problems and tensions may affect sexual relationship
5. fatigue.
6. early sexual experience
-hurried sex with prostitutes
Diagnosis often starts with sexual partner bringing attention of condition to medical doctor:
1.medical history especially about alcohol, drug abuse, smoking.
2.medical examination including genitals and prostate
3. Blood tests of testosterone
Successful treatment of erectile dysfunction includes:
1.Education of sexual techniques:
a.teach how to recognize impending ejaculation
b.stop start technique
c.Masters and Johnson squeeze technique
d.arousal control - learning to control arousal too quickly using relaxation methods
e.mental control - control the mind especially performance anxiety and have a meditative mindset
f.breathing control - deep breathing reduce excitement and early ejaculation
g.perineal muscles exercise to control the muscle relaxation of the penis
h. sufficient foreplay to stimulate the female partner such as stimulation of the clitoris and G-spot
i.alternative coital positions which allows the male to last longer
2. Lifestyle modifications:
a.exercising
b.quitting smoking
c.reducing alcohol/drug abuse
d.counseling to manage anxiety/stress/marital problems
3.small dose of antidepressant medication may delay ejaculation
4.medication for treatment of premature ejaculation
There is now a new oral medication available to treat premature ejaculation called Priligy.
Priligy or dapoxetin is a short-acting Selective serotin reuptake inhibitor (SSRI) marketed for the treatment of premature ejaculation.
It is able to delay the ejaculation of the penis.
5.Communication and honesty with the spouse is important in premature ejaculation so that she understands the problem and that she is not the cause of the problem.
In recent years, more men are becoming aware of the treatment of premature ejaculation and are seeking help.
Prognosis:
response to therapy is excellent in over 95% of patients who are willing to seek help
No comments:
Post a Comment